Germany expat health insurance: know this to inform your decision

Expat health insurance for Germany: after some research, it looks like this is the one thing you still need in long list of requirements for your visa application.

German authorities are asking you to cover health risks during your stay in Germany. It makes sense but it’s hard to be sure because German health insurance is a complicated topic.

This guide aims at clarifying what is meant by “expat insurance” in Germany, whether it’s relevant to you, what to pay attention to and which providers to recommend.

Feel free to ask questions in the comments too.

Bastien

Germany expat health insurance: TL;DR

You can dive into the details of this topic. Here is a short summary:

• The so-called “expat insurance in Germany” is a private insurance policy specifically designed to meet the requirements of the local German health system & of the immigration office.
• It is relevant for newcomers to Germany who need their visa approved: students, job seekers, freelancers, au pair, visiting professionals.
• It’s also relevant for anybody (incl. EU people) that need a temporary solution until they can get a proper Krankenkasse in Germany.
• It’s not welfare: you need to advance medical costs yourself and get a refund afterwards. Most important services & treatments are covered, but there are caps and premiums on other things.
• It’s much cheaper and flexible than local health insurance policies but it can be only be used for a maximum of 5 years. It cannot be used to renew residence permits.
• You will need to switch to a local provider eventually. It’s more expensive but it’s better coverage.
• Feather & Ottonova are trusted & experienced providers with a great digital service. Service 100% in English, fast certificate delivery. Read the fine prints before committing.

What expat insurance really is in Germany:

It’s a private insurance that meets the basic requirements for residence titles defined in the German residence act (Aufenthaltsgesetz – AufenthG section 2). They meet the same standards as a normal health insurance providers, specifically:

• It should not cap the reimbursements when the insuree is sick.
• It should not contain special contract terms regarding expiration or indemnity related to age of insuree, activities or occupation, changes in residency title.
• It should not ask unreasonable payment excess to the insuree.
• It should not exclude the insuree from standard benefits (as per local definition)

You will need to read the small prints in your contract but most often than not, you can expect the following things to be covered:

• Hospital treatment and emergency services
• Medical treatment at the doctor and common medication
• Medical equipment such as walking aids or wheelchairs
• Transportation to the nearest hospital
• Funeral or transfer/repatriation expenses.

“German expat health insurance” is not really a good name for it. It is sometimes called something else depending on who you talk to: “incoming insurance”, “expat insurance” or “travel insurance”.

I personally think it’s best to call “temporary German health insurance” because that’s really what it is.

German expat health insurance is not welfare

As you can tell, it’s not health insurance as typically defined in a welfare state type of situation. Think of it more as a money-back guarantee when you have medical expenses in Germany. For example, if you need medication like antibiotics, you would first pay for it out of the pocket, and then send the bills to your insurance company, which then pays the money back to you.

The experience is not all the same than just showing your German national health insurance ID at the doctor and popping to the pharmacy, the rest being taken care of on its own.

The good: cheap and flexible

German expat health insurance is designed to be accessible to those who don’t have local options, and this at a substantially lower price: up to 5 times cheaper in some cases. Expect prices ranging from 80€ to 200€/month, instead of 300€ & upwards.

Contract terms are also pretty friendly: you can usually cancel without much notice period and with no fee.

Most of all: those policies are designed to get approval from immigration service.

The catch: interim & limited only

Expat health insurance is a short-term solution because it cannot be valid longer than 5 years. It can help you get your first residence permit, but you cannot renew. You will eventually need to switch to a proper health insurance provider, as detailed in the next section.

Also in plenty of cases, refunds are capped and/or premiums are high for things like:

• Dental treatment
• Prostheses
• Auxiliary remedies or transportation back home.
• Pre/post natal care, childbirth
• Physical therapy
• Pre-existing conditions

Reading the fine prints is important.

Who should consider this

The typical user for an expat health insurance in Germany is one of those profiles:

• Foreign students coming to study at a German university.
• People coming to Germany for an internship, language course, as an au-pair or visiting scientist.
• People coming to Germany on a freelance visa or a job seeker visa.
• People who don’t yet have full-time employment in Germany.
• EU citizens & third party nationals moving to Germany for the first time, with no other insurance alternative for now.

These profiles all need a proof of health insurance to live in the land of Goethe. They all have in common that they might stay for a short while and/or are not sure to settle permanently here. Hence the name “Expat insurance for Germany”.

Language students wanting to enroll at a German university later

A typical case: first come for a language course and get the required German level to apply at university. You can get a visa with an incoming insurance but as soon as you enroll at a German university, you will be insured by the statutory health insurance (costing about 120€ per month), and get better coverage. You can also decide to stay with the incoming insurance within 3 months after your enrollment, but you are then stuck with it until the end of your degree.

Students aged over 30 or starting their 15th semester of study

Such profiles are not covered by the student version of the German statutory insurance and must pay full price (350€/month minimum). That’s a lot to cough-up but keep in mind what was discussed above, it may makes sense too if you have a family for example. If you are single, then to stay on expat insurance in Germany may make sense too for your student visa.

Job seeker visa applicants

You have no income in Germany yet and you aim to find a job here when applying for a job seeker visa. During your job search, you can be covered under the German expat insurance policy. When you do find a job, this means that it will also pay for your health insurance, at which point you can switch to the public statutory health insurance scheme.

Au pair, interns and visiting scientists

Those profiles will be in Germany for a very limited stay so there would be no reason to invest in a more expensive insurance scheme than an German expat health insurance.

In case of major accident

Life is tough and stuff happens. It’s not a big deal to cure an ear infection, but what if you need a major spine surgery? Emergencies like this are covered too. Such procedures are naturally a lot more costly and this is where we can see the limits of the typical policy for an incoming insurance for Germany.

Why switching to local providers

Switching to much more expensive policies from local health insurance providers is sometimes difficult. It is something I often hear when discussing this topic with newcomers on Facebook, Forums or Reddit.

It is true that it looks like a bad deal when first looking at it. Both expath health insurance for Germany and local health insurance fulfill requirements for the purpose of your stay in Germany. Why paying up hundreds of euros more? That’s a lot of nice week-end trips!

As mentioned earlier, although it fills the same purpose, there is a big difference in coverage:

• A local policy will have no caps and you won’t even need to pay anything from your own pocket (when switching to public.). If you run into serious health trouble that can certainly make the difference.
• Pre-existing conditions don’t increase your premiums (public).
• You’ll have access to more specialist and health professionals.
• A public local health insurance company will cover you and your spouse and children under one policy, for the same price. An incoming insurance for Germany doesn’t do that by default.
• Most importantly: you won’t be able to renew your visa or apply for permanent residency with a policy like this. Visa renewals require a local health insurance provider.

German expat health insurance providers to consider

If you have made your research, you might have heard of established brands like Mawista or BProtected. Those are valid options but can be sometimes lacking in some areas, and it’s not guaranteed the consulate will accept it.

I can strongly recommend Feather Insurance & Ottonova who have closely looked at the experience of foreign nationals in Germany during their visa applications to come up with the best expath health insurance policies for German authorities.

Their policies have been specially designed to guarantee a successful visa application and help you transition your way into the German system. They have the following benefits:

• Confirmation same working day as sign-up.
• Cancellation any time – you’re not locked in like with other providers
• Works for first time visa guaranteed (we attach an extra letter for the visa office), often up to 3 year visas!
• Simple switching to public or private German based coverage possible, once you are established.

Reviews are also very good, so at least check it out. and naturally 100% serviced in English.

I hope this post made sense out of a confusing and sometimes obscure topic of Germany expat health insurance. If something is not answered here, feel free to ask questions in the comments.

Bastien

Source: 1, 2, 3, 4