A quick guide through the German health insurance jungle

A quick guide through the German health insurance jungle


German health insurance can be confusing, especially for expats and newcomers who don’t speak the local language. But this should not stop you from getting the best possible coverage. ottonova brings you this quick and easy guide to the jungle that is German health insurance - so you can find your way around easily. 

Anyone who lives and works in Germany needs health insurance - that’s simple. But what’s not so simple is navigating the system if you’re not sure how it works, or what’s on offer. Here’s the lowdown. 

How does the German health insurance system work? 

Germany operates a so-called dual-payer or two-tier health insurance system, in which the majority of healthcare is government-funded, but a secondary, privatised form of healthcare also exists. 

Under the public system, younger policyholders pay for the treatment and care of the sick and elderly, while the private system focuses on the individual but assumes solidarity between the healthy and the sick. Private policyholders’ premiums cover their own rising healthcare costs as they grow older. 

How many types of health insurance are there in Germany?

There are two main kinds of health insurance in Germany: public health insurance (gesetzliche Krankenversicherung) and private health insurance (private Krankenversicherung). 

Public health insurance (gesetzliche Krankenversicherung)

Almost without exception, everyone in Germany is eligible for public health insurance. As a public system, the premiums are based on income - so the more you earn (up to a certain limit), the more you pay. 

Private health insurance (private Krankenversicherung)

If you are a high earner, self-employed or a public official, you may be eligible for private health insurance. Your premiums are determined by the level of coverage you choose, the age at which you enter the private system, and your overall health status. 

Which health insurance is better in Germany: Public or private?

Depending on your income and employment status, you might be able to choose freely between public and private insurance in Germany. Ultimately, deciding whether public or private insurance is better for you depends on your personal situation. 

There are certain things you should consider before making your decision: including whether or not you can make a choice, the costs, and the coverage. Let’s break this down into a bit more detail. 

Can I freely choose between public and private?

Taking out health insurance is mandatory in Germany. However, not everyone has the option of being privately insured.

  • Public: As a fundamental rule, employees with a gross salary below 63.250 euros per year must choose the public system. Unemployed people, farmers, gardeners, sailors and most students must also choose statutory health insurance in Germany.
  • Private: Employees with a regular gross salary above 63.250 euros per year are free to choose between public and private health insurance – as are public officials and self-employed people.

Costs: How much does health insurance cost in Germany per month?

Obviously, one of the biggest factors to take into consideration is how much your chosen health insurance in Germany will cost you per month. This varies between public and private insurance:

  • Public health insurance premiums are income dependent and calculated as 14,6 percent of your gross income, up to a maximum income threshold, plus an additional contribution rate of around 1,3 percent. Your contributions therefore only rise in line with your salary.
  • Private health insurance premiums are based on the tariff you choose, your health, and the age at which you take out private health insurance. Younger people who join earlier in life enjoy far lower premiums than people who join when they’re older. Private health insurance premiums have risen by an average of 2,3 percent per year since 2020.

Coverage: What treatments and services does your insurance cover? 

One of the main differences between public and private health insurance - apart from the way your premium is calculated - is the treatments covered:

  • The treatments covered by public health insurance are set out in the German Social Code and can be amended by legislators at any time. They include doctor appointments, hospital treatments, out-patient treatments, surgery, maternity care and basic dental care. However, coverage is limited by law to “economically viable” services, which means that more expensive or complex treatments may not be covered. 
  • The coverage provided by private insurance depends on the tariff you choose and is fixed for a lifetime. You can choose what coverage is right for you and your needs. 

Why choose ottonova?

Of course, there is a range of health insurance providers on the market, and you should certainly compare the coverage and benefits of different tariffs before you commit. As Germany’s first fully digital health insurance provider, ottonova offers its policyholders a full range of benefits and features, including:

  • Tariffs specially designed for expats: Giving you a savings potential of up to 300 euros each month. 
  • Excellent personalised coverage: No more waiting time for specialists, single bedroom hospital accommodation and up to 100 percent of your dental bills covered. 
  • Full support in English via app chat or call: Get fast answers to any question about your tariff or health from your personal concierge.
  • Zero paperwork: Scan your documents with your phone camera and have them all neatly organised in your ottonova app.
  • Digital appointment booking: Book medical appointments with English-speaking doctors in just a couple of clicks.
  • Goodie for you: Get a 30-euro Amazon voucher after signing up.

Book your non-binding consultation with ottonova’s English-speaking insurance experts to discover how easy and transparent health insurance can be.



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