Health Insurance in Germany: A Guide for South Africans In Germany, everyone must have health insurance. This means when you move to Germany, this is one the first things you need to sort our When you earn less than the Versicherungspflichtgrenze, you will most likely need to take out Public Health insurance. When you earn over that amount (€69.300 per year from 2024) you can choose between public health insurance (gesetzliche Krankenversicherung, GKV) and private health insurance (private Krankenversicherung, PKV). The right choice depends on your income, employment status, and personal circumstances. It is essential to thoroughly review and understand the details of your health insurance plan, whether public (GKV) or private (PKV), to ensure you know exactly what is covered. Each plan has its own set of benefits, exclusions, and limitations, which can vary widely depending on your provider and plan type. For example, while public insurance covers basic healthcare needs, it may not fully cover all dental treatments or certain specialized services, whereas private insurance may offer more comprehensive coverage but can come with higher premiums or additional out-of-pocket costs. Always verify the specifics of your plan, including coverage for services like dental care, specialist treatments, and hospital stays, to avoid unexpected expenses and ensure that you are fully protected. Public Health Insurance (GKV) Public health insurance is the most common option for residents in Germany. Your contributions are linked to your income. Affordable premiums Your contributions are based on your income (up to a certain limit), making it more affordable for those with lower incomes.While the system is fair, the more you earn, the more you pay (up to a maximum threshold). Comprehensive coverage Public health insurance typically covers most basic medical treatments, hospital visits, and prescription medications. Basic dental coverage is generally included. Family coverage If your spouse and children do not have their own income or are low earners, they can be included in your insurance at no additional cost. Network of doctors and hospitals Most doctors and medical facilities in Germany accept public health insurance, giving you broad access to healthcare. Longer waiting times Public health insurance may come with longer waiting times for non-urgent treatments. Limited choice of treatments Some treatments or services may not be covered, or you may have to pay extra for more luxurious treatments or private rooms in hospitals. Private Health Insurance (PKV) Private health insurance offers a more tailored approach to healthcare. Instead of contributions being based on income, private insurance premiums depend on your age, health, and the level of coverage you choose. Faster access to treatment In many cases, private insurance offers shorter waiting times for appointments and treatments. Enhanced coverage You can choose additional benefits, such as private hospital rooms, more specialists, or alternative treatments. Flexibility You can choose from a range of plans that suit your needs, allowing for a more personalized healthcare experience. Potential savings for younger, healthy individuals If you’re young and healthy, private insurance can sometimes be more affordable than public insurance. Higher premiums Private health insurance can be more expensive, especially as you age or if you have pre-existing health conditions. Family coverage costs extra Unlike public insurance, private insurance does not offer free family coverage for low-income earners, meaning you must pay additional premiums for each family member. Premiums can increase with age While the premiums are often lower when you’re younger, they tend to increase as you get older, which can make it expensive in the long run. Limited coverage if you leave If you decide to leave private insurance or return to public insurance, it can be difficult to re-enter, especially if you are over 55. Good to know 01 Switching from private to public insurance can be challenging while transitioning from public to private insurance is relatively straightforward. 02 Public insurance contributions are based on your salary, while private insurance premiums are determined by your risk profile, which includes factors like age and health. As you age, private insurance premiums tend to increase. 03 With private insurance, you usually pay upfront for medical expenses and then claim reimbursement. In contrast, with public insurance, your claims are automatically submitted and paid directly by the insurance provider. 04 Private health insurance is only available to certain groups, such as civil servants, self-employed individuals, students, and employees whose salary exceeds the annual income threshold (Beitragsbemessungsgrenze). In 2024, this threshold is €69.300 gross per year. 05 Many people with GKV choose to purchase supplementary dental insurance to cover the extra costs for things like higher-quality materials (e.g., ceramic crowns) or more extensive treatments like orthodontics. Resources on the web An article from “How to Germany” about the different health insurance options “Just Landed,” wrote an article about health insurance in Germany Top up medical cover You can top up your medical cover for example Dentist cover.You can read more about it on the How To Germany Site. There is also a good article (German) from Focus about Zusatzversicherung Tourist or Temporary Health Cover Tourist needs travel and medical insurance before they can apply for their visas.Some of the options are your medical aid or a company like TIC.Please be aware of the requirements from the Embassy, not all credit card cover is accepted.When you need cover for 6 to 12 months, you can look at Klemmer. Cover for freelancers At the time of writing, the following companies offer medical aid for freelancers in Germany. Except for publicists and people working in the arts, all freelancers and self-employed should be privately health insured. https://www.cigna.com/ https://www.hansemerkur.de/ Dr Walter / Provisit Cover for students and Au Pairs You will need medical insurance to cover the whole period that you are in Germany. Good options are Klemmer or Dr Walter Comparative websites The following websites offer a comparison of medical insurance. Please always read the fine print before signing up through comparative sites Krankenversicherung-vergleiche Check24 Medical insurance companies Krankenkassse has a list of private and public health insurance companies. PKV lists members of the Private Krankenversicherung (PKV) Advisors listed on this site If you are in need of assistance with
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