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Health Insurance for Expats in Germany

Submitted: September 2013

Private health insurance in Germany is mandatory if you are not covered by the social insurance system. Otherwise private insurance is still good to have, as it may cover some expenses which are not fully covered by social insurance, such as dentistry or eye care. It is advisable to get your insurance arrangements in order prior to entering Germany.

As opposed to social insurance, private insurers will generally determine your premiums in accordance with your health and your age. Nonetheless, the law requires German insurer to collect higher premiums from the young in order to ensure higher premiums for the elderly.

A German hospital is unlikely to accept your insurance details or credit card payments. Consequently, you should be prepared to pay upfront and apply for reimbursement from your insurer.

Obligation to be insured

Any individual living in Germany must have health insurance, be it public or private. The good news is that this means that no German private insurer may refuse to take you on board.

A basic premium (Basistarif) has been introduced by law. Any individual, regardless of existing medical condition, may apply for the basic premium (around €700 per month). Low-income individuals may get some help from the German welfare system if they cannot afford the bill.

As a general rule, you shouldn’t rely on the basic premium if you are healthy.

Opting for the private health insurance system

Private health insurance (Private Krankenversicherung) may be an alternative to social insurance for high-income or healthy individuals. You may opt out from the social insurance system and pay private insurance instead if you are:

  • self-employed
  • a civil servant, or
  • an employee earning more than €52,200 per year.

Don’t think that you will evade redistribution effects by opting for private insurance. This is because the costs of private health insurance include a tax to save for Germany’s rising healthcare costs due to its aging population.

If you choose to rely on the private system, be aware that there is no guarantee that you will be able to return to the social insurance system in the future.

Immigration rules

In most cases, you will simply not get any German visa unless you have appropriate health insurance, even if you come as a tourist.

If you already have health insurance, including international policies, you should check or review your insurance arrangements prior to applying for a German visa. You never know if your current policy will meet the requirement of the German authorities, such as coverage in all Schengen countries, etc.

International cover

You should check the geographical coverage of your existing insurance policy, if you have any.

If you have a foreign policy but you haven’t been sold it as an international insurance cover specifically designed for expats, your policy is unlikely to work in Germany. In that case, you should let your insurer know that you are moving to Germany, and switch to an international cover. Your insurer is likely to charge you extra for this, but do bear in mind that the very fact of being insured in several countries carries an extra burden as well.

A good international cover would insure you against:

  • medical costs in Germany
  • medical costs in your home country (or another relevant foreign country), and
  • medical evacuation costs (without adequate insurance, these can be well above  $10,000, or even in excess of $50,000).

The option to contract out from social insurance is not an option not to have any insurance at all. Thus, you must have a qualifying private health insurance policy if you are not enrolled for social insurance. Consequently, an international cover or a foreign insurance policy may or may not meet the German private health insurance requirements.

 

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