Picking the right private health insurance in Germany
Freelancers and high-earning employees are free to pick private health insurance in Germany over the public statutory system. This is specificity of the German healthcare system not a decision to take lightly.
What follows is designed to help you reach an informed decision. At the end of this guide, you will be able to weight pros & cons of going private, have an overview of important contract clauses & how to pick the right policy for you.
Picking the best private health insurance in Germany: TL;DR
The best private health insurance plan in Germany is one that fits your needs. That’s why it’s a complex topic with many variables. Take your time to read the full guide but here are the main points to remember:
- You should consider private plans only if you expect a high income, if you have no other choice for now, or if you plan to leave Germany before retirement. This is because premiums rise dramatically over time.
- People who are privately insured, as opposed to those who have statutory insurance, can cover only the services that are relevant to them. We have a comprehensive list here to help you decide which ones are important for you.
- Don’t rush that decision: carefully read this guide first to determine whether private health insurance really is the best long-term option for you: Switching to private health insurance in Germany: consider this first.
- When going private, take your time deciding which benefits you actually need. This is difficult to change later. It’s also impossible to switch providers without substantial losses/drawbacks.
- It’s difficult to navigate this topic alone. Meeting with a neutral advisor is really recommended and well worth the investment. We tell you how to find neutral & honest advice.
- Choose a strong insurance company, financially speaking. This is important to keep your costs low in the long-run.
- Popular providers with newcomers in Germany are Feather & Ottonova. That’s because they cater to that particular segment with service in English, a fully digital experience & good customer support. But again, do your homework first.
Feel free to ask questions in the comments too. I gladly answer them.Bastien
Going private: this is what you get
Everyone must weigh the benefits and drawbacks of private health insurance in Germany for themselves. As a reminder, here are the most compelling arguments for and against private health insurance. You can also read a more detailed overview in this other dedicated guide: public vs private health insurance in Germany.
Preferential medical care and treatment
Access to top medicine, also with specialists, is usually better with a private health insurance companies. When it comes to scheduling appointments, doctors also prioritize private patients since they earn more for the same service.
Guaranteed treatments and benefits
You can select a private health insurance plan with the features that are important to you. As a result, you get the coverage you want, as long as you can afford the pay the premium. The benefits outlined in your contract are guaranteed, which is not always the case with statutory (e.g: dental coverage has decreased a lot with public providers).
Great for the young & healthy
German private health insurance is best for the young and healthy. Unlike statutory health insurance, is not a solidarity-based scheme. It’s based on risk profiles. When the risk is low (young & healthy), so are the premiums, which can be cheaper than with the public system, given the right conditions. However, in the event of serious illness, pre-existing conditions or old age, this can become a true money pit.
Private insurers have the right to refuse customers, demand fees, or exclude certain illnesses from insurance coverage if they believe the risk is too great. Statutory health insurance must cover everyone.
Contribution is not related to income
Insurance premiums rise over the years, partly because health care is becoming more expensive. Between 2013 and 2023, premiums rose by an average of about 2.8 percent per year, according to industry reports.
If for some reason or other, your income suddenly drops when you are older, you still have to face high insurance costs. It’s a high risk to take, unless you are sure to move out of Germany by that time.
It is best to set aside a fixed monthly amount early on just for health insurance in old age. Otherwise, the monthly costs can grow over your head if you only get a small pension, even with so-called “old age reserves” (Altersrückstellungen) companies put in place. They do not cover the increased costs of medical progress and general inflation in the future.
Statutory is objectively better in some regards
Many people are surprised to learn that even of the best private health insurance policies in Germany do not provide complete protection. It is true that they are substantially stronger than statutory health insurance funds in several areas, such as doctor’s fees. But for psychotherapy and physiotherapy for example, there are sometimes gaps that statutory health insurance funds cover automatically.
Furthermore, you should also keep in mind that private health insurance does not provide family coverage. You’d need to cover each family member separately. Public policies cover family members at no extra costs.
Life-long commitment to a company
Another downside is that you are nearly inextricably linked to a single organization. If another insurance company offers better terms over time, switching to that company is not financially feasible because by then, your older age will probably play against you. The same is true if you are frustrated with your supplier and its service.
If you switch insurers, you can only take a portion of the age-related provisions (Altersrückstellungen) with you. This means you’ve been paying a higher premium for years for nothing in order to provide for your retirement.
You can in theory switch if you are unhappy, but in practice it’s quite difficult.
Pay out of your pocket first
Even with the best private health insurance in Germany, you must foot the bill first. Only then will your health insurance company reimburse you.
Disputes are common during the billing process. Doctors may charge for treatment treatments that the insurance company does not cover. The costs are then your responsibility.
Patients frequently fight with their insurance company over excessive medical expenditures or if they were medically justified. For years, these two issues have been at the top of the list of causes for complaints with private health insurance providers in Germany.
Do this before picking a provider
Finding a the best private health insurance provider in Germany for your lifestyle can take some time: that is ok. Putting in a few days of work pay off, when you know much money you can save with your research.
Step 1- Make sure private health insurance is right for you
Siding with private health insurance has life-long consequences. You need to be sure that switching is the right choice for you in the long run. Remember that it is only worth it for a minority of cases: 10% of the German population is in the private system.
We have made a detailed guide to help you decide whether your situation would benefit from going private: how to decide if private health insurance is right for you.
If your decision is made: move onto the next steps.
Step 2 – List treatments and benefits that are important to you
The best thing about German private health insurance is that you can tailor it to your own needs. The contract benefits are guaranteed for the duration of the contract. It’s important to decide what goes into that or not.
To help you with deciding what should be included in your policy, you will find below a list of common benefits/clauses/treatments included in most contracts. They are identified in 3 groups:
- Must haves
- Very important
- Up to for consideration based on your personal preferences
- Not recommended for most
Doctors’ fees (Arzthonorare) – Doctors in Germany charge according to a regulated scale for doctors (Gebührenordnung für Ärzte – GOÄ) or dentists (Gebührenordnung für Zahnärzte – GOZ). For most treatments, it is sufficient if the insurance refunds the standard rate and the maximum rate on that scale. If you also want to insure treatment by specialists, private clinics or abroad – i.e. what goes beyond the benefits of statutory health insurance – then you should choose a tariff that also reimburses above the maximum rate or without reference to the fee ordinance.
Choice of doctor (Arztwahl) – Some companies impose certain doctors (like a certain mechanic for car insurance) otherwise, the insurance company can reduce its benefits. With a free choice of doctor, on the other hand, you can go to any doctor you’d like. Treatments by so-called medical auxiliaries (Heilhilfsberufe) like physiotherapists or or ergotherapists are also only covered if this is explicitly stated in your contract.
Medication (Medikament) – Pay attention to possible deductibles or limitations on reimbursement. The best private health insurance in Germany don’t limit this to generic drugs, i.e. imitation drugs. All brands should be covered.
Dental benefits (Zahnleistungen)– The insurance conditions distinguish between dental treatment, dentures and orthodontics. Sometimes there are different rules and reimbursement levels for each area. Also keep an eye on the so-called dental scale (Zahnstaffel): it puts a cap of refunds in the first few years. Make sure this is waived in case of an accident.
Medical aids (Hilfsmittel) – These range from life-sustaining aids such as respirators to so-called body substitutes (prostheses, artificial eyes) and wheelchairs. But orthopaedic aids such as walking aids are also included, as are glasses or diabetes related devices. Look at all aids to see to what extent they are reimbursed and think about how much they will cost in 20 years time.
The overall list of included aids can be in a closed catalogue (defined set of devices that cannot forever) or in a open catalogue (evolving set that include future innovations/devices not yet invented). As you can imagine, an open catalogue is preferable but also more expensive.
Treatments abroad: when you travel or visit family back home, you should also make sure that the coverage of costs is not limited to the German level. Otherwise you may be stuck with higher bills.
Area of coverage (Geltungsbereich) – This is particularly relevant to use foreigners. This is good to have if you want to work abroad or even live there long-term.
Most contracts are valid only in the entire EU. If you leave these countries for a longer period of time, you have to check under which conditions the contract remains valid. Even a three-month trip can lead to the contract being cancelled! Otherwise, an additional travel insurance might be a good idea (for only a few euros per year).
Daily illness allowance (Krankentagegeld) – People who earn a lot of money or who work as freelancers should get daily sickness allowance insurance. This is frequently the only means for the self-employed to cover a temporary loss of earnings due to illness. Employees continue to be paid by their employer for the first initial six weeks. Past this date, your own allowance takes over.
Preventive examinations/vaccinations (Vorsorgeuntersuchungen/Impfungen) – Preventive examinations such as early cancer detection are also covered by every private health insurance policy. Vaccinations, on the other hand, must be listed separately in the insurance conditions. The scope should at least correspond to the recommendations of the German vaccination commission.
Clinic stays (Stationäre Versorgung) – For this, you should choose a clause that does not limit the reimbursement of hospital costs according to regulations. They are called Federal Nursing Rate Ordinance (Bundespflegesatzverordnung), the Hospital Fees Act (Krankenhausentgeltgesetz) or the so-called flat rate per case agreement (Fallpauschalenvereinbarung). That’s what you get by default on the public system.
Some insurers have a clause that requires patients to report their stay in hospital within a certain period of time – otherwise the benefit will be reduced. Pay attention to that too.
Transportation (Transport) – This refers to transportation to and from the doctor’s office or hospital. Even if you are merely treated as an outpatient in an emergency or for initial treatment following an accident, transportation costs should be insured. Make certain that all modes of transportation are covered, with no cap, with no restrictions on the transit route, the nearest treatment provider.
Psychotherapy (Psychotherapie) – This treatment is generally included in the conditions as medically necessary, both in a clinic/ward or in practice However, most providers limit the number of possible sessions, especially with practices. By comparison, statutory health insurance pays for between 60 and 160 sessions for long-term therapy.
Other therapies – like physiotherapy, podology , speech therapy, occupational therapy should be insured. Make sure that not only doctors but also therapists are allowed to treat you.
Based on your personal preference
Alternative medicine/therapy (Heilpraktiker) – Many providers only pay for alternative practitioners to a limited extent because this category of professionals is largely unregulated. If this is important to you, you should ask what the contract says about this.
Private room during hospital stay (Einbettzimmer): Spending a hospital stay in a single room is more comfortable. Keep in mind that it does not change anything to the level of care you will get from doctors and nurses.
Glasses & contact lenses, eye surgery (Sehhilfen) – Check if the contract reimburse the costs for glasses, contact lenses or laser treatments.
Deductible (Selbstbehalt) – Your monthly contribution is reduced if you have a larger deductible. You can save money if you rarely need to go to the doctor. However, in order to compare the rates of different tariffs fairly, the deductible should be included in the premium. You will most likely have to pay it in full at some point. You should also be aware that certain treatments, such as dental, may have additional deductibles.
Beware: A large deductible can only be reduced with a new health check, which is difficult as you get older. Don’t raise your deductible to thousands of euros! You may come to regret it when you retire. But then again, you will stay in Germany long enough to care?
Watch out for small prints, they can be misleading. For example, when the provider conditions refunding a treatment on the basis of a prior agreement on a case by case basis. That usually does not play in your favor. That’s another way to say “Yes, we cover that but …”. That’s not the mark of the best private health insurance providers in Germany.
Usually not recommended for most people
Contribution price relief (Beitragsentlastung) – Many private health insurers offer a premium relief policy in order to decrease the typically high private health insurance premiums in old age. This implies that in addition to your usual premiums, you pay your provider more money, which they save for you. In exchange, when you retire, the provider reduces your monthly payment by a certain amount. That could be relevant if you don’t plan to retire in Germany.
However, when you retire, you will still be required to pay the relief tariff premium. Subtract it from the promised premium relief to determine how much less you would pay in retirement.
A reduction in donations makes little sense in most circumstances. If you have not yet used all your employer’s contribution, you may be eligible for a lower contribution rate. In general, it is preferable to put money aside for yourself and invest it in stocks, for example. You will earn a better return this way, and your investment will not be lost if you die or quit the PKV.
Switching options (Wechseloptionen) – Under specific conditions, some providers will allow you to increase your insurance coverage or lower your deductible without a health check and waiting time. This is referred to as an option. It can be beneficial in 2 cases:
- If you initially choose a contract with less benefits. You can raise those at a later stage.
- If you believe you can leave private health insurance later. You can turn your contract that can be converted into a private supplementary insurance. This way, your accumulated age reserves will not be lost if you switch back to statutory health insurance.
However, keep in mind that you may only use the option within a specified framework. Dates, age limits, or life events, such as marriage or becoming a government employee, are generally defined. If you miss the deadline, you will lose the ability to change, even with the best of private health insurance in Germany.
Step 3: Finding the right contract
You now have an overview of the benefits that private health insurance can include and which ones are important to you. Now let’s look for a provider!
There are many different private health insurance plans – all with different strengths and weaknesses. The one tariff that optimally fulfils all your wishes probably does not exist. That’s why you have to weigh up and compare to find the best private health insurance plan in Germany for you. It’s a complex process but this is something you don’t need to do you on your own.
- Independent advisors can help you do that, provided they give you neutral and honest advice. They can also give you an idea of the experience with individual companies, how they deal with their customer and health questions. You can also turn to reputable brokers catering to foreigners in Germany like Feather Insurance.
- The process can take several hours but it is worth the investment, saving you a lot of money in the end.
- Insurance advisors are preferable to insurance brokers because they are not given the same incentive during consultation. An insurance who provides private health insurance often receives a commission of eight to nine monthly premiums. This is thousands of euros or more. In contrast, you pay a fee to an insurance advisor yourself of 200€ to 300€. This is the cost of neutral advice.
Step 4: Picking the right company
Once you have made a short list of 2 or 3 providers, it is important to consider how the company itself looks.
- It’s good to think a little conservatively here. You want an insurance company that has been doing that for a long-time, with solid finances.
- Good financial reports published by the company can give an indication of how the premium may develop in the future, but there are still no guarantee.
- Some private providers also are running as non-profit companies. They redistribute the surplus of premiums to their members each year.
- Again here, it’s best to discuss this topic with a trusted advisor.
- Ottonova is an all-digital, English-speaking private provider that is popular with newcomers and foreigners in Germany.
About the costs
The costs of private health insurance depend on your age and your health when you take out the insurance, as well as on the particular contract conditions you picked. It’s impossible to give you quick estimate, but here are some numbers to “guesstimate”.
|Monthly contribution for a single healthy 35-year-old|
¹ with a deductible of 400 to 600 euros per year, 110 euros/day sickness benefit from the 43rd day
² with a deductible of 600 to 960 euros per year, 110 euros/day sickness benefit from the 43rd da
Again, the monthly contributions might be cheaper in the short run (compared to staturory), but it must be worthwhile in the long-run too!
I congratulate you if you’ve read this guide all the way down! I tried to keep it as concise as possible. Feel free to let me know how to improve or if you have questions in the comments.Bastien
FAQ – best private health insurance in Germany
In some areas yes, and in some others no. Private patients do get faster and better access to GPs and specialists but they bear an enormous financial risk. Some alternative therapies are better covered but family members are not included in the policy, unlike in statutory. You need to look at your facts of life and decide if it’s relevant for you. For the vast majority of the population, public remains the best option.
The unfortunate answer is that it depends entirely on you! Going private means that your personal preferences and your health profile determines which policy is best suited to you. Finding the right policy takes a little time: follow the steps outlined in this post to do just that.