Anyone who enters Germany is subject to the country’s health insurance requirement. This obligation applies not only to people who have their primary residence in the Federal Republic but also to foreign nationals. Regardless of whether the purpose of the stay is to travel, to look for work, to study, as an intern, au pair, or to apply for asylum – health insurance is mandatory. Everything you need to know about this is compiled below.
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Quick overview: The most important at a glance
- In general, everyone in Germany must have health insurance. For this purpose, there is a dual system in this country, which consists of statutory health insurance and private health insurance.
- Those entering the Federal Republic of Germany (FRG) must be able to prove that they have health insurance. In addition, health insurance is a prerequisite for the issuance of a visa.
- The important thing is the purpose for which you are traveling to Germany. If you come from abroad and only stay here for tourist reasons, you have a good chance – especially as an EU citizen – to be insured via domestic health insurance.
- The only thing necessary for this is to apply for the European Health Insurance Card. Under the EHIC, foreigners have the security of being able to undergo medically necessary treatment.
- For travelers whose origin is outside the EU, special travel health insurance or so-called incoming insurance is available. However, these are limited in time but are also required for a visitor visa.
- Anyone working in Germany or relocating to the FRG must be insured with a German insurance provider. Income and occupational group are significant considerations in this case.
Private health Insurance for short stays: Incoming health insurance
For short stays in the Federal Republic of Germany, private health insurance for foreigners within the framework of incoming health insurance is an option. This is ideal for foreign guests who have to stay in Germany for private or business reasons. In addition, the incoming health insurance also covers the insurance coverage in the entire EU and Schengen area.
When it comes to health insurance for foreigners, it plays an important role in which country you come from or whether you come from the EU or enter Germany from a country of origin outside the European Union. Those who come from a state of the European Economic Area can usually remain insured through the coverage of the health insurance of the country of origin.
Notice: For this purpose, only the application for the European Health Insurance Card is necessary, if this is not already printed on the general health card anyway.
What does the incoming health insurance cover?
Incoming health insurance pays for medically necessary examinations and treatment by doctors as well as for medication prescribed by them. In addition, the first aid by an emergency doctor as well as the transport and necessary hospital treatment are also paid. The same applies to dental treatment. However, the prerequisite for this is always a medical necessity.
To be noted:
- The benefits, especially in the case of medical repatriation, may well differ. The same applies to repatriation in the event of death.
- The maximum period of insurance under the incoming health insurance may well differ depending on the insurance company. The same applies to the term, which is a maximum of five years. An extension is not possible unless the current term does not yet completely exhaust the five years. In this case, the health insurance for foreigners can be extended to the maximum term.
- The handling of the insurance conclusion is also different. In general, it is advisable to take out incoming health insurance before the start of the trip, with the start of insurance being the day of entry. Some insurers offer re-insurance from 2 days after entry up to one month after entry.
- When applying for incoming health insurance, a valid identification document such as a passport is required. As a rule, the date of birth in combination with the duration of the trip determines the amount of the premium.
Long stays: Health insurance for foreigners in Germany
In Germany, the dual system applies. This means that people are either insured by law in the statutory health insurance (solidarity principle) or cover health insurance via private health insurance (benefit principle).
- The majority of people have compulsory or voluntary health insurance. Private health insurance, on the other hand, is only available to certain groups of people. In addition, the benefits are higher if desired. However, joining private health insurance is subject to conditions.
- Not everyone has the choice of which of the two options to take. If the annual income is below the annual income threshold (2021: 64,350 euros), an employee is compulsorily insured by law. Above this limit, they can choose whether to take out voluntary statutory insurance or opt for private health insurance.
- However, there are exceptions for self-employed persons, insured persons without income, and students. It is also worth comparing the costs for families. This is because children can usually be insured free of charge in the statutory health insurance system as part of the family insurance. In private health insurance, each family member receives their health insurance including the premium to be paid for it.
Differences between statutory and private health insurance exist primarily in the range of benefits. While statutory health insurance provides a solid basic cover, the range of benefits of which can be adjusted, private health insurance offers premium benefits if desired. This is reflected in preferential treatment when appointments are made, higher-cost coverage for doctors, and more modern treatment methods. In addition, once agreed, health benefits cannot be terminated unilaterally without further ado.
Origin is important
The country of origin of the person to be insured is important for private health insurance. This is because there is a difference between EU citizens, citizens living in a country that has a social security agreement with Germany, and non-EU citizens.
- Anyone who enters the Federal Republic of Germany as an EU citizen also needs health insurance, like everyone else, to cover the costs of medically necessary treatment. However, this insurance coverage can be ensured by the insurance carrier in the country of origin, as every EU citizen can apply for a European Health Insurance Card, or EHIC for short, through this carrier.
- The same applies to citizens from Iceland, Switzerland, Norway, or Liechtenstein. Likewise for countries with which a social security agreement exists, such as between Germany and Turkey.
- Costs are generally only reimbursed within the scope of emergency treatment. However, there is often the option to adjust the benefits abroad.
- Anyone entering the country with a visa needs private travel insurance or incoming insurance, which can be used for a maximum of five years. Subsequently, private health insurance for foreigners is required. This regulation also applies to people entering with a visitor visa.
Attention: Even those who only enter the country for a short time must provide proof of health insurance. This must be valid not only in the Federal Republic of Germany but also in the entire Schengen area. In addition, there is a minimum amount of coverage. This is 30,000 euros.
Status/ occupational group plays a role
Whoever travels to Germany as a foreigner and wants to work here or moves his residence to the FRG, has to comply with the obligation for health insurance like everyone else. Whether he or she is now subject to compulsory insurance in the statutory health insurance can insure himself or herself via the private health insurance or join the statutory health insurance as a voluntary member also depends on his or her occupational group.
- One in Germany salaried employee will be subject to compulsory insurance in the statutory health insurance, provided that his income does not exceed the annual earnings limit. This is registered by the employer. Thus, anyone who has a regular job in Germany is usually compulsorily insured.
- Attention: Posted employees as well as employees who only work here temporarily, such as seasonal workers, remain covered by health insurance in their country of origin via the European Health Insurance Card.
- For self-employed the basis for deciding which health insurance can be chosen is the type of insurance he has had up to now. If he had statutory health insurance in his country of origin, he can also choose statutory health insurance in Germany. If he had private health insurance or no health insurance at all, he chooses the private health insurance for foreigners.
- Interesting: If you have private health insurance abroad, you should check in advance whether it also applies to Germany.
- As a foreign student, the same applies to university students in Germany in general: There is the choice between statutory and private health insurance. The latter is made possible by incoming health insurance should his country of origin be outside the EEA.
- For students, originating from the European area, the insurance of the home country takes effect within the scope of the EHIC.
- Those entering the FRG as a family must also be insured or provide proof of appropriate health insurance.
- If an income is earned in this country and, as an example, an employee is working, there is the option to co-insure family members without income in the family insurance free of charge in the statutory health insurance.
- As a rule, pensioners who come to Germany from abroad are insured through the health insurance system in their home country.
- However, travel health insurance is generally recommended for all EEA citizens when traveling to foreign countries.
- However, it is worth mentioning the increasing contributions of a private health insurance when you get older.
Foreign job seekers
- Anyone staying temporarily in the Federal Republic of Germany to look for work is insured as a citizen of the European Economic Area via his or her home country.
- If he/she finds work in this country, he/she will be subject to compulsory insurance accordingly, or should the income be above the annual earnings limit, he/she has the option of seeking private health insurance.
Refugees and asylum seekers
- There is generally no statutory health insurance here. At the beginning of their time in Germany, people are covered by the Asylum Seekers’ Benefits Act (AsylbLG) in the event of illness. Only after a few months does the benefit level increase. After about 15 months, a statutory health insurance takes over health insurance for refugees and asylum seekers.
- However, the health insurance fund settles the payment with the institution responsible for the Asylum Seekers’ Benefits Act and not via the community of insured persons of the statutory health insurance funds.
Especially for private health insurances for foreigners an experts should be contacted
Anyone who needs to insure themselves in Germany or is unclear about which coverage options apply to them should confidently consult an expert on private health insurance for foreigners in Germany. Because in the insurance jungle of the EU as well as the Federal Republic there are many peculiarities and pitfalls. These include different deadlines, as well as minimum coverage, amounts already mentioned.
- In addition, language barriers present challenges to non-nationals with government agencies as well as when it comes to German insurance.
- A private health insurance expert also helps in this case and can help to save costs in the long run.
- Likewise, the specialist for private health insurance for foreigners is the optimal contact in terms of benefits.
- After all, there are many options here and not all of them are interesting for every insured person. In addition, it is important not to overlook and include the benefits that the policyholder actually needs.
Tips: Find an independent experts in private health insurance for foreigners, which is not only linked to a single insurance company. This helps to get an objective view of the current situation and the existing possibilities. In addition, this way compare offers which can have a positive effect on the insurance premium payable in the long term.
FAQ & Tips private health insurance for foreigners
Those who wish to opt for private health insurance must have the appropriate prerequisites to have this choice in Germany.
Those who are students can choose to be exempt from compulsory insurance, those who already have private health insurance in their country of origin can also choose this in Germany, and employees who earn above the annual earnings limit of currently 64,350 euros per year can do the same.
Those who meet the above criteria often have the choice of whether to take out private health insurance or join the statutory health insurance as a voluntary member. Nevertheless, private health insurance for foreigners should always be compared with the statutory health insurance for foreigners in such a case. A comparison can be worthwhile.
The amount of the contribution in the statutory health insurance depends on income and is currently 14.6 percent. There is also an additional contribution, which can vary from the health insurance fund to the health insurance fund. For the self-employed, a minimum of 149 euros per month and a maximum of 736 euros are due.
In private health insurance for foreigners, on the other hand, the premium is determined by the entry age, the desired benefits, and the current state of health. The premium is accordingly independent of income. The monthly expense can be less than 200 euros, but also significantly higher. Depending on the influencing factors. In addition, there is a share of long-term care insurance for both variants.
It should be noted, however, that the benefits provided by the statutory health insurance funds are largely the same. In private health insurance, on the other hand, the benefits can be adjusted according to individual requirements.
The country of origin is important for health care coverage during short stays.
If you come from the ERW countries and are an EU citizen, you only need the European Health Insurance Card (EHIC) to be treated in Germany in an emergency. You can apply for this from your health insurance provider if it is not already printed on your current health card.
For non-EU citizens, private health insurance for foreigners is useful for the period. Alternatively, travel health insurance can be used if the stay is short. It should be noted that the insurance must have a minimum coverage of at least 30,000 euros.
In the statutory as well as the private health insurance for foreigners, it is possible to reduce the monthly contributions somewhat and thus save money. This is made possible by a corresponding deductible. The higher the deductible, the lower the premiums. However, in the event of costs, only services that exceed this deductible will be covered.
In private health insurance for foreigners, the amount can usually be freely selected. In the statutory health insurance for foreigners, there is an optional tariff. In this case, you can also opt for a deductible.
You should therefore check in each case whether a deductible makes sense. This is because it requires that you are sufficiently solvent during your stay in Germany to be able to pay any costs incurred up to this amount yourself.
In terms of benefits, private health insurance is more flexible, but can also bring restrictions if the health condition of the person to be insured leads to exclusions. This can happen, for example, through a health examination in which pre-existing conditions are identified or if specific illnesses frequently occur in the insured person’s home country.
After all, a short vacation trip back home, for example, may result in an infection. It is therefore possible that certain benefits may be excluded from the health insurance contract.
On the other hand, private health insurance offers the possibility of including insurance benefits that were previously not possible. These include, for example, accommodation in a single room, treatment by a chief physician, high-quality visual aids, state-of-the-art dental treatment, and much more.
Within the scope of private health insurance for foreigners, interim visits to the home country are also insured. Provided that these do not exceed a certain length of stay. This can vary with the different providers and the different tariffs.
As a rule, however, it is 30 to 90 days per insurance year. In addition, written notification to the insurance carrier of the planned vacation in the home country is often required.
With the EHIC, people with statutory health insurance can access medical treatment throughout Europe. The European Health Insurance Card is recognized in all EU countries. In Germany, people with statutory health insurance usually have it with them at all times, as it is printed on the back of the regular insurance card.
A uniform design has been agreed upon throughout the European Union so that the EHIC can be recognized as such everywhere. In addition to the surname and first name, the card also stores the date of birth, the personal identification number, an identification number of the insured person’s health insurance company, the identification number of the card, and the expiration date.
People belonging to these groups must also have health insurance for the period of their stay. Interns from abroad are usually subject to statutory insurance in this country. Au-pairs only if their monthly income exceeds 450 euros. If this is the case, private health insurance for foreigners can be taken out. The same applies to exchange students.
It should be noted again that visitors coming from EEA member states can be treated by the European Health Insurance Card and may be allowed to claim benefits.
My name is Tim Bökemeier, private health insurance expert and operator of PKV-Welt.de. For over 10 years I have been advising customers on their health insurance: statutory health insurance or private health insurance, rates, switching & backgrounds.