health insurance in Germany

Health Insurance in Germany – In 7 key points

Learn about Health Insurance in Germany in 7 key questions – 2023

Today I am writing an article about the most frequently asked questions regarding health insurance in Germany. It is a thing in Germany, because it is mandatory to have insurance.  In other words, every person who lives in Germany must be insured. 

Firstly, let me introduce myself. My name is Liza, and I have been working for the largest health insurance company, Techniker Krankenkasse (short TK), since 2016.  Secondly, my job is to help customers get settled and understand our health insurance. 

TK is not only one of the largest Insurances, but also one of the best. We have around 11 million customers across the country.  However, what sets us apart is that we provide many of our services in English. The reason for this is, we know that the health care terms can be difficult to understand – even for some Germans it is not that easy. 

So, you are faced with the issue of getting in touch with an insurance company, if you want to get settled. 

I collected and answered the most common questions I get asked. If you still have questions, I will be happy to help! 

1. How does the German social security system work? 

The German social security system is one of the most efficient in the world. As mentioned before, everyone who lives here must be insured. 

Social insurance system is based on five pillars:

  • Health insurance
  • Long-term care insurance
  • Pension insurance
  • Unemployment insurance
  • Accident insurance

It is based on the solidarity principle, meaning that the contributions are paid in accordance to one’s own financial capacity. Important to note, regardless of how much you pay everyone receives the same benefits, given they meet the requirements. 

As an employee half the contributions will be paid by your employer and half by yourself. And in most circumstances it will be taken directly from your salary.

As an unemployed person, we can check if you can be insured together with your spouse or whether you must pay for the health insurance and long-term care insurance separately. 

In some situations, you can choose between a private or public health insurance. 

First, it is only necessary to know that in the social security system you can only choose your health insurance. All other Insurances are mandatory. If desired, they can be topped up with private supplementary insurance.

2. What are the differences between private and statutory public health insurance in Germany?

For public (statutory) health insurance we have the principle of solidarity, which means that all members are entitled to the same benefits, regardless of their income and how high their contributions are. The services and benefits can vary between the Insurances, but 80% of them are the same.

For private health insurance in Germany, you get insured in accordance to your personal risk. And the more you pay, the better you are covered. For you as an employee, there is an income threshold in order to join a private insurance.   As of 2023, this is an annual salary of 66,600 euros. If you are self-employed or unemployed without any statutory support, you can also be insured as a privately insured person. 

To apply for private health insurance in Germany, you need a health examination and the contributions can then be raised depending on your health status. Treatments can be excluded or your membership fails, because of your health.  

Switching to private health insurance is easy but coming back to public health insurance is difficult. Please keep this in mind when making your decision.

3. What do I have to do, if I get ill (as a publicly insured person)? 

If you have something like a flu, you can visit your general practitioner. If specialist treatment is needed and/or further treatments are necessary, they will give you a “Überweisung” (prescription). With this you can make an appointment with a specialist. 

If you normally go to a doctor, you present your health card. You will get the card at the beginning of your membership

What do I have to do, if I need to go to a hospital? 

If your general practitioner gives you the advice, you will also be given a referral. And in an emergency call the ambulance or go there by yourself. 

Personal Contribution must be paid, but only 10 euros per day 

4. What happens if I get “krankgeschrieben” (you are written off work)?

Normally you can stay at home for two days without sick leave. But you must inform your employer and ask them if there are any special rules. On the 3rd day you will need to see a doctor and get a sick note (Arbeitsunfähigkeitsbescheinigung).

Usually, your employer pays you the salary until the 6th week of sickness. They just continue to pay your salary. 

After that the health insurance will pay you sick pay. However in order to receive this we always need an official sick note. And, it is very important to see the doctor, as the latter transmits the data on incapacity for work electronically to TK. 

5. Why do so many specialists or doctors not accept new patients? 

This is really an issue within the German health care system itself, many of the doctors are kind of overloaded. We offer an Appointment Service as a solution, where we will arrange appointments for you. 

You can also search with the TK-Doctor-Guide for specialists, that tool also lists the language spoken or language you require. 

If it is urgent or an accident, you can always go to the hospital. They will have some specialists on call and on duty. 

6. I don’t have a German address yet; can I apply for health insurance without that? 

Yes, you can. Your membership will begin with the start of your employment.  However, it is recommended to have interim insurance for the time between your arrival and when you begin your employment. 

To start the registration process with TK, follow this link and send me a mail to follow up.

If you do not have a German address at the time of your registration, it is best to enter the address of your employer. Please let them know so that they can keep the letters for you until you arrive here.

 If you have a permanent address please send us the “Einwohnermeldeamtsbestätigung” as soon as possible.

7. How does it work with couples? Do they go onto the same insurance?

We will gladly check whether your spouse or children can be insured with the health insurance free of charge. However please be aware there are some requirements that must be met.
For example, they may only have a low income or no income at all, age limits for children vary between 18 and 25 years depending on their situation. They must also stay with you in Germany. 

If your spouse is also working in Germany he/she needs their own membership. 

For unmarried partners or parents of the member it is not possible to be included on the noncontributory dependents insurance. We will gladly check if they can be insured with statutory insurance. 

So, these are the most frequently asked questions that I encounter in my work. 

I hope I was able to give you a good overview of how the health care system in Germany works and clarify your initial questions. 

I wish you that you arrive well in Germany and find your way around. 

Transparency: this article was written by TK, one of our German health insurance partners. If you click on one of their links and register an insurance with them, we earn a commission but there is no additional cost to you.