Health insurance

Living in Europe | Entry conditions/visas, Health insurance, Medical care | Germany

Health insurance ("Krankenversicherung") forms part of the statutory social security contributions. It is regulated in Book V of the German Social Code ("Sozialgesetzbuch"). Pursuant to § 1 SGB V, its purpose is to "maintain, restore and improve the health of the insured".

In Germany, health insurance is compulsory for all employees with annual income lying below the insurance threshold (2017: 57,600 euros; 2016: 56,250 euros) and above this for many other groups (cf. § 5 SGB V). Researchers and their accompanying family members are also subject to compulsory health insurance.

What has to be covered is medical treatment in the event of serious illness and accidents in Germany. In case of prior illness, please obtain all necessary medication in your home country, as your private health insurance in Germany generally will not cover this, meaning you will have to bear the costs yourself. In contrast, statutory health insurance providers must assume the full costs for insured persons with a prior illness from the very first day (even for cases of prior illness). We also recommend contacting the health insurance provider before travelling to Germany to clarify all questions in advance and to ensure insurance coverage is provided from the very first day. The responsible Aliens' Registration Office requires proof of such health insurance for the residence permit.

In order to issue a residence permit the local immigration authorities require proof that you are covered by this kind of insurance.

First of all, check whether your insurance at home covers medical and hospital expenses incurred during your stay in Germany. The insurance company must then confirm in writing that insurance cover is valid in Germany, too. If the insurance cover is not adequate, you will have to take out an additional insurance policy.

Travel insurance is not sufficient: this only covers specific health risks when travelling, but does not provide sufficient cover for your time in Germany.

If you are in Germany for more than 6 weeks and are therefore normally resident in Germany, please note: Since 1 January 2009, anyone resident in Germany is required to possess health insurance cover from an insurance provider licensed in Germany, in so far as they are not covered by statutory health insurance or entitled to allowances for members of the civil service. In this case we recommend obtaining health insurance from a German provider. For the duration of the stay in Germany the foreign health insurance cover can be switched to the tariff for the qualifying period.

In Germany there are private as well as statutory health insurance companies. As of 1 January 2009, there has been a standard rate for all statutory health insurance companies. There is quite a range of statutory health insurance providers and private insurance companies to choose from. In order to help you get a better overview we have drawn up a list of statutory health insurance providers and private health insurance companies under "Further information".

A fellowship to fund a research stay does not normally give you access to statutory health insurance in Germany unless you are also contractually employed by a research institution or university for the duration of your stay (please see the relevant information in the section "Research stay based on an employment contract"). Exceptions exist for foreign nationals who are citizens of EU member states; for these please see our further information under "Special case: EU citizens".

In rare exceptions you may have the option of voluntarily purchasing statutory health insurance as per § 9 SGB V. If in doubt, please enquire about this option with your funding provider or directly with the statutory health insurance providers in Germany before commencing your research stay.

In all other cases we recommend that you purchase private health insurance for the duration of your stay in Germany in advance. Your funding provider can offer recommendations.

If you are employed on the basis of an employment contract then as a matter of principle you are subject to compulsory German health insurance.

However, exceptionally, where there is a Social Security Agreement ("Sozialversicherungsabkommen") in place between Germany and your own country the health insurance regulations of that country may continue to be applicable. Your health insurance provider or social security authority at home will confirm this using form number 1 or 101. On the basis of form number 1 or 101 you will continue to be subject to your national health insurance regulations and be exempt from statutory German health insurance, provided that the Social Security Agreement that is in place with your own country applies to health insurance.

As an employed person, if you do not possess form number 1 or 101, you will be subject to statutory German health insurance. Your level of income will determine whether you must obtain private or statutory health insurance.

Up to a gross salary of 56,250 euros (upper income limit for 2015: 54,900 euros) you must be insured by a statutory health insurance company. The general statutory health insurance rate is a standardised 14.6% of the gross salary. Employer and employee each cover a share of 7.3% of the insurance rate.

However, from 01/01/2015 on, statutory health insurer may charge a supplemental premium if they calculate that they cannot meet their expenses. Nevertheless, non-working spouses and children are still insured at no additional cost by a statutory health insurance.

Health insurer deside themselves on the amount of the supplemental premium. In case your health insurance company first introduces or increases the supplemental premium, you will be entitled to a special right of cancellation of your health insurance contract.

The benefits of statutory health insurance are, for the most part, standardised. There are differences in customer service, additional benefits and optional premiums. You are free to choose your statutory health insurance company. A comparison of the different insurance benefits is therefore still worthwhile.

If your gross annual salary regularly exceeds 56,250 euros, you are free to choose between a statutory health insurance provider and a private health insurance company. This means that you may opt for both a statutory and a private health scheme.

You must inform your employer which health insurance company you have chosen. It is the employer's task to register new employees with the health insurance company. The latter then forwards the registration to the other social security providers. Contributions to health insurance are deducted from the employee's salary at source.


Further information