While most people are covered by public insurance (Gesetzliche Krankenversicherung, GKV), those with higher incomes, freelancers, and certain other groups have the option to choose private health insurance (Private Krankenversicherung, PKV).
Most people stick with public insurance. But for higher earners and self-employed individuals, private health insurance can offer lower premiums and a wider range of benefits — provided you meet certain criteria.
Premiums for PKV are calculated based on a risk assessment done by the insurer, and generally vary based on your age and health. It’s important to note you can be rejected by a private insurer if you’re deemed too risky to cover. This isn’t the case with public health insurance.
If you’ve come to Germany with dependents, such as children or a spouse, they aren’t automatically covered by your private health policy and will generally require separate premiums.
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If you decide on private insurance, you’ll have to cover the upfront costs of seeing doctors, going to hospital and obtaining medication. You’ll be either fully or partially reimbursed afterwards by your insurer.
What private insurance options are there?
There are about 40 private health insurance providers in Germany. Some expat-friendly providers include Feather, Ottonova, and GetSafe.
You may want to speak with an insurance broker to determine which provider is right for you. These do not charge for advice. English-speaking brokers include KL For Expats and VersicherungsbĂĽro Weiss.
Who can benefit from going private?
High earners: Private insurance costs don't scale with income in the same way as public insurance, which means that high earners often find it cost-effective to go for private insurance.
Young professionals: Because costs are based on personal characteristics like age and health rather than income, people in their 20s and 30s may find that private insurance costs less than the fixed percentage approach taken by the public system.
Self-employed people: While employers usually pay half the cost of public insurance, the self-employed have no such luck. That means private insurance can often be cheaper for them.
What are the cons?
Premiums rise with age: Unlike the public system, where contributions remain income-based and stable, private premiums tend to increase with age. That can make switching expensive for people who have already been working for a number of years.
You pay for every insured person: Each family member needs a separate private plan, unlike in the public system which covers children and non-working spouses at no extra cost.
You can be denied coverage: Private insurers can charge higher premiums or even deny coverage based on your medical history.
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Retirement can be costly: Public insurance is usually more affordable in retirement, and it can be difficult to return to the public system once you’ve been being privately insured.
What about expat or student insurance?
Some private providers like Feather and Mawista offer so-called “expat” or “student” insurance. These plans are usually much cheaper than fully fledged private or public plans but offer extremely limited coverage.
Expat insurance can be useful for people who are moving to Germany to look for a job, for example. However, you’ll usually need to be able to show you have full coverage if you want to renew a work or residence visa.
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