As an expatriate moving to Germany, one of the crucial decisions you'll face is choosing between private and public health insurance. This decision can significantly impact both your healthcare access and financial situation. In this article, we'll explore the advantages and disadvantages of each option to assist you in making an informed choice.
Table of contents
Public Health Insurance: The public health insurance system – also known as statutory health insurance or gesetzliche Krankenversicherung (GKV) in German – offers a basic, universal standard of healthcare to everyone resident in Germany.
Private Health Insurance: Private health insurance providers – Of the 42 ordinary member companies, 36 offer comprehensive health insurance – have far greater scope to tailor their coverage and offer premium treatments and services.
In Germany, the health insurance system is divided into two main categories: statutory health insurance (GKV) and private health insurance (PKV).
In the statutory health insurance, your contribution depends on your salary and is calculated as a percentage of it. The amount of your statutory health insurance contribution is determined by the legislator with the general contribution rate – currently this is 14,6 %. The reduced contribution rate is 14%, but then you don't have a daily sickness benefit.
In addition, there is the additional contribution, which each health insurance fund determines itself. This is the only difference between public health insurance providers. This is 2.50% on average. Thus, legally insured persons in Germany pay an average statutory health insurance contribution of 16,2%.
The general contribution rate of 14,6% is applied up to the contribution assessment ceiling. Once this salary limit is reached, insured persons pay the maximum contribution (including the respective supplementary contributions of the health insurance fund) and the contributions no longer increase with increasing salary. This limit is €66,150 per year in 2025.
The contribution ceiling is not to be confused with the annual earrings ceiling. This is the limit from where employees can take out private health insurance.
For those earning above the contribution limit for statutory health insurance (66,150 Euro per year), your insurance costs will be at the maximum rate possible. On average this is €1,174.16 without children and €1,141.09with children. (For employees the employer pays the half of the contribution.)
If you earn above the annual earrings ceiling and are single with no dependents, this isn’t the most financially advantageous choice.
Your monthly rates in the private system are based on your age at the time that you sign the contract, your health and the coverage you want. The premiums are designed to ensure that your monthly payments cover your medical costs. So, some pre-existing conditions may result in a small surcharge. For example, all 33-year-olds would pay the same base rate, but a health condition like asthma might result in a small percentage increase.
In order to mitigate rising healthcare costs in old age, provisions for old age, i.e. a financial buffer, are set aside additionally.
An 32 years old employee would pay €295 in our Business Class tariff, a self-employed person €604 in the same tariff as they don't have an employer that pays the half of the contribution.
For expats that stay only for a maximum of 5 years in Germany, we have created a special expat tariff.
There are downsides to the public system. For one, the scope of coverage is basically fixed. Although some public insurance providers (of which there are 94 in 2025) offer slightly different coverage, the treatments covered generally follow the minimum requirements of the German Social Code. Lawmakers can also amend this at any time, so your level of cover is not guaranteed to last forever.
The public system also covers fewer treatments, especially when it comes to dental care. To have more coverage for dental treatment, it may be worthwhile to purchase a supplemental dental insurance.
In private health insurance should be included in any case reimburse all medically necessary treatments, but certainly, go beyond that. That means there should be no problem getting reimbursements for dental prostheses or visual aids such as glasses and contact lenses. But also the basic billing of the doctor at least at 3.5 times the fee schedule rate, as well as the assumption of alternative healing methods such as alternative practitioners, treatment by a chief physician or a single or double room in the hospital.
If you are in good health and have no family history of serious illness, or if you are simply looking for a more affordable option, you can choose a more basic level of coverage. On the other hand, you can also choose a full-coverage policy to cover all eventualities. Such policies are naturally pricier but offer peace of mind, leaving you safe in the knowledge you have done everything possible to safeguard your health.
Plus, private health insurance coverage is guaranteed by contractual agreement: Your provider can never curtail or change this coverage.
Statutory Health Insurance |
Statutory Health Insurance |
Private Health Insurance |
Private Health Insurance |
||
|---|---|---|---|---|---|
Medical Treatments: |
Statutory Health Insurance |
Basic medical treatment Multi-bed room Standard medications Standard appointment scheduling Private doctor only as a self-payer |
Private Health Insurance |
Consultant treatment Private room Specialized medications Priority treatment Coverage of private medical bills |
|
Costs & Benefits: |
Statutory Health Insurance |
Lower costs for large families Likely premium increases Few to no benefits beyond basic coverage |
Private Health Insurance |
Higher costs for large families Potential savings on monthly contributions (up to €3,100 per year) Comprehensive benefits |
Insurance from other EU countries
If you are from a different EU country you have the option to use your European Health Insurance Card (EHIC) in Germany. That means even when you get health insurance in Germany, your insurance in the other EU Country will pay for it.
Attention this only works when:
When you start working in Germany, your EHIC does not cover you anymore. If your payment is more than 520 Euro you need to get a german health insurance
Our ottonova team of experts has over 40 years of experience in private health insurance and answers questions about it every day. What are old-age provisions and for whom does private health insurance make sense? What is the actuarial interest rate and which tariff is right for you? They know!
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