The German healthcare system and which insurance to choose as an expat (short)

​Since 2009, all expatriates are obliged to have a valid health insurance. When applying for your residence permit or even for the registration with the authorities, you have to provide a proof of your residency. And, trust me, it is better to have a health insurance here in Germany. 

Together with France, Sweden and Netherlands, Germany spends the biggest part of its GDP on healthcare within the european union. In this article, I will not go into too many details but rather look at what is better to choose: state health insurance (Gesetzliche Krankenversicherung) or PKV (private Krankenversicherung). If you want more information, then have a look here: WIKIPEDIA ARTICLE or EVERYTHING YOU WILL EVER NEED

State Health Insurance (Gesetzliche Krankenversicherung)

Around 80% of Germans are inside one of the state health insurances. 

There are over 100 different ones to choose from. Although they are provide the same basic healthcare, they tend to differ in the smaller services. The basic healthcare is in-ward care at your nearest hospital by the doctor on duty, visit to the licensed doctors (Kassenärzte, which is the majority of doctors) and basics dental care.  Each different insurance specialises on certain areas (alternative medicine, better dental care etc...) and they have the same basic costs (7.3% get paid by your employer, 7.3% by you of your gross salary).

HOWEVER, they are allowed to charge an additional premium in order to cover their costs. This can vary from 0.5%  to 1.1% (of your salary), so choose carefully. I have made my life easy and simply went for the cheapest one, never having used any of the additional benefits that the state healthcare offers. I used this calculator. 

Here is a nice little ressource for finding doctors that are Kassenärzte: KVB Search Engine (in German)

Regarding finding doctors that speak english (useful for expatriates): Actually 50 to 80% do speak it to a quite good extent. The best is to look for younger doctors as English is more prevalent with these. 

International Friends has a Guide to City for each city it is, there you can find a list of english speaking doctors. You can download the apps here:

Private health insurance (Private Krankenversicherung)

You can choose private healthcare instead of GKV if you earn over a certain amount (€55000 in 2019), or if you're self-employed or a civil servant. Students can opt for this system too at special rates (I will get into this later, students please read on).

If you have private health insurance, you have normally a much wider coverage of healthcare benefits and treatments. You will be considered as a private patient and therefore can expect a higher level of service from the medics, as the doctors and healthcare professionals can charge private patients higher fees. You can often also request doctors who can speak your language but, from experience, you should be just fine with 50-80% of the Kassenärzte if you can speak english. 

There are about 40 private health insurances Germany-wide.

And here comes the burner, the argument that convinced me that the state health insurance is better: you get charged differing amounts depending on your age, the amount you earn and any pre-existing conditions.

Now lets look at the flip-side of the charging system. Now you earn good money, now you have a good job and (likely) you do not have any pre-existing conditions. What happens when you loose your job? When, due to some fluke, you cannot earn any money anymore? You get old? You will still have to pay your private health insurance and you cannot change back into the state health care.

Students health insurance

Foreign students (whose parents are not living in Germany and do not have a German health insurance) also have to be health insured (it is the law). BUT, there is a way to easily insure you privately. No worries though, your insurance can be covered by a private insurance (the state one is far too expensive at 150 Euro minimum per month). While I was living my first few months here in Germany, I was covered by a private health insurance called MAWISTA. In the end, it worked out cheaper by a huge margin.

Conclusion

This is a very short summary of the health insurance system here in Germany. There are two main types of health insurance. 

The state insurance is the basic insurance that more than 80% of the Germans have. It has a standard pricing system and is relatively easily to negotiate. Personally, I would recommend this type of health insurance as the tariff is based on how much you earn.

The private health insurance gives you a premium in service, and you may get better health care (although even that is debatable). I would not recommend this type of health insurance because the tariffs are independent of how much you earn at this moment in time, and, if you loose your job, you may still have to pay the high tariffs that you paid while you had your job.