Do I need health insurance in Germany?

If you live in Germany then it is a legal requirement to hold health insurance. That can be as part of the statutory public health insurance system (gesetzliche Krankenversicherung) or private (private Krankenversicherung). 

The majority of Germans – around 89 percent – have public health insurance. The providers are often called Krankenkassen.

Okay, is it possible to change my Krankenkasse?

Foreigners in Germany who may be unfamiliar with the German system are often unaware that they are able to change their health insurance provider. Perhaps they joined one of the big companies like Techniker Krankenkasse (TK) or AOK and have stayed with them ever since arriving in Germany. 

But it’s worth keeping in mind that there are alternatives out there. 

Why would I change, and is it actually possible?

Health insurance providers regularly raise their additional contributions (Zusatzbeitrag) meaning you have to pay more. The providers usually announce their rates for the coming 12 months at the start of the year.

At the start of 2022, one in four people in Germany saw an increase in their health insurance contributions.

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Those who are affected by increases are given a special right of termination which applies until the end of the month when the health insurance introduced the new contribution rate.

But do not despair, because it is possible to change your Krankenkasse after this point.

The only requirement is a minimum membership of 12 months. So if you’ve been a member of a health insurance provider for a year, you can switch. This period was reduced from 18 months in January 2021, giving consumers a better deal. 

Knowing how difficult it can be to cancel contracts in Germany, it’s fairly simple to switch providers.

Once you have found a suitable health insurance provider, you apply for membership. 

After receiving the application, the new health insurance company calculates the notice period and informs the previous health insurance firm of the wish to change. The previous health insurance company then informs you of the end date of the current insurance contract. 

You can inform your employer about the switch. 

READ ALSO: EXPLAINED: The three new services covered by German health insurance

This has been made easier since 2021 – before this point you had to provide notice of cancellation to your health insurance provider before switching. 

Keep in mind that public health insurance providers are not allowed to reject anyone on the basis of their health or age. However, there are restrictions for older privately insured people who want to switch to public.

Can I actually save money?

It is definitely possible, but you have to weigh it against the benefits that the health insurance providers offer. 

Most of the benefits provided by statutory health insurance organisations are identical.

However, there are some differences in the voluntary benefits, including dental health (professional dental cleaning and discounted dentures), vaccinations (flu vaccinations for under 60s and travel vaccinations), various cancer screening examinations and osteopathic treatments.

READ ALSO: How to make the most of reward schemes on your German health insurance

But it may be that you want to see what other options are out there to bring the costs down, especially because the costs of living have gone up recently.

The cost of public health insurance in Germany is a fixed salary percentage of 14.6 percent, while the reduced contribution rate for employees without entitlement to sick pay is 14.0 per cent. Self-employed people pay both the employee and employer contribution, though they can get support from the state if they work in a creative profession. 

Beyond that, health insurance providers set an additional contribution (as we mentioned above), which can currently be up to 2.5 percent.

The cheapest nationwide health insurance provider is the HKK with a contribution rate total of just under 15.3 percent, reports German news site RND. Those insured with DAK or Barmer pay 16.1 per cent.

With an average gross income (€3,300 per month), this can make a difference of around €160 per year. If you subtract income tax, you save more than €110.

Check with online comparison sites, talk to a health insurance broker or do your research with different companies to find out the best prices for you.

But it might not just be about cost. Perhaps you feel the service in your current health insurance provider isn’t up to scratch, or you’d like to try one of the smaller companies. Or perhaps you want to consider joining a company that provides an English-speaking service. 

One thing to keep in mind is that if you have recently received approval from your insurance provider for a health procedure, but haven’t started it yet, you will have to go through that approval process again if you want to change. 

What about private health insurance?

If you’re insured privately, you can change tariffs, but check that you will be able to afford any rising premiums in future. 

If you are insured under the German public scheme and start to earn more than €64,350 per year, you can change to private health insurance, or you can remain as part of a Krankenkasse with the status of a ‘voluntary member’, and will have to pay the maximum premium.

This report is intended as a guide only and should not take the place of advice from a qualified advisor. Got any questions? Get in touch at [email protected].