German health insurance: what makes sense for you?

No matter what you are doing in Germany, you are required to have some form of health insurance – either public or private. Yet depending at what stage you are in life – employed, self-employed, raising a family or a student – you may have very specific needs from that health insurance.

German health insurance: what makes sense for you?
Photo: Getty Images

Together with digital insurance provider ottonova, we look at what you may require from your compulsory health insurance, depending on your situation – and whether private health insurance could be the right option for you. 

If you’re employed

It’s important that as an international worker, you have the coverage you need to meet your healthcare needs. Whether you’re working part- or full-time, private health insurance (Private Krankenversicherung, or ‘PKV’) gives you important peace of mind to focus on your career, giving you one less thing to worry about while working abroad. 

Compared to public health insurance (Gesetzliche Krankenversicherung or ‘GKV’), you are able to access a wider and more-comprehensive range of medications and treatments. If you’re able to meet the income threshold to take out private insurance (€64,350 per year), you can also be sure that you are able to save money, especially when it comes to the premiums you would otherwise be paying in the public health system.

There are a few other things you should keep in mind regarding health insurance as an employee. If you get ill, your employer will pay your salary for six weeks. After that, if you have private health insurance, it will kick in with a daily sickness allowance – the level of which you can decide when taking out cover. 

If your salary drops below the income threshold, you will need to switch to public health insurance. If your situation changes again, you can then apply for an exemption that will allow you to continue with private health insurance. 

On the same topic, while it is generally fairly difficult to switch from private to public health insurance later in life, there are several ways that you can do it without too much of a cost burden, such as switching to a spouse’s or family plan. If you lose your job, you are also able to switch back to public health insurance. Many services also exist to help you navigate between the two systems, depending on your situation. 

Employees who have private health insurance can also access a range of preventative screenings and other treatments that could help you enjoy a healthy, fulfilling career. 

Book a non-binding consultation with one of ottonova’s English-speaking insurance experts today 

If you’re self-employed

If you’re self-employed, or run your own business, you’ll want to carefully consider your options, because if you can’t work, your income will be severely affected. Luckily you benefit from being able to choose between public and private health insurance, if you’re self-employed, or a business owner. 

Private health insurance may make sense as a self-employed person. If you get ill, you won’t only get access to better treatments and more comprehensive care, but you’ll also have access to a daily sickness allowance payed by your insurance – so you’ll be back making your own decisions as soon as possible.

Another possible advantage of private health insurance as a self-employed person is the fact that private policies are very flexible – there are many options that you can choose from, to ensure your specific needs are met. 

With private health insurance you are also able to make preparations for old age and retirement, with such measures as ageing reserves – additional, voluntary payments that can be used towards your later care, keeping your premiums stable in old age. 

Finally, if you’re travelling, you can also rest assured that depending on your tariff, you’ll be covered worldwide. 

If you have a family

If you have a family, nothing is more important than health. If you qualify for private healthcare in Germany, choosing which type of insurance to use is a big decision and you’ll want to carefully weigh up all your options.

Taking out private health insurance for families means that you have access to the best possible healthcare for your partner and children. Concierge services, as offered by a number of providers, means that much of the burden of organising appointments and paperwork can be removed, and you can be reminded of what’s coming up for your family in terms of procedures and treatments.

Private health insurance means that you are able to access top of the line treatments and medications, without restrictions, that clearly meet the needs of your family members.

If you have private health insurance, you also have total control of coverage, deductibles and sickness allowance. You can adjust these when you want, to reflect the changing needs of your family.

Furthermore, you’re likely to save money with private insurance if you have a family. If your family’s combined income is above the annual threshold, you will pay the maximum premium within public health system for procedures, treatments and preventive examinations.

Safeguard your family and yourself and arrange a no-obligation consultation with ottonova’s English-speaking experts

Photo: Getty Images

If you’re a student 

As a student, you’re just starting your journey and life, and you’re far more flexible in your needs than later in life. It’s a good thing, then, that as a student you have the option to choose either public or private insurance. Many employees don’t have this option, so it’s really worth weighing up your options if you have the chance – you can sign up to three months after enrolment at university. You also have another opportunity when your family insurance ends.

While not many students have private health insurance, joining early is an excellent decision. This is because your premiums are based on the age that you join. Premiums as a student also don’t include any ageing provisions, making them even cheaper. Best of all, student tariffs can be accessed until age 37.

If you’re not sure whether private health insurance is right for you at this time, you might also like to consider supplementary insurance, such as dental or hospitalization insurance, which can fill the gaps of your public insurance coverage and give you extra peace of mind, when you need it.

A smart choice, entirely in English 

When choosing private health insurance, there are a number of good reasons to consider ottonovaFirst, almost everything from your individual coverage, daily sickness allowance, doctors appointments and so on can be controlled from the ottonova app – it’s a totally digital service.

Second, all services and the app are entirely in English, reminding you of upcoming appointments and organising all your relevant medical documentation. Operating through an app allows lightning-fast reimbursement of medical bills up to €500 within 48 hours, on weekdays. 

Your English-speaking concierge helps you through all aspects of the German healthcare system, and assists you in accessing the best healthcare available, like finding English-speaking doctors, and securing appointments with specialists promptly.

Finally, you’re able to access supplementary insurance through ottonova that you can use to provide extra coverage for your public health insurance, in areas such as dental and hospitalization, and also benefit from all digital services.

Explore ottonova’s wide range of private health insurance solutions with one of their English-speaking experts and take control of your healthcare

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EXPLAINED: What to do if you face a long wait for healthcare in Sweden

Sweden theoretically has a "healthcare guarantee" limiting your wait to see a GP to three days, and to see a consultant to three months. The reality is somewhat different. Here's what you can do if you face a long wait.

EXPLAINED: What to do if you face a long wait for healthcare in Sweden

What is Sweden’s ‘healthcare guarantee’? 

Sweden’s “National Guaranteed Access to Healthcare” or vårdgaranti, is a right to care, protected by law, that has applied in Sweden since 2005. You can see the latest version of the relevant laws here and here. Here is a summary of the guarantee on the website of the Swedish Association of Local Authorities and Regions (SKR).

Under the system, all patients are guaranteed:

  • contact with a primary care centre by phone, in-person, or by video-link on the day they seek care 
  • an appointment with a doctor, nurse, physio, or psychotherapist within three days of seeking help 
  • an appointment with a specialist doctor or consultant within 90 days of seeking help 
  • treatment or operation within 90 days, if the specialist considers this necessary 

Does the guarantee mean I have a right to treatment? 

No. If the doctor at the primary care centre, after examining you and questioning you, decides that there is no reason to refer you to a specialist doctor, they do not need to do so. 

Similarly, if the specialist doctor, after examining you, decides that no treatment is necessary, then your case is considered completed.  

Can the waiting times to see a specialist or to get treatment be longer than 90 days? 

Absolutely. In fact, they very often are. 

According to the Swedish Association of Local Authorities and Regions (SKR), in February, 32 percent of patients had been waiting 90 days or more to see a specialist, and 43 percent of those who had seen a specialist had been waiting for treatment for more than 90 days.  

The situation in primary care was a little better, with 80 percent of those seeking care in contact with their primary care centre on the same day, and 83 percent having their case assessed by a doctor or nurse within three days. 

In addition, if you agree with your specialist doctor that you are willing to wait longer for an operation, then that wait doesn’t get counted in the statistics. 

So what can I do if I’ve been waiting longer than the guaranteed time? 

In reality, it’s actually less a guarantee than a target.

In primary care, there is no way for individual patients to complain that they have had to wait too long to see a doctor or nurse, or to cut their waiting times by citing the guarantee. 

“There’s no system for enforcing that guarantee,” says Emma Spak, the primary care doctor who doubles as section chief for SKR’s healthcare division. 

It would make no sense to set up a complaints line for those who have had to wait too long for phone contact with their primary care centre, she points out, when they could instead talk to patients seeking a primary care appointment in the first place. 

“It’s more of an incentive system for the regions,” she explains.

Every primary care unit and every region reports their waiting times to the national waiting time register, and then as part of the access agreement between SKR and the government, the regional health authorities receive a bonus if they meet their waiting times goal, or if they improve their waiting times. “That’s one way of sort of enforcing this guarantee,” she says. 

When it comes to specialist treatment, though, patients do have the right to demand to be examined or treated by an alternative specialist or hospital if they’ve had to wait longer than 90 days.

If your primary care centre issues you a referral to a specialist, and the specialist cannot then offer you an appointment within 90 days, the specialist, at the same time as offering you a later appointment, will often put you in contact with a unit at the regional health authority who will offer to find you an alternative specialist, either within the region or elsewhere in Sweden. 

The regional health authority will then have to reimburse any extra travel or hotel costs incurred by the patient.  

Similarly, if after examining you, a specialist cannot offer you treatment within 90 days, they will normally put you in contact with the same unit. 

Some regions have a phone line for people who have been waiting too long, or else you can contact your specialist or primary care centre and ask for information on seeking an alternative specialist. 

What happens if I don’t want to travel to see a specialist or get treatment? 

If your regional health authority offers you an alternative specialist, either within your region or in another region, so that you can get treated within the 90 day period, and you are unwilling to travel, then you lose your rights under the guarantee. . 

“If you’re in Gothenburg, and they say you have to go to Stockholm to get your treatment, and you say, ‘no, I want to go here, then then you’ve sort of forfeited your right, and you have to take what’s on offer,” Spak says. 

What happens if I agree with my specialist to wait longer? 

If your specialist says that they can treat you in four months, but also offers you treatment elsewhere within the guaranteed 90 days, and you choose to be treated by your specialist, then that counts as a patient choice, which will not then be counted in the statistics. 

“The specialist might say, ‘I don’t think you will get any worse for waiting two months extra, and if you wait five months, then I can make sure that you get your surgery done here, and we can make sure that you get all the aftercare and everything here as well,” Spak says. 

But these patient decisions are also counted in the statistics, and if a region sees a sharp rise in patients choosing to wait, SKR will tend to investigate. 

“If some region all of a sudden has a lot of patients choosing a longer waiting time, then we will call them and ask what’s going on here, because patients don’t tend to want to wait extra,” Spak says.  

Can I get financial compensation if I’ve been waiting too long? 


What other ways are there of speeding up the wait for treatment? 

Don’t underplay your symptoms

When drawing up their timetable for treatment and assessment, specialists will tend to give different patients different wait times depending on the urgency of their case.

For this reason, it’s important not to underplay your symptoms when visiting a primary care doctor, as they will tend to include a few lines on the urgency of your case when they write their referral. 

Stress your flexibility 

If you are unemployed, a student, retired, or have a very flexible job, it is worth telling your primary care doctor about this, because they may write in your referral that you are able to make appointments at very short notice. The specialist may then put you on their list of people to ring if one of their patients cancels. 

“Sometimes I write in my referrals that this patient could easily come at short notice, so please put the patient on the list for people you can call if there’s a time slot available,” Spak says. 

If you haven’t told your primary care doctor this, it’s not too late. You can ring the specialist yourself and tell their receptionist that you are very flexible, and ask to be put on the back-up list. This is particularly useful if you’re waiting for a scan, but you could also potentially work even if you’re waiting for heart surgery or a hip replacement. 

“If they’ve accepted you as a patient, and they’ve made sure that you fulfil the criteria for having that scan or whatever, then you can call them and say, ‘I have a really flexible job, I can come anytime if you have a gap,'” Spak says.

“A lot of people do that, because they can have [back-up] waiting lists. If you tell them ‘I work around the corner and I only need 15 minutes to be there’, then they might call you if someone doesn’t show up.” 

Ring up your specialist 

The queue system tends to be quite ad hoc, with no strict rules over who should be treated first, so it is often possible to reduce your wait by ringing up your specialist a few times a month, just to bring your case to their attention. Sometimes the receptionist will remember a slot that has just come free and bring forward your treatment while you are still on the telephone.