Understanding Germany’s Healthcare System

The healthcare system is Germany is known to be exemplary on a global scale. To ensure that the system stays that way, the government insists that everyone, locals and foreigners, needs to have health insurance. In doing so, every individual can have access to quality and subsidized medical care. 

Understanding the German healthcare system is vital in ensuring you can easily access medical care while in the country. Even though most of the requirements are straightforward, foreigners can get confused on what works for them and what will not. Here are a couple of things you need to know about the German healthcare system when planning to move into the country.

Do I need health insurance in Germany?

Since 2009, it has been a legal requirement that everyone in Germany get health insurance.  The compulsory health insurance law states that all residents in should have at least public health insurance. You can also choose to get both public and private insurance so you are covered on both ends.

How does the healthcare system work?

The German healthcare system combines both statutory (public) and private health insurance. Statutory health insurance is a must for employees who earn below a certain threshold. Private insurance, on the other hand, is for self-employed and high earning individuals. The two insurance options are comprehensive and cover a myriad of medical issues.  They are funded by employees, employers and the government. You have the right to choose whatever insurance coverage works for you.

Statutory health insurance

Statutory health insurance is mandatory for most of the coverage in Germany. The regulation ensures that everyone can afford it. The cost of statutory health insurance ranges from 14.6% -15.6% of your salary. Insurance is calculated on an income basis and is split between employer and employee but if you are self-employed, you cover the entire cost.

Statutory health insurance covers different medical services. These are the main services you can access using it:

  • Outpatient care from a general practitioner or a specialist
  • Prescription drugs
  • Inpatient care as a ward patient
  • Basic dental care
  • Pregnancy and maternity care
  • Rehabilitation
  • Mental health
  • Medical aid and devices

The following are areas that are not covered by statutory health insurance:

  • Private hospital rooms
  • Certain dental services
  • nonprescription medicine
  • Cosmetic procedures
  • Alternative and complementary therapies

Apart from all this, statutory health insurance also covers your dependents living in the same address as the policy holder. They receive the coverage at no extra cost and all that is required is for them to get registered with the same insurance provider as the paying member.

Private health insurance

This is an alternative to statutory health insurance for anyone who is not required to have statutory health insurance. It is common amongst high income earners, self-employed people and civil servants.  These insurance policies work on a contract basis so individuals get to choose personalized policies with their providers.  The premiums depend on one’s age, health, as well as the desired coverage.

For individuals under the age of 30, the premiums range from €100 to €300 monthly. €Between ages 30 and 50 the premiums range from €200 to €500 monthly, while individuals over 50 pay anywhere from €400 to €800 monthly. Talking to your provider and going through your options helps you pick a policy that works best for you.

These are the areas covered with this policy:

  • Consultations and examinations
  • Surgeries
  • In patient care
  • Prescription medication
  • Dental treatment
  • Alternative therapies

These are the areas that are not covered by this insurance:

  • Cosmetic procedures
  • Pre-existing conditions
  • Certain alternative therapies
  • Long-term care
  • Experimental treatments
  • Travel related medical expenses.

Cost of healthcare for foreigners

As discussed above, employers living in Germany pay between 14.6%- 15.6% of their salary as health insurance. Since this cost is shared by the employer, they end up paying half of it. There are, however, different rates for foreigners living in Germany. Here is how much you will be expected to pay for health insurance as a foreigner in Germany.

  • Students. University students get the best rates, with student below age 23 paying up to €117 per month while student above 30 pay €120. International students have their insurance rates set at €70-100 a month.
  • Tourists. Foreign visitors can pay for the public health insurance option but tourists are encouraged to get a private policy that covers over €30,000 of medical expenses
  • Minors. Children receive the same rates as adults. The best thing about Germany is that healthcare for children are affordable, with most medication costing below €10.

Which is better between statutory and private health insurance?

One thing many people have an issue with is picking the right insurance option. If you had the opportunity to only choose one, then go for the statutory health insurance. It is affordable and you will be covered for most of the medical issues that might arise. You also get to share the cost of the premium with your employer, which is an added advantage. If, however, you prefer a specific cover that caters to specific needs, then you should consider private health insurance. They are tailored to meet whatever individual needs a person might have.

Changing from one insurance to another

If, for any reason, you want to switch from private to public or vice versa, or you want to change your provider then apply for membership with the new provider. The one thing you need to remember with this is, there is a lot of bureaucracyinvolved. It therefore helps of the insurance periods overlap each other so you are covered as the paperwork gets solved. The other thing to remember when it comes to paperwork is you cannot simply switch from public to private as you wish; there are several requirements you need to have first.

Consequences of not having health insurance in Germany

Since 2009, it has been decided that it is compulsory to have health insurance in Germany. If you do not have it, for one reason or another, you will be fined. These fines will take into account the period of time you spent in Germany uninsured. To avoid paying these fines, always ensure you have health insurance at all times.

Pros and cons of the healthcare industry in Germany

Just like any system in the world, there are pros and cons of the German healthcare system. Understanding them helps one make an informed choice on what will work best for a person. 

Pros

  • Patient freedom in choosing providers
  • High quality medical care
  • Comprehensive benefits coverage 
  • Universal coverage
  • Option between private and public coverage

Cons

  • Long waiting time for non-emergency cases
  • Rise in healthcare costs over the years
  • Limitations on access to private insurance
  • Bureaucracy in administrative processes

If you are coming to Germany, then ensure you get your insurance sorted as soon as you arrive. There is a grace period when you arrive, but because of the unknown, it is best that you get the insurance as soon as you can. Lack of health insurance will negatively impact your resident permit application so keep this in mind.

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