Health insurance in Germany

Germany is often praised for having one of the best health insurance system in the world. It may very well be true but it also very complex! I have also struggled to understand it when first arriving here so i thought i’d share my experience in this overview covering the different types, and what to do if you need one of a residence permit. 🙂

health insurance in germany residence permit

 

Health insurance in Germany: efficient but complex

In some countries, health insurance is managed by the government as a public service, and in some others it is purely a private service. Germany has a hybrid & interesting system.

The German state has delegated around 300 insurance companies to manage it’s population’s health coverage. They all work under a contract with the state, can be public or private and are called “Krankenkasse”. Now the trick is that you can sometimes choose if you want to insured by a private one depending on your income situation. Let’s try to understand how health insurance in Germany works.

There a 3 kinds of status of health insurance in Germany you can be under: Gesetzlich, Freiwillig or Privat.

 

    • Gesetzlich (versichert) also called pflicht(versichert ) is most typical coverage as it compulsory for people earning less than 56K€ a year. You have to be insured by a public insurance company that your employer will most likely pick for you if it is your first job in Germany. Your employer will directly take over the payment of the coverage by paying its share and yours through your wage. The rate is set by law at 14.6%. The good news is that what you pay is directly related to what you earn so if you face a sudden decrease in income, the fee will also decreasing. If you have kids, being with the public system is really good because you can take your kids under your own coverage at no extra cost.

 

    • Freiwillig (versichert) is basically the same at Gesetzlich except that you earn more than 56K€ a year. You will then pay your share directly to your Krankenkasse while your employer adds your half to your gross salary. This can also mean that you are self-employed and choose to stay in the public system.

 

    • Privat (versichert) means that you choose to insured at a private Krankenkasse provided you earn more than 56K€ a year or don’t qualify for the public system for any number of reasons. The fees applied by private Krankenkasse are usually lower than in public ones for a better coverage if you are a young healthy person, but it increases over time. Private Krankenkassen have more complex offers than public ones in terms of what get covered and so on, so choose wisely. You also get different advantages like reduced waiting time at the clinic or at-home nurses. However, it does come with drawbacks. If you have kids, you have to pay extra for each them to have them covered. Coming back to the public system after being in the private one is also extremely difficult if not impossible.

Basically, in the public system, the rate depends on what you earn, and in the private system, it depends on your health risks.

The biggest companies for health insurance in Germany are : Techniker Krankenkasse, AOK : Allgemeine Ortskrankenkasse, BKK: Betriebskrankenkasse, IKK : Innungskrankenkasse, LKK : Landwirtschaftliche Krankenkasse, etc…

All in all, depending on your Krankenkasse, you usually pay directly or indirectly minimum 270€ per month to be covered by your health insurance in Germany. The bill can even reach a whooping 500 – 600 € if you are freelancing with decent earnings. I’m coming from a country where social and health insurance is provided for free to all, so it came a bit as a shock the first months as you can imagine. (A German friend once told me “ If I have enough money to pay rent, transport, and Krankenkasse, I’m on safe side.”)

A minority of people also decide not to take coverage because they cannot afford health insurance in Germany. However this is illegal and i strongly advise against doing such thing.

Of course when you go home to visit your family and simply go abroad for holidays in Europe, your German health insurance will cover you and giving your reference numbers should be enough to be reimbursed in the end. Be careful though, you will be reimbursed at the rate that is considered normal for that particular treatment in Germany, so while it will probably cover most of the costs, the rest will come from your pocket in some cases.

Health insurance in Germany is efficient, but still costly for individuals.

Finding the best rates for private health insurance in Germany

Public Krankenkassen offer more or less the same amount of service across the board for roughly the same price. This is however not the case for private Krankenkassen. Think about how internet providers have different plans and different level of services; the market is more complex and more diverse. You need to pay attention, explore the market and pick something that suits your needs. A good place to do that are comparison platforms like TarifCheck or Preisvergleich. It lets you pick options to define what coverage you want. These are:

  • If you want additional coverage like teeth, vision, alternative medicine (Zusatzleistungen)
  • On the financial side, how much deductible you can afford (Selbstbeteiligung)
  • If you have to stop working for a while, when should a daily sickness allowance should kick in, and how much it should be (Krankentagegeld)
  • If you stay at a hospital, do you wish to have a private room, be handled by the head doctor, etc. (Krankenhausleistungen)

If you are an artist, a writer, performer: think KSK

The German government knows it hard to make a living when being an artist. Paying an expensive health insurance on top of everything else is not easy. That’s why Künstlersozialkasse (KSK) exists. If you are able to prove your main occupation is to live from artistic and creative jobs, the KSK will pay half of your current fees every month (only if you are part of the public system). The tricky part is that there is not a clear distinctions between what’s a art job and what’s not so it might be hard to get into it. Some people hire specialists to fill in the paperwork to make sure they tick the right boxes.

Taking on a German health insurance for residence permit or other visas

If you are not an EU citizen and you love Germany so much that you plan to stay to study or for a job, you will need to show that you have chosen an health insurance in Germany. It is required to obtain a residence permit or even enroll in a university. Germany is usually not very good at recognizing non-EU systems so make sure your health insurance is valid for the German system.

For a lot of foreigners applying for a German visa here for all sort of reasons, the solution here will be to sign-up for a German travel insurance provided by a German company. This makes sure that the insurance policy complies with the minimum requirements expected by the authorities. It can be classified as a private health insurance in Germany but for limited stays for up to 5 years.

 

If you want to study in Germany

If you are under 30 and enrolling in a university program in Germany, you have to take on a German public health insurance. This has a lot of benefits and costs only 81€ a month. It doesn’t happen automatically when you register at the university though. You have let the university know which Krankenkasse you picked. This is unfortunately only possible when you have registered an address in the country. If you are not able to join the public system for whatever reason, it is also possible to join a private insurance.

If you are self-employed

If you are running your own show, paying a Krankenkasse with everything else can be major hole in your monthly budget. This is definitely of the drawbacks of the German system; low-earning self-employed people pay a relatively high amount for their health insurance in Germany. If you have been in a public scheme within the E.U recently, you might to choose what is called a Freiwillige gesetzliche Krankenversicherung. This means that you stay in the public system, which is advised for people with kids and spouses.  For others, it is advised to stay with the private system.

I hope this little run-down helped you to understand the German health insurance system and make a better choice for your own coverage. Good luck.

Tip 1 : If you are lost on how to apply to a Krankenkasse and you plan to be a full time employee, you can often ask for help to your colleagues or to any administrative assistant that may exist in your company. They can be very helpful. In reality, you will most likely have to go on the chosen Krankenkasse website and open an “account” there. You will get a document that says that you subscribed to their coverage, you’ll send it to your company and poof ! There you go! Your employer will take care of the rest.

 

Sources: Ministry of Education & Research, More info on benefits and the state health system on its website here.

84 Comments

  • Reply Estell 26/04/2017 at 17:27

    Thanks for the info. I have a very difficult situation at the moment. Perhaps you have some advice? I have been living and working in Berlin for 2 years now as a freelancer. I was previously insured privately with an international health insurance that covered me globally. At my last visa appointment I was told that my insurance was inadequate and that I need a German health insurance. I have since been applying to public and private health insurances , and pretty much all of them at this point have rejected me. Public ones say that they can’t insure me because I’m a freelancer, and private health insurances either give me no clear reason why they’re rejecting me or have said that my visa isn’t valid for longer than a year so they can’t insure me. I was only given a year long visa extension because of my lack of german health insurance though. I have my new visa appointment coming so it has nearly been a year of me trying to get insured and I assume my visa will not be renewed if I don’t have insurance, but no insurance will take me!! What can I do?

    • Reply Bastien - Settle in Berlin 26/04/2017 at 17:47

      Hi Estell, have you tried to go with HanseMerkur or Mawista? They are german insurance that specialize in covering foreign workers with limited stays visa. Good luck with everything?

  • Reply Drini 23/04/2017 at 19:27

    Hi,

    this blog is amazing. It really helped me a lot, thank you. Quick question. I’m starting to work in Berlin on May 2nd, but I will only be able to register in Berlin, and hence apply for health insurance, next week. How long does it take on average to get all setup?

    Thanks!

    • Reply Bastien - Settle in Berlin 24/04/2017 at 09:28

      Hi Drini. It’s hard to say precisely, but i think that you should be set-up within 2 weeks after signing up.

  • Reply Guy 12/04/2017 at 19:12

    Hi, thanks for all the info here and on all the other pages! I’m a NZer living in Berlin and I plan to take out travel insurance with a German provider, as a means of applying for a 12 month working holiday visa. Are there any providers you’d recommend for this purpose?

    • Reply Bastien - Settle in Berlin 13/04/2017 at 10:04

      Hey Guy. I haven’t made research about this but it’s a good idea to add a suggestion for people in your case. I don’t have a recommendation for you but i will add one soon. You can also let us know what your research uncovered. 🙂

  • Reply Mahmoud Abdelazeem 09/04/2017 at 11:23

    Hello everyone,

    I have a question; I have been here in Germany for 3 and half years. I’d studied here and got my degree, Master of science. At the beginning I had a public health insurance for students. Then I turned 3o years old, I switched to private health insurance which is the case right now. I’m going to have a new job. As far as I know, I must have a public health insurance as long as my salary is less than a certain amount of money which is the case right now. The question is can I switch back to public health insurance without any problems?

    Thanks in advance

    • Reply Bastien - Settle in Berlin 10/04/2017 at 09:56

      Hello Mahmoud. It shouldn’t be an issue, especially if you were in the public system in the past in Germany.

  • Reply jessica 09/04/2017 at 03:42

    Hi, i will be moving to berlin in july to continue my studies, however university only starts in october… and i’m not sure if i will have a job for those 3-4 months… what should i do?

    • Reply Bastien - Settle in Berlin 09/04/2017 at 10:38

      Hi Jessica, i assume you are asking what to do about health insurance. If you come from an EU state, you can bring your EHIC card with you, it will cover you for that time. If you are outside in the EU, you might need to book an extra travel insurance for that gap of time.

      • Reply Jessica 10/04/2017 at 21:27

        great thank you

  • Reply sonia petrini 27/03/2017 at 19:54

    Hello,

    I would love some help on how to get health insurance with AOK in berlin. I am really confused with it all at the moment.I came from Ireland and I am on the AOK system but I do not have a health insurance card. I have a European union card at the moment and I have been using that for the doctors, each time I go they give me a little form I do sign and then my visit to the doctors is covered but I went to AOK asking how I get the card and they said I need to get an E104 form or S1 form I got the forms and managed to get the E104 form. If i go back to AOK with this form would they help me get the insurance or is there another way of getting the insurance? Any advice would be nice. Thank you.

    • Reply Bastien - Settle in Berlin 28/03/2017 at 09:17

      Hi Sonia. You can use your EHIC card if your stay in Germany is temporary. If you plan to be a resident here, you need to switch to a local Krankenkasse. You already made the right first few steps to doing that. You are on the right track. If you are starting a new job, the HR people can also help you there.

  • Reply Rodrigo 26/03/2017 at 13:05

    Me and my wife are moving to Berlin. I will have a job in the UK, hired by a UK company, and receive health insurance from the UK. However, since we are planning to stay long term in Germany, we do want to join the public health system. Since the company is not german, they will not pay half of it. Would I have to pay the full Premium? I would not be in fact self-employed, but I wouldn’t be on a German company either.

    Thanks!

    • Reply Bastien - Settle in Berlin 27/03/2017 at 10:19

      Hi Rodrigo. This is a tricky one. I found on the NHS website some information for people in your case. Look there, paragraph “Living in Germany > Working in Germany”. If nothing works, you might have to go with a private Krankenkasse.

  • Reply Mélissa Brouillette 16/02/2017 at 22:49

    Hello there,

    First of all, thank you so much for all the precious information and all the effort you’ve put to share all this!
    I’m a Canadian married to a EU citizen. We also have a son and are planning to establish in Berlin for a while. We are currently living in Canada.
    We are both artists (musician, singer-songwritter). You’ve mentioned that we could get a health insurance through KSK if we are part of the public system. How can we be “part of if”? How to find if we are eligible to the public system?
    Would you know?

    Thanks a lot once again!

    • Reply Bastien - Settle in Berlin 20/02/2017 at 09:47

      Hi Mélissa. As a rule, it seems that if you have been part of public scheme in your own country before(Canada has universal free public health insurance i believe), you will be able to knock at a public Krankenkasse’s door and they will likely accept you. Being part of it is simply signing-up with one.

  • Reply Alan 12/02/2017 at 10:41

    Thanks a lot for the article!

    I did my anmeldung in July 2016 but still haven’t set up my health insurance (have been technically registered as a freelancer in the UK up until now). I’ve been trying to fly under the radar but want to get fully legit now. I’m just about to apply for a tax number and register as a freelancer here, as well as setting up state health insurance – my question is – should I do my abmeldung, then anmeldung again, so I don’t get backdated charges for health insurance for all those months up until now?

    • Reply Bastien - Settle in Berlin 13/02/2017 at 10:04

      Hi Alan. I see what you want to achieve with that trick but it will probably not work. They have you in their database ever since you registered; they would easily make the connection if you did that. I think you will be fine though; your domestic health insurance covered you up until now so you don’t owe anything. Or is there something i am missing?

  • Reply savie cas 06/02/2017 at 22:36

    Thank you so much for the article. that was heplful as I am trying to take the right direction. I have a question, is it possible to combine freelancing and employed status? and if so how does work with the health insurance, 50 – 50?
    many thanx saviex

    • Reply Bastien - Settle in Berlin 07/02/2017 at 10:27

      Hello Saviex. I’m glad this can help. It is possible to combine freelancer and employed status yes. Your freelancing will be called “Nebenberuflich”. In that case, your health insurance is covered by your employee benefits (No 50/50).

  • Reply Paloma 21/01/2017 at 17:49

    Hello there !
    First of all thank you so much for all the info you put on this website. It’s been a huge help in my preparation to move to Berlin. I have a question though about the fees as a student: I am Belgian and plan on starting a bachelor’s degree in a private school next September, does the diminished fee only apply to students from public universities or all students under 30 ? Or does it vary from school to school, whether public or private ?

    Have a nice day and thanks in advance for your reply !

    • Reply Bastien - Settle in Berlin 23/01/2017 at 15:24

      Hi Paloma, if you enroll in a university recognized by the German state, you will be able to benefit from the reduced fee.

  • Reply marat 16/01/2017 at 17:29

    hi Dan. thanks for the great article.. my question is a bit tricky. i am a student here, a non eu resident and i am 35.for almost five years insured over mawista student (private). after five years i am not allowed to have that private insurance no more… i just tried to communicate with aok over moving to their insurance but was said that i have nothing to do with them as i am over 30. i think i cant apply to.ksk as i am still at school. i have a tax id and actually working here over 4 years. would like to get an advice if possible.
    thanks
    m

    • Reply Bastien - Settle in Berlin 17/01/2017 at 09:41

      Hi Marat. It would be best if you talked to a professional with experience in Visa related issues since you are a non EU citizen. I don’t want to lead you into incorrect information that could impact your permit. best of luck.

  • Reply Terry Overton 14/01/2017 at 14:44

    Hi there,

    Very informative article, thanks for the taking the time out. Let me explain my situation, my wife and I moved to Berlin a year ago, me for my MBA and for her to work. She got her 5 year residence permit and work permit and thus is currently looking for work. I have just graduated and am also looking for work. So two unemployed married couple actively looking for work. She is covered by CareConcept AG as recommended by some people and myself am covered by AXA PPP international from London, I am British. We are thinking to switch her to another insurance company or go private. What would we be expected to pay per month in your opinion? Will there be anything stopping us getting public or private insurance as she is unemployed at the moment? Do you recommend staying with Care Concept? My thoughts are that the monthly premium is well below what Allianz or any other insurance company would charge so worries me that it is not a complete coverage.

    any help much appreciated

    Cheers
    Terry

    • Reply Bastien - Settle in Berlin 16/01/2017 at 12:28

      Hello Terry. It’s very difficult for me to guestimate your rate because (as mentioned in the article), it will depend either on your health profile or your income. With children, it is usually recommended to have at least one partner stay in the public system to cover them too. I can’t comment about Care Concept or other particular insurance companies because there are so many with so many different plans to suit different situations. You should probably get in touch with a broker with knowledge about visa issues if you are unsure. best of luck.

  • Reply Ana 08/01/2017 at 00:06

    This article is indeed very helpful! My husband and I were coming from the Netherlands EU and we bought a house in Emsland. I am from the Philippines and I have a resident permit in the Netherlands and wanting to change it to a German one. Both of us has no work and I am currently studying the German Language to find a Job later on. Now, we went to one of the Public insurance and they cannot accept us and they told us that we have to take Private Insurance which is very expensive for people who has no income although we have good enough savings. Has anyone here have the same problem? Any advice? Because its very stressful.

    Thank you!!

  • Reply Rubén 29/12/2016 at 13:02

    Hello, first of all I want to thank you for all your work in this page, its been really useful before moving to Berlin in a few weeks.

    I have one question regarding health insurance. My wife will be the manager of her company with enough income for both of us. In my case I’ll be looking for a job in the first months, so its not secure I’ll have an stable job by the time we choose our health insurance plan. I read that the best option for us its to choose a family public insurance plan, so my wife can insure me for free because my low income. Is it true? Whats the best option for us? I think its public insurance but im not sure.

    Thanks so much in advance,

    • Reply Bastien - Settle in Berlin 30/12/2016 at 17:11

      Hi Ruben. I would also recommend to go with the public scheme when first arriving to Germany. You can switch to private at a later point in time if it’s relevant to you. If you are a EU citizen, your home insurance can cover you until you find a job here.

  • Reply Meghan 26/12/2016 at 21:23

    Hi! Great post, I have been pulling out my hair trying to figure out what type of insurance I will need. I am starting an internship in February, and will be staying 6 months. I am from the US, so assume travel insurance will do the trick. Any suggestions on which travel insurances are the best to look into / purchase? Thanks for the advice!
    Meghan

    • Reply Bastien - Settle in Berlin 30/12/2016 at 16:59

      Hi Meghan, glad this could help. Since this is visa related, i wouldn’t dare recommending something that wouldn’t work out in the end. Google is your friend this time. 🙂

  • Reply Silva 22/12/2016 at 00:06

    Hi,
    I have had also some inconveniences with my public health insurance. My status has changed many times from student, freelancer, intern and potentially I will be a freelancer again the next year. So, please could you recommend me what to do: should I stay with the public health insurance (as an intern I do not have to pay), I used to pay 170 Euros when I was a freelancer months ago; but I am afraid that becoming again a freelancer again earning a little bit more than before, I will have to pay around 380 euros per month. It is very difficult to be compared options among health insurances as all of you have mentioned. Moreover, when I switched from student to freelancer at the very beginning the public insurance did a big mistake calculating my rate and they discounted me from my bank account 2000 euros. Fortunately, they recognised the mistake but took four visits (4 hours waiting in service offices) to fix the problem. I think they are efficient to charge you but not so fast to solve inconveniences with the rates for freelancer. Please could you help me to know what to do? For canceling the public health i need to decide asap because they will ask me to have another policy.

    • Reply Bastien - Settle in Berlin 22/12/2016 at 12:13

      Hi Silva. This is always a difficult choice when becoming a freelancer, or coming back to freelancing. I always advise to stay in the public system to begin with and switch to private only when you have a solid situation first, which can take years. Your rate will always be depending on your income. If you earn less than the minimum of 2178€ per month (Mindestbemessungsgrenze), you can let them know and they will find you a better rate.

  • Reply At wits end 11/12/2016 at 19:04

    Hi Bastien Settle in Berlin
    Thank You for this useful an informative site.
    May I ask I was previously self employed with an inconsitent low income and frequent invoice chasing for late payments. It has been tough and a worry to even cover rent payment. This has taken its toll. I had approached health insurance companies but I haven’t had any luck with getting a policy. Now I’m unemployed and Im determined to change my job situation asap but the arbeitsamt of course require I have health insurance. I have to go the health insurance and ask about p flicht versicherung..is this going to be impossible? Will i be completely refused . I’m not covered from my native country either.

    • Reply Bastien - Settle in Berlin 12/12/2016 at 09:35

      Hi there. You are in a dire situation indeed. It’s illegal not be covered in Germany and a Krankenkasse has to take you on board by law, even if you have limited means. I guess in your case, it would help to get a written statement from the Arbeitsamt saying you will get ALG1 or ALG2, which means it will pay for your health insurance too. It will probably increase your chances and let you avoid any questions for the Krankenkasse. Good luck.

  • Reply Amber 11/12/2016 at 11:12

    Hello! I’ve just moved to Berlin from Canada on a working holiday visa. In order to apply for the visa, I had to purchase one year’s worth of travel insurance to cover the full term of my stay here in Germany. Would I also need to apply for German health insurance on top of this? Thanks in advance!

    • Reply Bastien - Settle in Berlin 11/12/2016 at 15:28

      Hello there Amber, since it’s a limited stay, you probably don’t need to subscribe to a local health insurance.

    • Reply Lucila 09/01/2017 at 00:21

      Hello Amber!
      I am from Argentina, also on a Working Holiday Visa here in Berlin. I have the same doubt you had a month ago. Can you tell me what did you do finally?
      Thanks a lot!

  • Reply Bob 29/11/2016 at 13:26

    Hi there.
    Thanks for this its really helpful.

    [long comment edited by editor]

    I moved to Germany last year October 2015 and I freelance. I have public insurance which I find pretty expensive. 360 something a month. I dont make a huge amount a year but I get paid every few months in big amounts. Not that big but they get me through. Unfortunately I got paid in the last 2 months of the year 2015 when I got to germany and they took those 2 months income and determined my salary for the entire year.They have now asked me to pay 3000 extra and they increased my payments to 620 a month. Impossible to pay. Is there anything I can do? They calculated those 2 months in 2015 and are asking for the back payment on 2016 while increasing my monthly payments.

    Also can I get in on this Künstlersozialkasse (KSK)
    Im from UK and I live in Germany now freelancing with my family

    Any help would be appreciated.

    Thanks

    • Reply Bastien - Settle in Berlin 29/11/2016 at 19:17

      Hi Bob. I would simply reach to your Krankenkasse and explain your situation. They probably have a misrepresentation of your income and have to adapt to it by law. Concerning KSK: impossible for me to tell without more info about you. Your answer is in the post already too. Good luck sorting it out.

      • Reply Bob 30/11/2016 at 10:12

        Thanks for your reply:)
        I really appreciate it.

        Yes I have reached out so lets see and hope for the best.

        Thank you.

  • Reply Richard 23/11/2016 at 20:49

    Hi there,
    I am new to Berlin, on a 1 year working holiday from New Zealand. I am currently freelancing and looking at getting insurance. I have looked into private insurance but because I have an existing health issue (asthma) the private insurance companies have told me they can’t insure an existing condition… (seems a bit odd to me!) Is it possible to get on the public health system as a freelancer? The biggest concern for me is running our of asthma inhalers… :s is it possible to just go to a doctor and pay out of my own pocket? If so how much is that likely to be? Thanks 🙂

    • Reply Bastien - Settle in Berlin 24/11/2016 at 09:46

      Hi Richard, It it totally possible to get public health insurance as a freelancer as mentioned in the post. Concerning inhalers; i have no idea since i don’t know anyone with asthma but i can imagine that you’d get a note from the doctor that it might partly covered by the insurance.

  • Reply Max 27/10/2016 at 15:53

    Hi,
    Thanks for your post!
    I am an Australian moving to Berlin and had to buy 1 year’s Travel Insurance (very expensive) to get my Visa – will I have to sign up to German Health Insurance to get a tax card, or will my Anmeldung be enough?
    Cheers,

    • Reply Bastien - Settle in Berlin 28/10/2016 at 10:14

      Hi Max. I’m glad you liked the post. To my knowledge, there is no distinct link between having German coverage and obtaining a tax card. However, when you start working, you will probably need to switch to a Krankenkasse to renew your visa. As an employee, it will be quite easy to do. Best of luck.

    • Reply Lucila 09/01/2017 at 00:27

      Hello Max!
      I am from Argentina, also on a Working Holiday Visa here in Berlin. I have the same doubt you had a few month ago. Can you tell me what did you do finally?
      Thanks a lot!

  • Reply Terry 25/10/2016 at 14:32

    Hi,

    first of all thanks for all these info! more people should be like you.so my situation is i did the anmeldung and i am waiting for tax-id to be able to get the Steuernummer in order to issue invoices (i am working as a freelancer earning less than 600/month) i come from greece so i still have my EU insurance that will cover me for the rest of the year. I know it is illegal, but can i postpone the health insurance until i know if i m gonna stay in berlin? do you know how you can get caught and what happens if you do so? i am only planning to work as a freelancer in berlin

    thank you so much for your time!
    terry

    • Reply Bastien - Settle in Berlin 25/10/2016 at 16:50

      Hi there Terry. As you mentioned; if you are working in Germany, you should also contribute to the healthcare system. If you go on as you do, you will probably have to pay part or all of what you owe for all that time once you sign up with a Krankenkasse. In other words, if you sign-up in a year, they will ask where you were all that time since they will probably know you did your Anmeldung. They might ask you to pay up for what is a compulsory coverage. Hope that helps. Good luck. 🙂

  • Reply Eddie 06/10/2016 at 11:05

    Hi – thanks for this blog post, it’s confusing trying to navigate all the different German health insurance sites.
    I’ve just graduated and moved from the UK to Berlin about a week ago. I have angemeldet and my tax number should be on its way in the post. I’m working as a freelance translator (and may have to get a job on the side) and reckon I’ll earn between 450 – 550 € per month, at least to begin with. It sounds like private insurance may even be cheaper as an expat freelancer than state insurance? Also, do you know the regulations on getting some form of expat health insurance from your home country – would that be a viable alternative? At the moment what I’m earning is barely enough to cover rent and a health insurance where you pay something like 200 € per month. Because I’m freelance I won’t have an employer to help out with insurance costs etc.

    Thanks for your help!

    • Reply Bastien - Settle in Berlin 06/10/2016 at 13:54

      Hi Eddie, In your situation, i would take a part-time or full time job on the side that covers your health insurance until you have enough revenue as a freelancer to rely on this source of income. Your freelancing can be done “Nebenberuflich” in the meantime. Even with a private health insurance, it would cost you at least 250€ – 300€. Until you have found this job, you can probably rely on your NHS coverage from back home for a while. How long exactly i don’t know, try to look it up.

      • Reply Eddie 06/10/2016 at 15:06

        Thanks!

  • Reply Clarissa Chagas Gaiarsa 04/10/2016 at 18:27

    Hello there! I really like your blog and it has been very useful to clarify some things. I am Brazilian with Italian citizenship and working in Greece. I am moving to Berlin to study German, but I will continue working remotely for my company in Greece. They pay an insurance for me that can be used abroad. I will stay for 3 months initially (this is also the period that I rent the place for), and maybe longer, since I will apply also for a Master. What do you recommend in this case? Should I register and pay for the insurance?
    Thank you for the help!

    • Reply Bastien - Settle in Berlin 04/10/2016 at 19:01

      No need to pay an insurance here since you are covered by your greek health insurance system for now. If you do stay longer and become a student in Germany, you can register and obtain health insurance in Germany at a student rate, which is paid by the yearly fee for the Master degree at the University (if public university).

      • Reply Clarissa Chagas Gaiarsa 04/10/2016 at 19:37

        Thank you! And the Anmeldung, is it OK to do it later? I mean, in case I stay longer than the 3 months or should I do it right away?

  • Reply Mary 24/09/2016 at 18:19

    I have been living for the last year between London and Berlin.
    I am registered in the first flat that I moved into here since last December but moved out in April. I never got round to reregistering after that because I stayed in short term accomodation and then moved back to London, coming to Berlin occasionally for a couple of freelance jobs lasting for a few days each.
    I haven’t had health insurance yet because I haven’t been employed here.
    I have now moved back to Berlin for longer term and have a new flat that I want to register at.
    I want to register but realise I am still registered at the last flat that I left in April. Is it possible to deregister from that flat in “retrospect” so let them know that I haven’t been living there since April. I moved to London and don’t want to be liable to pay health insurance for the time I wasn’t here.

    • Reply Bastien - Settle in Berlin 25/09/2016 at 17:27

      You probably should go through the Ummeldung yes however, there are no concerns over health insurance fees as you are covered from your home coverage at home. No one will ask you any money in Germany given the fact that you are a freelancer. It’s not necessary to mention that you moved out in April, simply indicate the last place where you were registered when going to the Bürgeramt. Should be easy. 🙂

      • Reply mary jet anderson 26/09/2016 at 09:11

        Thankyou for the advice.
        Another thing, I now want to look for a job here and not be a freelancer. Can I wait until I’m employed until I deal with health insurance or do I have to sort something out in the meantime?

        • Reply Bastien - Settle in Berlin 26/09/2016 at 09:38

          Wait until you have found a full time job.

  • Reply Vijay 23/09/2016 at 01:12

    Hi
    I am an international student enrolled to a public insurance in Berlin. I will be submitting my thesis in march, (no defence) but I am planning to leave Germany by November .
    Can I cancel my Tk insurance in November , but still submit my thesis in march ?

    Thank you

    • Reply Bastien - Settle in Berlin 23/09/2016 at 09:43

      Correct me if i’m wrong but as student in a German university, is not the health insurance covered by tuition fees as well? In that case, you are covered until the end of the enrollment at no extra-cost, so why leaving early?

      • Reply Amelia 29/10/2016 at 12:28

        We need to pay the health insurance out of our own pockets.

  • Reply Joanna 17/09/2016 at 23:18

    Hey, we’re planning to move to Berlin, I will continued to be paid and taxed by my London based company, my fiancé has been self employed for 4 years in the UK and will continue this in Germany. Any idea what sort of health insurance we should be looking into? We might only be here till may before heading to Spain for the summer, we both have E111 cards and travel insurance, do you think this will be enough for 6 months? Should we register for an anmeldegung? We will be subletting or long term renting on Airbnb for the 6 months. Would love your opinion. Thanks, Joanna and Neil

    • Reply Bastien - Settle in Berlin 19/09/2016 at 09:28

      Hi there Joanna. If this is all short-term plans, you are fine with your NHS coverage and E111 cards. Unless you are planning to stay longer, i would not register in Germany like i mentioned in this article. I would look into Wunderflats for example too in your case, instead of Airbnb. It would probably be cheaper.

  • Reply ledio 13/09/2016 at 21:29

    Hello SiB,

    I have the european health insurance card given by italian health authority. I ‘m not italian citizen but I have an unlimited residence permit. I’m planning to relocate to Germany next month because I have a job offer. Do I still need a german health insurance?

    Thank you

    • Reply Bastien - Settle in Berlin 14/09/2016 at 10:09

      Hi Ledio. Yes. Your italian health insurance will cover you for the transition period when relocating to Germany, before you switch to a German health insurance. It will be paid by your employer.

  • Reply Ravi 09/09/2016 at 18:47

    Hello,

    I am on an academic research grant and just landed in Berlin (under 56k eu. payment). I am not sure that the American grant provider will pick up the co-cost for the public insurance. Perhaps it is easier to register for a private insurance? And if so, which is the best?

    Thank you!

    • Reply Bastien - Settle in Berlin 12/09/2016 at 09:42

      Hi there Ravi. My question to you is: who is employing you? Or are you still considered as a student? (honest questions; i don’t know anything research grants).

  • Reply A J B 31/08/2016 at 15:13

    Question: I’m an actress and a playwright /producer and a home owner in Berlin, so my situation is a little complicated. I now live in Berlin, and have a tax number associated with the meager profit made from rent when the apartment was tenated. Im told this tax number would change on becoming a resident, but drawing blanks on this. So as I now live here, I am seeing if i can find a way to make a living, but as with many, utterly clueless as to which health insurance (I’m from the UK, so never needed it either) and finding one that is affordable considering I’ve not yet earnt any money here yet. Also, i still get work on PAYE back in the UK, on short temp contracts, which I take to tide me over.

    When acting, I get paid a wage e.g. you get a daily rate, from which you pay out your tax (we don’t invoice).
    I’ve just had some extra work here, which again pays out a flat fee, not invoiced, and from which I would pay tax. They needed a Social Security number and I’ve yet to get one. Should I register therefore as a ‘Freelancer’ or ‘Job Seeker’ or ’employed’? I’m also aware that there is a body called the KSK that helps with emerging freelancers. Again, as earnings are so far few and far between, and that I still work in the UK, can I take ‘payment breaks’ when back home? And if I am earning little here, am I exempt from payments?

    Bit of a jumble, but as mentioned, my situation is not straight-forward and no one seems able to give me a clear indication of how to proceed.

    Thanks in advance for any input.

    • Reply Bastien - Settle in Berlin 01/09/2016 at 12:48

      If you are serious on moving to Berlin long-term then it makes sense to register yourself as a freelancer in Germany. You will then bill companies in the UK from Germany. If you are freelancer earning less than 18K a year (not exact amount mind you), then you are entitled to the “Kleinunternehmer Regelung” which means that you bill without V.A.T in Germany too. Concerning health insurance, you can register with the KSK yes, which helps freelancers and particularly artists to cover part or whole of their health insurance fees.

      • Reply A J B 15/09/2016 at 13:13

        Many thanks for the reply.
        As a UK national I believe I can enrol in the Public Health Insurance, if done within the first three months of being here, as i come from a Country that has public health insurance. The excellent Expath online tutorial mentions this as a possibility. During this time my EHIC card covers me, I’m told. So presently looking into this as an option. My concern is if I go private, my earnings simply will not cover living costs and health insurance costs. Brexit has understandeably made all us British expats nervous as to what the years ahead involve, and to sink such large sums into a system that we may not be able to draw on, e.g. pensions, is a concern. The other option is to de-register and return to the UK, keeping my flat as a kind of ‘holiday home’ where I come for regular periods of time to work on personal projects.

    • Reply Alexander von Engelhardt 01/09/2016 at 14:02

      Hi,
      When living and working in Germany, you must have permission unless EU citizen. You have to correctly register your type of income — be it freelance or employed. “Job seeker” does not typically have income because he is seeking a job. The KSK does not help emerging freelancers but is the old-age scheme for artists in Germany and also to some degree pay you. However, when you want to register with them you have to prove you are a freelancer — i.e. with tax number and tax identification number. You mentioned to have received a tax number. I further presume that you have not (yet) registered any business therefore what you received is only your tax — identification — number. They are not asking for that number.

      Good luck with your plans
      Alexander

  • Reply Sophie kim 11/05/2016 at 12:36

    Hi, thanks for hat tips, but here is another question.
    Before I came here with Work-holiday visa From South korea, I already signed up to International Medical Insurance that covered up in Europe.
    According to website, Seemingly I can print out some documents to issue out ID Card for that one.
    Still Do i need to contract with another german health insurance for that ?

    • Reply settle_in_Berlin 11/05/2016 at 14:09

      It depends on your situation. If you plan to stay in Germany and have residency there, you will need to switch to a local health insurance company (Krankenkasse) which will be paid by your employer or yourself, if you are self-employed. If you leave after your visa is expired, then you are good.

  • Reply Andy 07/12/2015 at 09:51

    Hi SiB,

    Thanks so much for this informative site. I have been in Berlin for a few months and am now planning to take the plunge and actually register/ anmeldung. I assume as a consequence I will need to be covered by Health Insurance.

    Seeing as I am seeking full-time employment (and thus have an income of €0) – which of the options would be most suitable for me? Would I still be covered under my EHIC post-anmeldung? Is there a specific cover for designed for job seekers?

    Thanks!

    • Reply settle_in_Berlin 07/12/2015 at 17:34

      It’s hard to say without knowing your precise situation. If you had some kind of health insurance before from your home country and it’s still valid, keep it until you have found a job that will take over those expenses. If you haven’t worked before in Germany, you have not earned any rights to coverage through unemployment benefits yet.

    • Reply sarah 25/11/2016 at 09:51

      Hi Andy, I know this is a year old comment but I moved to Berlin and am in exactly the same boat as you were. I was wondering what you ended up doing in the end?

  • Reply Franz 17/11/2014 at 16:19

    Hya all,
    I you want to learn more about all the legalities, I have started an encyclopedia on that: http://www.lg2g.info/
    BTW: the € 10 issue has been abolished a couple of years back… Anyhow a nice site!

    • Reply settle_in_Berlin 21/11/2014 at 09:43

      Fixed. thanks. forgot to update.

  • Reply Sandra 08/09/2014 at 20:41

    Hi,

    Can you clarify, which comes first? The Tax ID number or the Health Insurance number?

    Thanks,
    Sandra

    • Reply settle_in_Berlin 09/09/2014 at 14:09

      Hello Sandra. I don’t there think there is a particular order. However, if it’s your first job, it is likely that the Tax ID number will have to come first as you need to get a job to be covered.

      • Reply Sandra 09/09/2014 at 18:02

        Thanks!

  • Reply Dan 22/04/2013 at 14:15

    I think you should add how health insurance relates to residency permission. It is a requirement for getting a residency visa. The specifics, like whether you need dental coverage seem to be unclear and the enforcement is non-uniform. It would be great if readers could submit their real quoted costs. Health insurance is one of few products whose costs vary widely but cannot be compared easily without the help of a nice person like yourself.

    • Reply settle_in_Berlin 28/04/2013 at 18:26

      Hi Dan. Thanks for pointing that out. I must say that i’m pretty unexperienced regarding visa requirements as i am a EU citizen. Blessed be Europe for that ! 🙂
      I’m looking at gathering info for non EU citizens on topics like visa and health insurance but time flies by and it’s hard to get things done lately. You are welcome to help. I think dental coverage is not compulsory however, as not all krankenkassen cover those expenses.

    Leave a Reply