Health insurance is mandatory in Germany. The health system consists of mandatory, voluntary and private schemes. The best health insurance option in Berlin for you will depend on your income and health profile. In some situations, you can only enrol in one of the schemes.
Before you move to Berlin, it is important to understand the health insurance requirements that need to be fulfilled. An independent health insurance broker can give you individual advice in your particular situation. Remember that health insurance is mandatory from the day you enter the country.Any third-country national moving to Berlin needs health insurance for VISA and work permits. Depending on how long you plan to stay in Berlin, many also choose to opt for expat health insurances specially designed for short stays, but who also comply with the German law and VISA requirements.
German Health Insurance Options
Your insurance options in Berlin largely depends on your income and job status. There are two statuses that you can fall under:
- Compulsory insurance (Pflichtversichert); or
- Voluntary insurance (freiwillig versichert).
Expat health insurances are generally specifically designed to obtain a VISA and residence permit. Private health insurance plans, on the other hand, help you save for your future. You will pay a bit more now so your insurance cost will not increase later.But most expats stay for a shorter time and thus do not need to set this aside and instead benefit from a lower price. This is called Alterungsrückstellung, or “ageing reserves” and international health insurance plans don’t have to build these ageing reserves - thus making them a cheaper option.The Berlin Ausländerbehörde (foreign residency office) provide information and help with your work and residence permit. But somehow there is sometimes a bit confused about which type of health insurance is acceptable in Germany.
Compulsory Health Insurance in Berlin
If you are an employee in Berlin and make below €64,350 per year (2022), you must be compulsory insured through public health insurance. This means that public health insurance companies must accept you and you are unable to be privately insured.
Voluntary Health Insurance in Berlin
If your income in Berlin is more than €64,350 per year (2022), you are voluntarily insured. In this case, you can choose to have public health insurance or private health insurance. Private health insurers are not obliged to accept voluntarily insured persons.
Public Health Insurance in Berlin
The majority of German residents (approximately 90%) have public health insurance. Public health insurance is referred to as statutory insurance or GKV (gesetzliche Krankenversicherung). The insurers are non-profit companies and together make up the sickness fund (Krankenkassen). This also means that you can choose any public health insurer.
The price of public health insurance, or compulsory insurance, is based on your income up to a maximum of €58,050 (assessment ceiling or Höchstbeitrag). You pay between 14.6% and 15.6% insurance of your income each month.
If you fall under the voluntary insurance option, there are some things to consider if you choose public or private insurance. For example, public health insurance covers also dependants. But the cost of private health insurance is based on health, so a healthy young adult will pay less than a senior citizen for the same benefits.
Public health insurance is also easier to manage. When visiting a doctor you just show your insurance card.
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Private Health Insurance In Berlin
As an employed person, you can only have private health insurance if you are voluntarily insured. Only about 10% of residents in Germany have private health insurance. If you are insured under private health insurance in Berlin, it is referred to as PKV (private Krankenversicherung) and you must meet the salary requirements of more than €64,350 per year (2022).
The price of private health insurance is largely dependent on your age. This means that younger healthy adults are likely to pay less compared to older persons or persons insured under public health insurance in Berlin.Although private health insurers often provide much better service, treatment facilities and less waiting time, it is important to note that pre-existing health conditions are not covered compared to public health insurance.Private health insurance also has a deductible and works on a refund basis. The deductible is what you pay and the insurance company covers anything above this. But it means you need to show receipts and documents in order to get a refund.For expats and freelancers in Berlin, it is often advised to speak to an insurance broker. They offer advice in English, opposed to many public health insurers, and can guide you to what the best option is for you.
Health insurance For freelancers in Berlin
Employees pay only half of the insurance contributions themselves, the other half is covered by the employer. Freelancers, or self-employed persons, must pay these monthly contributions themselves. This is the reason why health insurance often seems more expensive for freelancers.It is also important to note that public insurance companies are not obliged to cover freelancers. This is the main reason why freelancers from non-EU countries moving to Berlin find it very difficult to get insured under public insurance. The majority have to choose private health insurance coverage because of this.
Public health insurance might be an expensive option for freelancers since they have to pay full amount of contributions, compared to employed persons where the employer covers 50%.
Health insurance For expats in Berlin
Since health insurance is mandatory in Germany, expats are required to have valid health insurance coverage when applying for a VISA. It is important that health insurance is valid from the time you are entering Germany.There are special expat health insurances that fulfil the legal requirements for obtaining a VISA or residence permit in Berlin.
Health insurance For students in Berlin
If you are are going to study in Berlin and are an EU citizen, you are already covered by applying for a free European Health Insurance Card (EHIC). In this case, you are sufficiently covered and do not need to apply for health insurance until you start work.Students up to 30 years of age receive a special student rate and pay less. Students under 25 years of age and earning less than €450 per month can also use their parents' public health insurance (since it covers dependants automatically).A student over 30 years of age might find it difficult to get public health insurance since they are not obliged to insure you anymore. In this case, you may be forced to choose private health insurance. Otherwise, the rate of your health insurance will be a minimum contribution. Student rates do not apply anymore.
The downside of International Health Insurances
The Berlin Ausländerbehörde sometimes claim that International health insurances are not acceptable in Germany. However, as long as they are compliant with §257 SGB V, §61(6) SGB XI, your international health insurance is valid.International health insurance providers in Berlin are generally also offering these plans with a limited lifespan of 5 years. They are geared for expats that stay in the country for a limited amount of time. The downside of this is if you develop chronic or other serious diseases, you are unable to switch to a private health insurance plan because they don’t cover pre-existing health conditions.
Special Expat Tariffs for Non-EU citizens
The German law states that only persons with a limited residence permit can sign up for expat plans. Since EU-citizens can take up residence in Germany without a VISA, only third-country nationals can benefit from these special rates.EU citizens have sufficient coverage by applying for a free European Health Insurance Card (EHIC).
Private hospitals and health centres in Berlin
If you have private health insurance in Berlin, you are usually free to choose any private hospitals, doctors and health centres. Furthermore, if your plan includes out-patient treatment, you also have included consultations with a doctor, diagnostic tests, physiotherapy, vaccinations, drugs and more.Although you should always make sure which services and private hospitals and doctors are included in your coverage, here are a few English-speaking clinics and hospitals in Berlin:
Martin Luther Hospital
Address: Caspar-Theyß-Straße 27-31, 14193 Berlin, Germany
Deutsches Herzzentrum Berlin (DHZB)
Address: Augustenburger Pl. 1, 13353 Berlin, Germany
Vivantes Klinikum Spandau
Address: Neue Bergstraße 6, 13585 Berlin, Germany