Healthcare in Germany: A guide to the German healthcare system

The German healthcare system is one of the best in the world, with universal coverage that means nobody lives in fear of huge medical bills. But one of the reasons the system is so good is just how much detail it contains - which can make it tough to take in. If you’re new to Germany or heading there soon, our guide will give you the key details involved in this complex but impressive system.

Quick facts on the healthcare system in Germany

Money in Germany is denominated in Euros - EUR if you’re talking about currency exchange, or simply € if you’re mentioning prices. But once you’re set up with German health insurance, you shouldn’t be looking at too many upfront costs at all.

• Public, private or universal healthcare: Germany has universal healthcare coverage, which means everyone living in Germany must have health insurance.
• Percentage on public vs private health insurance: Most people have public health insurance, but around 10% have private.
• Population % covered by health insurance: 100%
• Average cost for public health insurance for 1 person is 7.5% of income, or 15% if you’re self-employed.
• Number of pharmacies: Over 20,000 pharmacies in Germany, or one per every 4,000 people
• Number of hospitals: Around 2,000.

Average cost of healthcare in Germany

Is healthcare free in Germany?

German healthcare isn’t free, but when you’re covered with health insurance, getting ill shouldn’t be a costly affair. For most people, health insurance is paid for through your monthly salary - you’ll have to contribute around 7.5% of it. But there are lots of exceptions to this, as this article will cover later.

If you’re moving to Germany, it will be vital to have enough euros around at the beginning of your trip so that you’re covered for all the expenses you’ll face, including initial health insurance costs. Make sure you don’t lose out when transferring your money from your old bank account - Wise is fair and gives you the same exchange rate you find on Google, meaning you don’t end up paying big cuts like you do with banks and normal money transfer services. And with a Borderless account you can even hold your money in euros or up to 27 other currencies and then pay out to your German bank account at any time, protecting you against fluctuations in currency rates.

Germany’s medical system: Public, private, universal, national, state, single payer, which is it?

Germany has a universal healthcare system - one of the world’s oldest, in fact, dating back to the 1880s. It’s a legal obligation for everyone living in Germany to have health insurance and there are restrictions on the type of insurance that people can have, too.

There are both public and private systems in Germany. Most people have to have gesetzliche Krankenversicherung (statutory / public insurance). However, certain groups have the right to take private Krankenversicherung (private insurance) instead if they want to.

The German state healthcare system

Gesetzliche Krankenversicherung (GKV) is a system run by the German state, although it is administered by independent non-profits. There are over 100 of these to choose between, but because they are closely regulated by the state, they all offer similar policies with similar benefits. Most people in Germany have to have GKV.

If you have a job, GKV costs around 7.5% of your monthly salary and your employer contributes about the same amount on top. The overall contribution is, therefore, about 15% of your wages, but you only pay half of that yourself. If you’re self-employed, you’re personally responsible for the full 15%. This is why many self-employed people go private - it can work out cheaper.

However, for self-employed people working in an artistic field, the government offers to pay half of the bill in the same way that an employer would. This is done via the Künstlersozialkasse (KSK), and it means that state healthcare is often the cheapest and safest option for artistically-inclined freelancers. Talk to the KSK at the same time as choosing a health insurance policy to find out if you might be eligible.

The German private healthcare system

Only some people in Germany can exchange their statutory healthcare policy for a private Krankenversicherung (PKV or private policy), although people do have the right to top up their state coverage with private extras if they want to. For instance, it’s fairly normal for people to add additional private insurance for more thorough dental care.

You can choose private healthcare instead of GKV if you earn over a certain amount (€57,600 in 2017), or if you’re self-employed or a civil servant. Students can opt for this system too at special rates. The amount you pay varies depending on your age and state of health as well as what options you want.

Self-employed people have to pay their full health insurance bill themselves, with no government help unless they’re eligible for the KSK (see above). Cheaper private policies are often appealing to freelancers because they can work out as costing less than 15% of their earnings. At the other end of the scale, high earners may prefer to go private to take advantage of benefits not available on the state system.

Signing up for the healthcare system in Germany

This can take some time, so if it’s possible to get a head start before you arrive then you should try and do so.

If you’re moving to Germany from outside the EU on a residency visa, you’ll likely need to provide evidence that you have a valid health insurance policy as part of your visa application. So you should do all this well in advance of when you plan to move.

• Firstly, work out if you have to have statutory insurance or if private is an option. If you’re self-employed and work in an artistic field, don’t forget to consider the KSK.
• Use a comparison website or speak to a specialist to choose between the available options. This website has great information on the similar-but-different GSK providers, and PKV comparison sites include PKV-Gesundheit, Krankenkassen Deutschland and Check24.
• Choose a provider and talk things through with them - there will be some forms to fill out.
• You should receive a health card in the post once you’re fully signed up.
• When your details are in order, get yourself to a local practice and register with a Hausarzt (local doctor).

In case of an emergency in Germany

Emergency services are what get you to the hospital, and if you need to ring up a phone number, you’ll want to dial 112. When you reach the operator on the other end, it’s possible simply to receive advice over the phone or to call an ambulance if necessary. If for some reason you end up in an emergency and you’re not insured, you can still access emergency services. You just might be stuck with a bill at the end - and, if you should have had German insurance, you might have to pay back payments too.

EU citizens travelling in Germany - rather than moving there - are eligible for a certain amount of healthcare via their European Health Insurance Card (EHIC), so if you’ve got one, make sure to carry it with you. If you’re travelling to Germany from outside the EU, check what your health insurance policy provides and make sure you have some provision for international coverage before going.

In emergencies, you’ll likely be able to access the treatment you need fairly quickly. If you’d prefer something a bit more local than calling 112, you can still usually find a direct number to a local emergency doctor in your local newspaper. Waiting times are generally good for emergency care.

Hospitals in Germany

Private doctors and hospitals do exist in Germany, but you’ll need private health insurance to access these. If you only have public insurance, there are still plenty of public facilities around. You’ll just want to check beforehand that the hospital you’re headed towards isn’t a private hospital if you only have public health insurance.

Stays in a German hospital are fairly long by international standards - for example a new mother averages 6 days in the hospital compared to just 1-2 in many other countries. You’re unlikely to have a room to yourself, though, unless your insurance policy specifies as much, as many private policies do. And be prepared to bring your own pyjamas, slippers, and towels as many hospitals ask you to bring your own.

The cost of treatment itself should certainly be covered by your health insurance, but there are a few charges you might have to pay nonetheless - a small daily fee for hospital stays, for instance, and a minor portion of the cost of medication.

Doctors and specialists in Germany

English is quite widely spoken in Germany generally, so you may well find that your doctor can talk to you a little bit in English. But, if possible, bring along a German speaker or at least dictionary.

If you do need to visit a doctor, you can make an appointment in person or by phone without giving many details of the problem. It’s also possible simply to turn up and wait - though you may be there for a while. Office hours are often quite particular and practices may be closed for a couple of hours at lunchtime, so it’s certainly better to call and arrange something if you can.

Finding a GP / family doctor in Germany

You’ll need to go and register at the Hausarzt (GP / family doctor)** as soon as your insurance is sorted out. This resource is the official way to find a doctors near you, and Med-Kolleg is another helpful site - in English.

You shouldn’t have to wait for much more than a day to get an appointment, and if it’s an emergency, you can specify that you need something as soon as possible. Just keep an eye out for opening hours as they may open a bit early in order to close down the office for lunch.

Specialists in Germany

If you come to your Hausarzt with a particular problem, they may refer you to a specialist. You’re also able to sign up with some specialists directly, if you want. A lot of people use the system for regular checkups with, for instance, gynaecologists or dermatologists - these are generally covered by insurance plans.

Health insurance in Germany: Costs and plans

Most people are on a statutory insurance policy, meaning they pay half and their employer pays the other half. Certain people are allowed to go private, which, depending on what you opt for, might work out as cheaper or more expensive. But there are checks in place to ensure that nobody ever has to go broke because of healthcare: if you’re on benefits or unemployed, or even if you’re earning a very low amount, then the government has schemes that can help you out.

The German government insists on at least a minimal level of healthcare coverage from all policies, public or private. Hospital fees, outpatient treatment, drugs and basic dental care all have to be covered, and so do costs associated with pregnancy. While there still may be small fees that you have to pay, it’s a sturdy system that makes sure that if you’re insured, healthcare is always affordable.

With private coverage - which you can get in addition to your statutory plan if you want - extra options are available such as individual rooms in hospitals and access to private facilities. This comes at a cost, of course, and that cost will also depend on your state of health. The system works like insurance policies do anywhere: you pay a monthly premium and may have to pay excesses (deductibles) on top of this. For instance, you might have to pay the first €600 of coverage per year out of your own pocket.

Temporary health insurance for tourists

Always make sure you have insurance before travelling abroad. Check if you’re covered by your health insurance policy in your own country, and to what extent. If you’re from the EU, you’ll need to remember that the EHIC doesn’t include repatriation costs, so if you fall ill in Germany your travel back to your home country won’t be covered.

There are many options for both travel insurance and specific international medical insurance. A comparison website such as Comparethemarket or MoneySupermarket might be a good place to start.

Useful medical phrases in Germany

Useful links

• Toytown Germany is a very active forum for expats in Germany and a great resource for health insurance queries if you find yourself a bit stuck.
• If you’re still overwhelmed at the thought of finding a doctor near you, try the official KBV website.

It’s true that the German healthcare system is a complicated one. But the good news is that it’s also very thorough, and provides a level of care that means that if you do fall ill, medical bills shouldn’t cost you the earth.