Germany has very modern and accessible healthcare that is heavily regulated and subsidised by the government. A two-tier health insurance system is the basis of German healthcare and ensures that almost everyone has coverage. Unlike in other European countries where government-run health centres or emergency rooms offer services for free, the German system offers little free care, but the government picks up the insurance tab for the poor, as well as those receiving government benefits and unemployment.

About 90% of Germany is covered by public health insurers, known as Gesetzliche Krankenkassen. These insurers are actually hundreds of private insurers subsidised by the government to offer benefits, including a sliding fee scale, as well as free coverage for children and non-working spouses. If you are self-employed or earn more than €48,000 per year, you can opt for the country’s private health insurers. Fees are not income-based and spouses and children don’t ride for free under private insurance, which can make it an expensive endeavour. The main difference in the two is dental and vision coverage – public will only offer a pittance each time you visit the dentist, while most private plans will cover the entire visit as well as preventative measures.

The rule of thumb when choosing insurers is that single people and those who never plan on having children are better off under private insurance, while everyone else benefits from the public system. Be warned: once you’re in a private programme, switching back to a public health insurer isn’t allowed, unless your monthly income falls below €4,000 or you become unemployed. Under public insurance, you and your employer essentially split the monthly fees. Employers aren’t required to pay for private insurance, but most will cough up the equivalent of a public health insurance policy.

Your residency permit will require you to have some form of coverage and it’s best to arrive in the country with at least temporary health insurance in case of an accident or an unexpected illness.
Because the German system is one of the world’s most expensive, reforms have included the introduction of co-pays (additional charges) on some visits and medications. For example, patients are now required to pay €10 the first time they visit a doctor each quarter or any time they see a specialist without a referral.