Insurances in Germany: what's mandatory for foreigners & how to apply

10 min read

If you are moving to Germany, you are required by law to have health insurance. Find out how to apply for medical insurance in Germany and which other insurances you need to consider.

Andrea Roth Last updated on May 6, 2022
Illustration of a house and a pile of gold coins on a scale as a metaphor for insurance

Types of insurances in Germany: only 3 are mandatory!

You may have heard a rumor that Germany is the nation of insurance. As it is often the case, there is a grain of truth in this bold statement. The German insurance system offers a large variety of insurance options, including household, liability, accident, and occupational disability insurance.

This Nioomi Whitepaper introduces you to the different mandatory and optional insurances for everyone living in Germany long-term – from migrant workers to university students. We equip you with everything you need to know so that you can make an informed decision based on your personal situation.

Mandatory insurances (Pflichtversicherungen)

Like many modern countries, it is compulsory for all citizens and legal residents in Germany to have health insurance.

  • Health insurance (Krankenversicherung)
  • Car insurance (Kfz-Versicherung): if you have a car, select between full cover (Vollkasko) and partial cover (Teilkasko).
  • Dog liability insurance (Hundehaftpflichtversicherung): if you have a dog; only mandatory in some states.

Next, let’s take a look at which insurances are optional in Germany and for whom they are recommended.

Optional Insurances (Freiwillige Versicherungen)

To make the list of optional insurances in Germany more structured, we have divided them into two sections:

Insurance of Personal Matters

  • Legal insurance (Rechtsschutzversicherung): recommended if you have regular or frequent personal or professional legal questions, e.g., around real estate, employment, taxes, and other issues.
  • Dental insurance (Zahnzusatzversicherung): recommended for individuals expecting costly non-cosmetic dental treatments
  • Occupational disability insurance. (Berufsunfähigkeitsversicherung): safeguards your professional capacity to work and is recommended for people with higher occupational hazards and pre-existing conditions.
  • Life insurance (Lebensversicherung): recommended protecting your family, especially as you get older.

Insurance of Items

  • Liability insurance (Haftpflichtversicherung): covers private or professional damages to third parties and is recommended for a safe everyday life.
  • Household insurance (Hausratversicherung): recommended if you own expensive furniture, tech gear, and/or other costly household items; otherwise, it may be more suitable to insure valuable items individually.
  • Bicycle insurance (Fahrradversicherung): recommended if you have a valuable bike; bicycles are commonly stolen in Germany.

If you feel overwhelmed, take Nioomi’s free quiz to determine which health insurances and providers are best for your personal situation.

Health insurance in Germany

The German Health Insurance Reform (2007) legally requires all citizens and legal residents in Germany to hold universal health insurance for at least hospital and outpatient medical treatment. This is regardless of employment/student status, income, marital status, or other factors. Gaps in health insurance coverage are not a crime but can result in penalties of up to 9.000 € (~10,000 USD). Besides, you are responsible for paying the bills should you need medical help during this time, which can easily be tenfold the penalty amount if you have an accident or severe illness like cancer.

Therefore it is actually cheaper to simply get health insurance for Germany. You’ll comply with the law, and you will need to submit your healthcare provider when taking up employment and applying for your German National Visa. Besides, you’ll be happy to hear that healthcare in Germany is among the best in Europe. In fact, Germany is also famous for medical tourism with strict hygiene standards and innovative technology and treatment techniques.

The German health insurance system

Medical insurance in Germany follows a dual system. You are free to choose between

  • Public health insurance (Gesetzliche Krankenversicherung - GKV)
  • Private health insurance (Private Krankenversicherung - PKV)

A few things to keep in mind:

  • Public health insurance providers have to accept your application (unless you have previously taken out private health insurance!).
  • Private health insurance providers may decline your application based on pre-existing medical conditions, age, or other criteria.
  • Private health insurance is only available to business owners, doctors, mini jobbers, civil servants, students, and employees with a minimum salary of 69,300 € (~75,900 USD) per year.
  • Individuals with a higher income typically have financial benefits when selecting private insurance; attention: it may be difficult to impossible to switch back to public health insurance once you’ve taken out private health insurance.

While health insurance is mandatory in Germany, you only need to choose one private or public health insurance provider.

Employees in Germany also benefit from the following insurances. In case you are self-employed, you can take them out voluntarily.

  • Unemployment insurance (Arbeitslosenversicherung)
  • Retirement insurance (Rentenversicherung)
  • Accident insurance (Unfallversicherung)

Health insurance providers in Germany

Among the largest public health insurance providers in Germany are Techniker Krankenkasse, BARMER, DAK, and AOK. The different public health insurance carriers mainly differ in their range of additional voluntary services (e.g., physiotherapy, natural medicine) and in their bonus programs (reward payments for medical checks and a healthy lifestyle). You are free to select any public medical health insurance provider you like.

For employees, the cost of health insurance is divided between you and your employer. Your personal insurance rate depends on your annual income. The statutory health insurance rate in Germany is 14.6% (or 14.0% at the reduced rate). When you start a new job, you must provide your employer with the information of your health insurance provider. The majority of Germans (89%) are insured through public health insurance providers. Young professionals may find public health insurance relatively expensive, but the cost is compensated over time.

Among Germany’s largest private health insurance providers are Debeka, DKV, Allianz, Axa, and Signal Iduna. Unlike public health insurance, the private health insurance rate is calculated based on your age and health status. The costs vary on your employment status, age, and overall health. Rates vary and can be 400-800 € (~450-900 USD) for self-employed business owners or 300-600 € (~ 330-660 USD) for employees. If you have private health insurance, you will typically get doctor’s appointments easier and quicker. Private health insurance generally is less expensive when you are young, and the cost will increase over time.

Which type of health insurance is right for me?

To determine whether public or private medical insurance is more suitable for your situation, you can ask yourself the following questions.

  • Do you fulfill the eligibility criteria for private insurance (see eligibility criteria)?
  • Do you have a family? Public health insurance covers children and an unemployed spouse.
  • Are you above 50 years old and/or do you have (severe) pre-existing medical conditions? Private health insurance rates typically increase accordingly.

If you move to Germany, you will find that health insurance is compulsory and tied to many other aspects of your new life. Let Nioomi assist you with this process so that you can start your new life in Germany hassle-free!

How to get health insurance in Germany as a foreigner

Depending on your employment or student status, foreigners can qualify for private or public health insurance in Germany. Your existing foreign health insurance may be recognized in Germany if there is a social security agreement between the country where you have health insurance and Germany.

Foreign employees (skilled migrant workers)

Your German employer will register you with your selected health insurance carrier if you choose public health insurance. Your employer must do so within two weeks of starting the job.

If you choose private health insurance, you are responsible for registering with your selected health insurance carrier directly and on your own. You will need a copy of your employment contract, passport, and residency permit.

Foreign students

Students enrolled in degree programs may choose a public health insurance provider, while students over the age of 30 and in preparatory/language courses must choose private health insurance plans. Either way, you have to register with the selected medical insurance provider directly and on your own. Supporting documents include student ID/enrollment, passport, and residency permit.

Depending on your situation, you may need temporary travel health insurance to enter Germany, for example, when you arrive as a job seeker.

Remember: Health insurance is compulsory for everyone who stays in Germany for more than three months, works, and studies in the country!

Key takeaways

  • Health insurance is mandatory for everyone who lives in Germany. Gaps in coverage can result in fines of up to 9,000 € (~ 10,000 USD).
  • Having health insurance is required to take up employment in Germany and to apply for a German National Visa (D Visa).
  • Depending on your situation, up to seven voluntary insurances can be helpful when living in Germany: liability, dental, bicycle insurance, and more.

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