Health insurance

Living in Europe, Working 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, statutory health insurance is compulsory for all employees with annual income lying below the insurance threshold (2022: 64,350€) and above this for many other groups (cf. § 5 SGB V). In general, researchers having a working contract as well as their accompanying family members are subject to compulsory health insurance.

In Germany, there are statutory as well as private health insurance companies. For statutory health insurances, the contribution rate of 14.6% has been applicable since 01.01.2019. Under certain circumstances, health insurance companies may charge additional contributions. The costs for the health insurance contributions (including possible additional contributions) are equally split between emloyers and employees.

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 that can be found under "Further information".

 


The following information applies to citizens of EU States, as well as citizens of Iceland, Liechtenstein, Norway and Switzerland, who are spending time abroad:

Those who are insured on a voluntary basis or who are covered by statutory insurance may make use of the health services in other EU States, as well as in Iceland, Liechtenstein, Norway and Switzerland, and have the costs reimbursed by their health insurance scheme. Thus, with regards to ambulant treatment, those insured can choose whether they wish to be treated in Germany or in another Member State. If they consult a doctor or use other medical services within the European Union, they initially have to pay the costs of the treatment on the spot and then submit the receipts to their insurance scheme in their own country. The costs will then be reimbursed at the same level as they would if they had been incurred for treatment in Germany; any excess costs usually must be covered by patients themselves.

In the case of hospital treatment in another State, the health insurance scheme must agree to the treatment in advance. This may only be refused if the same or equally effective treatment at the same general standard of medical knowledge could be obtained for the patient in good time at a hospital in Germany.

Extended health insurance cover comes into force if someone covered by statutory insurance and his or her family are only staying in another country on a temporary basis - for example on holiday or business. In case of illness, they are eligible for services that are necessary medically, including hospital treatment.

If a contract for employment in Germany has been signed and you are actually working here, you are subject to compulsory health insurance here.

The European Health Insurance Card

To facilitate treatment during temporary visits abroad, every health insurance scheme is obliged to issue its members with a European Health Insurance Card. In case of illness in another EU country, or in Iceland, Liechtenstein, Norway and Switzerland, medical services are provided according to the laws of the host country and reimbursed according to the charges applying there: by presenting the card, patients are eligible both for services which are free of charge in the host country as well as for free medical treatment. Costs for services which usually incur charges in the host country will be covered by the health insurance scheme on presentation of the insurance card.

However, the European Health Insurance Card only has a limited scope.

It is valid:

  • for temporary stays abroad
  • for necessary medical services

It is not valid:

  • for trips abroad specifically for the purpose of treatment
  • for the costs incurred in transporting an invalid home

Extended stays

An extended stay abroad is one that goes beyond a holiday or business trip or a conference visit such as a guest professorship or research trip that lasts a semester or a year. For extended stays abroad within the European Union, as well as in Iceland, Liechtenstein, Norway and Switzerland, instead of the European Health Insurance Card, the following applies:

If you are entitled to statutory health insurance at home, then your domestic health insurance provider will issue you with an S1 Form (formerly E 106) on request. This S1 Form entitles you and your family members to register with a German health insurance scheme. The German health insurance scheme will then provide all the services that a German health insurance scheme member is entitled to. The German health insurance scheme will subsequently bill the domestic health insurance provider for their costs.

If you are entitled to statutory health insurance in Germany and some members of your family have remained in your own country, then the German health insurance provider will issue an S1 Form (formerly E109) on request. This S1 Form allows those members of your family who have stayed at home to make use of the services of the statutory health insurance scheme without needing to pay contributions. The domestic health insurance provider will subsequently bill the German health insurance scheme for their costs.

 

Further information

  • Useful forms for social security rights

    These forms are useful for exercising your rights to benefits as an EU national living and/or working in an EU country other than your own - or having done so in the past. The forms are valid if you legally live in an EU country, irrespective of your nationality.

    European Commission


For a research stay in Germany, medical treatment in the event of serious illness and accidents in Germany must be able to be covered . In case of preconditions, please obtain all necessary medication in your home country, as private health insurance in Germany generally will not cover preconditions, meaning you will have to bear any treatment costs yourself. In contrast to private insurances, statutory health insurance providers are required to cover the full costs for insured persons, even preconditions, from the very first day of coverage. It is a good idea to contact the health insurance provider you have selected before travelling to Germany to clarify anyquestions you may have in advance and to ensure insurance coverage is provided from the very first day. The responsible Immigration Office will require proof of health insurance in order to process residency permit applications.

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 the insurance coverage is also valid in Germany. If the insurance cover is inadequate for visa or residency permit application purposes, you will have to take out an additional insurance policy.

Travel insurance is not sufficient: travel insuance only covers specific health risks when travelling, but does not provide sufficient healthcare coverage for your time in Germany.

If you are staying in Germany for more than 6 weeks and are therefore considered to be resident in Germany, please note: Since 1 January 2009, anyone residing in Germany is required to possess health insurance coverage from an insurance provider licensed in Germany if they are not covered by statutory health insurance or entitled to health allowances for members of the civil service. Therefore, in these cases it would make sense to obtain health insurance from a German provider. Insurance coverage abroad can then be switched to the For the duration of your stay in Germany, the foreign health insurance cover can be deferred for this time.


 

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").

In rare exceptions, you may have the option of voluntarily purchasing statutory health insurance as per § 9 SGB V. If in doubt, please ask 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.

A working group of the German EURAXESS network has developed this overview of substitutive health insurance options for international scholarship holders to help orientate yourself. 


 

If you are employed on the basis of an employment contract, then you will most likely be subject to compulsory public German health insurance. 

However, there might be an exception. If a Social Security Agreement ("Sozialversicherungsabkommen") exists between Germany and your own country, the health insurance regulations of your country may continue to be applicable. In these cases, 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 employee, if you do not possess form number 1 or 101, you will be subject to German health insurance. Your level of income will determine whether you must obtain private or statutory health insurance.

If your gross salary is less than 64,350 euros a year (as of 2022), you must be insured by a statutory health insurance company. The general statutory health insurance rate is set at a standardised 14.6% of the gross salary. Both the employer and employee pay 7.3% of the insurance rate.

Starting in 2015, statutory health insurers may charge a supplemental premium if they have established that they cannot otherwise cover their costs. Spouses out of employment and children can be insured at no additional cost in the statutory health system.

The health insurance providers decide themselves on the amount of the supplemental premium. Should your health insurance company introduce or increase its supplemental premium, it is possible to switch to a different health insurance provider more quickly based on a special right of cancellation. 

The care provided for by statutory health insurance are, for the most part, standardised, though there are differences in customer service, additional benefits and optional premiums between companies. You are free to choose a statutory health insurance company, meaning that it can be worthwhile comparing the benefits of different providers. 

If your gross annual salary regularly exceeds 64,350 euros (as of 2022), you are free to choose between a statutory health insurance provider and a private health insurance company. This means that you may opt for either a statutory and a private health scheme.

You must inform your employer which health insurance company you have chosen so that the contributions can be paid. The employer registers new employees with the health insurance company they have chosen if the employee is not yet registered with a health insurance provider. For first time arrivals, the health insurance provider then forwards the registration to other social security providers. Contributions to health insurance are deducted automatically from the employee's salary.

 

 

Further information

  • The National Association of Statutory Health Insurance Funds
    Information on the statutory health insurance in Germany National Association of Statutory Health Insurance Funds
  • Private health insurance companies
    List of all private health insurance companies (in German) Verband der privaten Krankenversicherung e.V.
  • German Academic Exchange Service (DAAD)
    Health, Liability, and Accident Insurance available to foreign scientists sponsored, supported or represented by members of DAAD or DAAD Partner Organizations
    DAAD-Group Insurance Scheme
  • German Association for international Students (DeGiS)
    Overview of health insurance options available to foreign scientists and scholarship holders
    DeGiS