Whether it’s for employment opportunities, the high standards of living, the vibrant culture or access to the rest of Europe, it’s easy to see why Germany is a popular option for expats to live and work. Between the excitement of cities such as Berlin and Frankfurt, and the sheer variety of natural landscapes, this is a country that offers something for everyone including career opportunities.
If you are thinking of relocating to Germany, here are 10 things you need to know about its healthcare system before you make the move.
- The Bismarck model
Germany, like many other European countries, has implemented the Bismarck model for its healthcare system. Named after reactionary German chancellor and Prussian statesman Otto von Bismarck, the approach is centered around the principle that health insurance should be mutual, and that the sick should not have to pay more than the healthy. In other words, everybody pays into the system, but if you don’t get sick or have an accident, then you don’t get your money back. It is a welfare state, where everybody supports each other.
- Health insurance
Health insurance is now mandatory in Germany following the enforcement of a healthcare reform bill by the German government in 2007. There are three options available: government-regulated public health insurance (known as GKV), private health insurance (known as PKV) or a combination of the two. For employees, whose gross salary is up to €56,250 per year (2016 figures), membership to GKV is compulsory; for employees above this threshold, it is voluntary. GKV is also funded by contributions from employer and employee.
While the majority of Germany’s population is required to hold statutory health insurance, there are a few exceptions to this including students aged 30 or over, postgraduate students and guest scientists. People that are exempt from GKV can opt for PKV from one of Germany’s private health insurance providers. Professionals that earn more than €56,250 per year, about 11 percent of Germany’s population, can also opt for private health insurance.
Expats who are only staying in the country for a short time, could apply for a European Health Insurance Card (EHIC) which provides temporary access to certain types of healthcare. This is not a long-term solution and it does not replace travel insurance, or cover private healthcare costs. The card is only available to EU, EEA and Swiss citizens. It covers medical treatment expats may need during their visit if they’re ill or have an accident. It also covers treatment for long-term (chronic) conditions and existing illnesses, and routine maternity care. The card is free to apply for and is valid for up to five years.
The German government’s public health insurance scheme is administered by some 120 health insurance providers (krankenkassen), which are non-profit associations. For employees that earn €56,250 or less per year, GKV is paid via salary deductions – half of which are covered by the employer. Employees pay 14.6 percent of their income to GKV, and may also have to pay a supplemental rate of 1.1 percent. Though it is up to an employee which krankenkasse they choose, the general minimum period of membership is 18 months before switching. There is more information about the latest healthcare updates at The Federal Ministry of Health and Social Security website.
The other option for expats is to choose international health insurance which may offer a better standard of service. For example, as well as shorter waiting times, patients can also request, and are more likely to get, an English-speaking doctor. Private insurance can vary, so it might be worth checking the level of cover – for instance, that the policy includes chronic disease and elderly care. The insurance company should also be registered with the German regulator BaFin.
- Standard of care
There are more than 2,000 hospitals in Germany. Many of these are equipped with high-tech resources that enable doctors and surgeons to deliver innovative, world-class treatments. Germany is renowned for the high quality of its healthcare system, which includes care for the elderly and people with chronic diseases. Although it is not a requirement, it is also likely that most doctors in German hospitals will speak English.
- Waiting times
German healthcare facilities offer exceptional standards of care, short waiting times, and an efficient administrative process. Patients can usually expect to be seen promptly and are not generally expected to endure long waits for surgery.
- Visiting the doctor
Membership with GKV covers visits to a General Practitioner (family doctor), as well as payment for registered specialists and basic dental care. As of 2013, patients no longer have to pay a consultation fee to see a doctor and it is also now free to see a dentist. If a patient needs to receive specialist treatment, they do not have to receive a GP’s referral before booking an appointment.
- Going to hospital
There are three types of hospital in Germany: public, non-profit private and for-profit private. Expats will usually need to bring proof of health insurance to any of these facilities, as treatment could otherwise be expensive. If a patient is registered with GKV, the most they will be required to pay for a hospital stay is €10 per day. If their costs exceed this amount, the rest will be paid by the insurance provider. However, GKV will not cover the costs of private doctors, private hospital rooms, homeopathic treatment or advanced dental treatment.
- Medicines and prescriptions
There are pharmacies (apotheken) in most German towns. These stock prescription and non-prescription drugs – both of which are kept behind the counter. Pharmacies can be easily identified by a red ‘A’ on the sign. They will usually close on weekday evenings, Saturday afternoons, Sundays and Wednesday afternoons. Pharmacy costs in Germany are generally affordable, as patients only have to pay 10 percent of the cost of prescribed medicines.
In case of a serious medical emergency, expats can call an ambulance by dialing 115. Alternatively, if they can get to a hospital, they might be able to visit the ‘notaufnahme’ (accident and emergency department), although not all private hospitals have emergency departments. If the patient has no health insurance in place, they will still be seen in an emergency, but they will have to pay for the treatment themselves.
Due to compulsory medical insurance, there is an exceptionally high standard of care available to everyone in the country. Whether you choose GKV or PKV, you will still have access to efficient and affordable facilities. Germany’s reputation for world-leading healthcare is an added reassurance for expats making the decision to relocate to Germany.
Disclaimer: The information included in this article is provided for information purposes only and is not intended to constitute professional advice or replace consultation with a qualified medical practitioner. All information contained herein is subject to change.