Germany's Private Insurance: A Complementary Coverage Option

Germany has a dual health insurance system, with both public and private options available. While public health insurance covers around 90% of the population, some people opt for private health insurance as a supplement to the basic cover provided by the public system. This is known as complementary or supplementary insurance. It covers services not included in public health insurance, such as dental care, and can be purchased from private insurance companies.

Who can opt for complementary private insurance in Germany?

In Germany, health insurance is mandatory for all residents, but some individuals can choose between public and private health insurance. This choice is usually determined by financial and non-financial incentives.

Who can opt for private health insurance?

Private health insurance is chosen by around 10% of the German population. To be eligible for private health insurance, an individual must meet one of the following criteria:

• Earn over €69,300 per year (as of 2024)
• Be a student, depending on certain criteria
• Be self-employed
• Be a civil servant (insurance is subsidised by the employer)

Private health insurance can offer a higher level of care, shorter waiting times, and additional services. For example, private insurance may cover major dental work, visual aids, and worldwide coverage, which public healthcare does not. Private health insurance also offers more choice when it comes to doctors and hospitals, as patients are able to visit both public and private-only doctors.

The cost of private health insurance in Germany can range from €150 to €1500 per month, depending on age, health, profession, and tariff options. The cost is usually higher for older individuals with pre-existing or chronic conditions.

With private health insurance, individuals usually have to pay the hospital or doctor's fees upfront and then claim the costs back from the insurer. For larger invoices, direct cost coverage can be arranged with the insurance company.

What are the benefits of complementary private insurance?

Germany has two main health insurance systems: public and private. The majority of Germans are publicly insured, with only around 10% of the population having private health insurance.

For those already covered by the generic public health insurance, there is the option to increase coverage with a complementary private insurance plan. These privately arranged insurance options offer an increased level of coverage and benefits above the public variety, as well as the ability to make certain choices during medical treatment.

Benefits of complementary private insurance

Dental supplementary coverage

Over the past few decades, payments from public insurance for dental treatment (especially for dental replacement treatment) have decreased significantly. For those planning an extended residence within Germany, specialised dental supplementary insurance coverage is highly recommended.

Hospital/inpatient supplementary coverage

While less essential than other variations, this style of plan offers an extended level of comfort and choice for hospital inpatients. Inpatient or Hospital Supplementary Health insurances grant patients a choice of hospitals, treatment from a head of department, and a private room with a choice of bed styles. Hospital Supplementary Insurance is especially useful for expectant mothers requiring privacy and extended care, and for those who wish to continue working within the seclusion of a single room with Wi-Fi.

Outpatient supplementary coverage

Outpatient supplementary coverage allows patients an extended variety of options during their care outside of a hospital. Patients can choose from a number of options not covered by public insurance, such as natural or holistic treatment, coverage for opticians and glasses care, and private patient-style care.

Travel health insurance

Travelling outside of the European Union means that German-based public plans no longer offer coverage. Therefore, it is essential for the traveller to arrange additional private coverage for the duration of their time outside of the EU. This avoids the potential to become fully accountable for any medical costs incurred while abroad.

What are the drawbacks of complementary private insurance?

Germany has a dual health insurance system, with both public and private options available. While complementary private insurance is available, there are several drawbacks to consider.

Firstly, private health insurance premiums are risk-related, meaning that individuals with higher health risks, such as the elderly, sick, or chronically ill, pay significantly higher premiums than those who are young and healthy. This can result in substantial financial burden for those with pre-existing or chronic health conditions. Additionally, each family member must be insured separately, and women often face higher premiums than men. As a result, private insurance may not be a financially viable option for families or individuals with higher health risks.

Secondly, private health insurance may provide preferential treatment to its enrollees, leading to inequitable access to healthcare. Private insurers pay higher tariffs to healthcare providers, creating incentives for doctors and specialists to prioritise private patients. This can result in shorter waiting times and more favourable treatment for privately insured individuals, disadvantaging those with public insurance.

Thirdly, private health insurance often requires individuals to pay medical bills upfront and seek reimbursement later. This can place a significant financial strain on individuals, particularly in the case of expensive or unexpected medical treatments. In contrast, public insurance typically covers costs directly, reducing the financial burden on individuals.

Another drawback of private health insurance is the difficulty of switching back to public insurance. Once an individual opts for private insurance, it is challenging to return to the public system, especially for older people. This lack of flexibility can be problematic if an individual's circumstances change, such as a decrease in income or a change in health status.

Lastly, private health insurance does not automatically cover family members, and spouses and children must be insured individually, which can be costly. In contrast, public insurance often provides free coverage for spouses and children, making it a more financially attractive option for families.

How much does complementary private insurance cost?

The cost of complementary private insurance in Germany depends on the scope of cover. Some complementary insurance policies are very cheap, starting at around €10 per year, while others are more expensive, with supplementary dental insurance, for example, starting at around €30 per month. The cost of complementary private insurance can also depend on your age and the benefits and services you want to include. For example, a 29-year-old would pay around €14 per month for a standard tariff and around €43 per month for a premium tariff.

The cost of complementary private insurance in Germany can also depend on your age and health status when you sign up, with the coverage being more flexible and the cost varying a lot. Generally, the younger the person, the lower the premiums. Private health insurance providers normally offer a low-cost, a mid-range "comfort", and a premium health insurance plan. The level of benefits of the lowest level of insurance is generally better than that of statutory health insurance.

The average monthly premium for private health insurance in Germany in 2024 was around €500-€600 for men and €600-€700 for women. However, these figures are just averages, and the actual cost of private health insurance can be significantly higher or lower depending on individual circumstances.

When it comes to private health insurance in Germany, premiums are calculated based on the risk profile of the patient. This means that those with chronic conditions, older individuals, and people who engage in risky behaviors are likely to pay higher premiums. Additionally, the type and level of coverage you choose can also affect your premiums. Comprehensive coverage plans with lower deductibles and copays can be more expensive than basic plans with higher out-of-pocket costs.

How does complementary private insurance work with public insurance?

In Germany, complementary private insurance is known as complementary VHI (Voluntary Health Insurance). It is available to the whole population and provides access to services not covered by the statutory scheme, such as dental treatments. It also covers the cost of user charges for services only partially covered by the statutory scheme.

Around 36% of all residents in Germany who have public health insurance have additional supplementary private health insurance. This is because, while public health insurance is mandatory for all residents in Germany, it only covers the costs of treatment provided as part of standard care. This means that innovative, naturopathic, and cosmetic treatments are often excluded from the scope of cover. Even when it comes to medically necessary treatments, the proportion of costs actually reimbursed can be rather low, particularly if it is considered a premium treatment.

Therefore, many public insurance patients opt for supplementary insurance policies to improve their insurance cover. This means that the treatment they receive in specific areas is comparable to that of a private patient, regardless of their income.

The cost of supplementary insurance policies depends on the scope of cover. Some policies are very cheap, such as health insurance for foreign travel, which starts at around €10 per year. Other policies, such as supplementary dental insurance, are more expensive and start at around €30 per month.

It is important to note that complementary private insurance is different from substitutive private insurance. Substitutive private insurance is an alternative to social health insurance arrangements and is only available to certain groups, including high-income employees, self-employed individuals, and civil servants.

Frequently asked questions