German Healthcare System

German Healthcare System: Benefits of Living & Working in Germany

If you are planning to move to Germany as an expatriate, it’s imperative to understand the seemingly complex but well-defined German healthcare system. While the overall healthcare in Germany is considered one of the best across the globe, a few ins and outs of the system can be hard to understand for first-timers. With 11.2% GDP spent on health, which is greater than any other EU country, Germany has one of the most effective, resilient, and accessible health care systems across the globe.

German healthcare is powered by a mandatory contribution from the people in the form of health insurance. So, if you’re moving to Deutschland, here’s your guide to the health benefits of living or working in Germany.

Healthcare in Germany: An Overview

The German healthcare system is based on several health insurance plans to meet the financial capacities and medical needs of people. The robust system is known for constantly improving life expectancy in the country. The current average life expectancy in Germany at birth for male residents is 78 and for women is 83.

Built on a multi-payer-based approach, the health care system consists of statutory health insurance and private health insurance. Euro health consumer index ranked German in seventh place for having the most consumer-oriented and restriction-free healthcare system in the EU. In fact, in 2017, the German government had a record reserve of over €18 billion for healthcare, which made it one of the wealthiest healthcare systems across the globe at that time. Germany is known to spend the second-highest per capita amount on health in the EU.

How Healthcare in Germany Works

The first country around the world to establish a national social health insurance (SHI) system in 1883, Germany, quickly developed a dual public-private system to empower healthcare. With heavy reliance on self-governing structures, German healthcare has public health insurance aka the gesetzliche Krankenversicherung or Gesetzliche Krankenkasse (GKV) and a private health insurance Krankenversicherung (PKV). To live in Germany, you are legally liable to have some form of health insurance coverage, either public or private. Healthcare insurance is even essential to start a job or to obtain a visa.

An employer in Germany can hook you up with a health insurance company but if you want to choose your own, you may have to submit medical health insurance before taking a position in a company. Sometimes HR managers tend to register employees in the public health insurance system so it’s important to let them know whether you want public or private insurance.

German Healthcare System: Important Points

  • Is public healthcare free in Germany? Contributions to a German health care provider are mandatory as soon as you have an income above 450€ per month. Recognised and compliant German health insurance has to cover all aspects of health care that can be considered medically necessary. Everything that is considered to be medically necessary is free of charge should you need to use it. Should you want a cover that is over and above medically necessary then it is possible to choose private health care insurance or to top the public up with private supplementary insurance (dental, hospital etc.).
  • What public healthcare cover?Public healthcare covers your basic healthcare needs. Treatments and services such as prescriptions, immunisations, and dental checkups are all included in GKV. Providing this sort of nationwide basic health coverage allows Germany to keep the average healthcare costs to a minimum. The effectiveness of public health insurance in Germany has enabled several developing countries to adopt the same idea.
  • How much will public healthcare cover cost? Depends on how much you earn every month. Healthcare contribution costs in Germany range between 14.6 to 15.6% of your monthly gross income, the maximum amount out of which public health care insurance is calculated from is €58,200€ for the year 2021. The state-run healthcare system will get half of the amount from the employee and the other half from the employer.
  • What is the eligibility criteria for public or private health insurance in Germany?All the salaried workers with a gross monthly income less than 5,362.50 EUR and annual income less than 64,350 EUR must have gesetzliche krankenversicherung or public health insurance.You can later purchase private health insurance additionally if you become eligible. For example, a salary hike can get over 64,350 EUR per year and if you want to avail yourself the private healthcare benefits, you can do so with insurance from a private company.

Private vs Public Healthcare Insurance

When choosing between private or public healthcare insurance, a lot of factors play a significant role, such as:

  • Age
  • Legal status and family situation
  • Salary & occupation
  • Duration of your stay in Germany
  • Services & benefits you want

In PKV or the private sector, you can avail certain medical services faster. However, several things should still be considered such as who is covered or what is covered or what will be the coverage cost. Answering these questions can uncover significant differences between GKV and PKV.

The easily accessible public healthcare insurance covers most people living in Germany. This is due to the fact that private health insurance is mostly available for those exceeding an income of 64,350 EUR per year or the self-employed. While German civil servants are not liable to follow that rule, expats hardly find a job in the civil service.

Fees for private insurance providers are usually less than the maximum premium paid for public insurance, making the former one more attractive and preferred. Private health insurance can be a good option for adults in good health without any kids or who are not planning to stay in Germany. Moreover, having private health insurance can also be an aid to your public insurance plan. There are several benefits of having them together. For instance, you get the option to stay in a single or double room rather than sharing a small room with three to four other beds

Benefits of Public & Private Healthcare

Private Health Insurance:

  • Faster Service
  • Can be quite cheaper than public premiums
  • Access to exclusive healthcare experts
  • You can have multilingual doctors
  • Convenient if you’re on a short stay in Germany

Public Health Insurance

  • Accessible by everyone in Germany
  • Available without the income bar of 64,350 EUR per year
  • Also covers dependent family members (spouse and children)
  • No extra fees required for non-working spouse
  • Your plan includes your children

When Do You Need Private Health Insurance in Germany?

If you are already insured with the state health system, you don’t need private health insurance coverage however, depending on your situation it can be very beneficial.

Private health insurance is more preferred by high-paid professionals, self-employed people living in Germany, and all German civil servants. In the case of civil servants, not everyone is obligated to get state health insurance since the state covers between 50% and 70% of the health care costs. When it comes to freelancers, they can get private insurance irrespective of their income.

Getting insured by a private insurance provider can be a complex process considering a long questionnaire they hand you over regarding your medical history and ask you to submit proof of income.

Unlike the public healthcare system, your employer will not help you through the selection and application process for getting yourself insured privately, there are companies that specialize in helping expats through this process. Health care in Germany is generally of a very high standard but the cover offered through private insurance is usually of an even higher standard. It will certainly help you with quick doctor appointments and medical attention. Also, you can also have doctors speaking your native language throughout the medical care.

When visiting Germany on a visa or with a residence permit, you also have to show healthcare coverage proof. If you’re planning to stay in Germany for a short period, you may benefit more from private health travel insurance but unlike public insurance, you would also need to get your non-working spouse and kids insured too.


Relocating comes with a lot of stress and confusion. The overwhelming process of moving abroad can be daunting without knowing relevant information about the destination country. This guide to the healthcare system in Germany can help you understand the perks of living or working in Deutschland. Our expert advisors are ready to make your settling in Germany seamless. Why not start early and contact us for all the information you need.

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