Understanding social insurance in Germany, particularly the German healthcare system and how it operates, is one of the first questions people have when moving to or considering moving to the country. It’s no wonder, as our health and access to medical care are crucial factors to consider when traveling to other countries.
There are certain specifics that might be somewhat confusing for foreigners and expatriates planning to relocate to Germany.
In this article, we explain what the healthcare system consists of and how it functions, which may help you before coming to Germany or if you need to understand it while already here.
To give you an overview, when we talk about social insurance in Germany, we need to know that it includes five main areas:
Krankenversicherung:
- Health insurance
Sozialversicherung:
- Long-term care insurance
- Pension insurance
- Accident insurance
- Unemployment insurance
Would you like to know easily which health insurance is right for you?
Use our simple HEALTH INSURANCE FINDER TOOL. In just a few answers, we’ll provide you with the information you need.
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The Different Types of Insurance in Germany’s healthcare System
Since 2009, having health insurance is mandatory in Germany. Whether you are job hunting, visiting a relative, learning the language, a university student, or especially if you have a job or are self-employed, it is essential to have health insurance.
Public Health Insurance (Gesetzliche Krankenversicherung)
This is the health insurance you need to arrange in Germany, known as Gesetzliche Krankenversicherung, managed by public insurance providers called Krankenkassen.
All Krankenkassen provide minimum legal medical coverage. Differences among them can be found in the contribution amounts (what you pay) and the specific coverages they offer (what is covered).
Public Long-Term Care Insurance
In German: Pflegeversicherung. Part of your contributions goes toward long-term care insurance, which is for those needing such care. This means that everyone with a Krankenkasse is covered, regardless of the public insurer they choose.
This insurance is part of Sozialversicherung or Social Insurance.
Pension Insurance
Public pension insurance (Gesetzliche Rentenversicherung) is organized by the German Federal Pension Insurance Institution (Deutsche Rentenversicherung Bund), regional pension insurance institutions (Regionalträger der Deutschen Rentenversicherung), the German Pension Insurance for Miners, Railways, and Maritime (Deutsche Rentenversicherung Knappschaft-Bahn-See), and the agricultural pension funds (Landwirtschaftliche Alterskassen).
In summary, it covers pensions after retirement and disability pensions. It is also part of Social Insurance.
Public Accident Insurance
The responsible bodies for public accident insurance (Gesetzliche Unfallversicherung) are the accident insurance institutions for the industrial and agricultural sectors (Berufsgenossenschaften) and the public sector accident insurance institutions.
If you are employed, your employer handles this insurance for you. It is also part of Social Insurance.
Public Unemployment Insurance
This insurance (in German: Gesetzliche Arbeitslosenversicherung) is mandatory and is managed by the Federal Employment Agency (Bundesagentur für Arbeit, BA), which consists of a headquarters, regional offices, and local agencies. It covers all employees, including manual workers, office workers, trainees, and people with disabilities.
This is the final type of insurance in the Sozialversicherung.
Which Health Insurance is Best in Germany and How Do I Choose?
This is one of the most frequently asked questions we receive. Generally, people know they need health insurance in Germany, but do they know which one? It depends on many factors: Have you registered your residence? Are you starting work soon? Are you here to look for a job or study the language for a few months?
These questions determine the type of insurance you need. We recommend consulting professionals to avoid headaches or making mistakes that could be inconvenient later.
Insurance Types:
To make your choice easier, we have created a small form to guide you on the type of health insurance that might be suitable for your situation. Although other factors, such as your personal situation in Germany, also matter, we believe this form is very indicative and will help you find the most appropriate insurance based on your answers.
Find the Right Health Insurance in Germany
Answer a few simple questions to find out which insurance is suitable for you.
Our Recommendation:
We know social media is an important source of information, but unfortunately, based on our professional experience, what someone recommends might not always be the best for your specific case.
Therefore, if you have any questions and need advice on health insurance in Germany, you can contact us for free professional advice. And in your language! We couldn’t make it easier, right? 😊
How is healthcare system funded in Germany?
The German healthcare system is funded through employee contributions. Both the employer and the employee make monthly contributions.
Once you start working, you must pay contributions for health insurance, long-term care, unemployment, and pensions in Germany. Part of this comes out of your salary, and the rest is paid by your employer. This is done automatically when you sign up for public health insurance. The employee does not make any direct payments; it is deducted from the paycheck each month.
Similarly, the self-employed are also part of the social insurance system in Germany. They manage their contributions to various insurances themselves.
Health Insurance for Employees: How Does It Work?
Once you find employment in Germany as an employee (as long as it’s not a mini-job or a job with a salary under €538), you will need health insurance. Although you might be offered health insurance directly, it is recommended to find your own Krankenkasse to arrange your health insurance.
Why? Because many public insurers in Germany offer specific benefits or extras, and you can save money and find one that is more convenient for you (considering factors such as being single, having a family, pre-existing conditions, etc.).
What Happens After You Get the Insurance?
Once you get health insurance, you will receive an insurance number (Versicherungsnummer) necessary for recording your work contributions.
If it’s your first job, once you complete the registration with a Krankenkasse, you will receive the German social security certificate (SV-Ausweis or Sozialversicherungsausweis).
Don’t worry, you don’t have to issue it yourself; you will receive it at your home once you have your health insurance in Germany.
The Social Security Card Contains:
- Surname, first name, and maiden name
- Social security number
- The issuing pension insurance institution
- Issue date
- A serial number
How to Visit a Doctor in Germany?
1. Social Security for Employees (Krankenkasse)
If you have health insurance with a Krankenkasse, you will receive a health card at your home. You will need to present this card whenever you visit a doctor, so always carry it with you.
In Germany, there isn’t a single building like a health center where you must go to your general practitioner (who usually refers you to specialists). Instead, you can choose the specialist you need directly (which means you can look for one who speaks Spanish or other languages).
This also applies to general practitioners or family doctors. You need to find one yourself based on your preferences (language skills, recommendations, etc.), and they don’t need to be in your living area.
Note that sometimes the doctor you want to visit may not accept new patients due to a full quota. In this case, you can use online reviews to help guide your search.
General Practitioner:
Initially, this system might seem uncertain as we are used to going to our assigned doctor, who then refers us to specialists. In Germany, if you are unsure which specialist to visit because you don’t know what you have, you can go to a general practitioner who will give you a “Überweisung” (referral) to see a specialist. You will still need to find and book the specialist yourself (although it may be easier to get an appointment as you will have a doctor’s referral).
What if You Have an Emergency?
In an emergency, you can go to the hospital with your health card to receive care. Hospitals have a Sozialdienst (social service) that can guide you through the necessary procedures. Remember this if you ever need it.
2. For Those Without Krankenkasse (with Temporary Insurance)
If you are in Germany temporarily (job seeker or learning the language, for example), you likely have temporary private health insurance. You won’t receive a health card like with a Krankenkasse.
It works like travel insurance with a specific duration. The insurer will provide you with papers to present to the doctor. The doctor will issue a bill that you must submit to your insurer for payment.
This insurance has specific details you need to be aware of. In our section on Temporary Private Health Insurance, we explain when to get it and common questions about it.
3. Private Insurance in Germany
Besides the previous two cases, you can also choose private health insurance in Germany. To be eligible, employees must have a gross monthly income of more than €5,750.
This type of insurance can be very beneficial depending on your income, as it can save you significant money annually and offers additional services and benefits.
Private insurance is often recommended for self-employed individuals or freelancers. Regardless of monthly income, self-employed people can choose private over public insurance.
Important Phone Numbers
- Firefighters, emergencies, rescue: 112 (valid across the EU)
- On-call doctors: 116117
When you call, you’ll be asked some questions (where you live, your Krankenkasse, etc.), and an emergency doctor (Notarzt) will come to check the situation.
Healthcare system in Germany for Students
As a student, you can choose between public health insurance with a Krankenkasse or private insurance. Depending on your current situation, future plans, length of stay in Germany, types of studies, etc., one option might be more beneficial.
Generally, if you are under 30, you can access both insurances. It is always best to analyze your individual case to see which one is more suitable.
Our website also provides information on health insurance for students in Germany.
Key Points for Students to Consider:
Estudiantes:
- From EEA countries (EU member states, Liechtenstein, Norway, Iceland, and Switzerland) or countries with agreements with Germany.
- From other countries.
- Over 30 years old or have completed the 14th semester.
- Enrolled in preparatory language courses for university.
- Pursuing a postgraduate degree and/or with a scholarship.
Social insurance in Germany for Non-EU Citizens
People coming to work in Germany from outside the European Union also need health insurance. They must present a residence permit and a work permit.