Private Medical Insurance for Expats Living in Germany

As one of the richest country in Europe, Germany offers a very high standard of health care from primary care through to high-tech hospitals and they have made very good provision for care in old age and for chronic disease.

Germany’s Bismarck system operates across most of Europe, including the Netherlands, Switzerland, France, and Austria. Where the UK’s NHS system is loved by the British because it is free at the point of use and taxpayer funded, it does not match the Bismarck system in terms medical outcomes and patient satisfaction.

Waiting for medical attention in Germany is very close to being non-existent, even where economic pressures apply because of its ageing population, consistent with most Western countries. Where an expat requires treatment for cancer or needed certain complicated operations, insurance cover may have to provide for lengthy stays in hospitals, often at expensive rehab centres in the Black Forest.

With Germany spending 11.3% of it GDP on healthcare, residents expect good health outcomes, and they are very respectable with life expectancy at 77 for men and 83 for women (Data.worldbank.org, 2014).

German Health Care

In a similar way to the UK, American and most other European states, Germany is vulnerable to the problems of mounting healthcare costs. This is due to having a shrinking workforce coupled with an increasing but ageing population. This is further compounded by their falling birth rate which in time will lower the available workforce. The German Chancellor, Angela Merkel, aims to limit the ever-rising taxes on employers, who jointly with the state, fund the system through equal contributions. The rising costs of insurance premiums for healthcare, is a further concern.

What the changes mean?

From 2011, employers have had to pay around 15.5% of their income towards healthcare, which is a larger proportion of their income when compared to other western countries. However this provides a cradle-to-grave healthcare service and by securing the employers’ income-related contribution rate, the onus falls on insurers to handle future cost rises by increasing premiums or reducing cover.

Shop around

As with all insurance based health schemes, policyholders will need to weigh up what they pay in premiums against the benefits offered by their policy.  A German government spokesman previously stated: “The premium, which has to be paid by all members of a health insurance fund, is a transparent price signal. It allows the insured to compare the price and the benefits package and choose the fund with the best price-performance ratio.” If the average added premium goes over 2% of a policyholder’s income, the individual is reimbursed by the state.

If a health fund has to levy an additional premium, it must notify its members of their right to cancel their membership. Members are allowed to leave their old fund and join a new one within two months of being told of an additional premium.

Compulsory purchases

It is mandatory for expats and German citizens to buy the cover with a registered insurer. A problem for Expats who travel widely on business is that they need international medical insurance and this can mean that the individual could be doubly insured.

If an individual’s monthly earning are over €4,000, they can take out private insurance and drop the state-approved cover. However, the policy needs to be at least as good as the German Public Health Insurance, including provision for chronic disease and elderly care.

A spokesman mentioned that a British resident working in Germany can take out private health insurance in the UK but would have to prove to their employer that their health insurance covered the mandatory minimum that the German public health insurance would cover. As well as matching the German state insurance, in terms of benefits, the employer would need a certificate from the employee’s British health insurer, guaranteeing that this was the case.  If there is no certificate, the employer would be obliged to register the employee with a public health insurer.

International premiums

Expats who are earning high salaries, or those who want wider geographical cover, may find it cheaper to buy international private medical insurance and we understand that AxaPPP, is among the least expensive of a list of insurers provided by the Medical Insurance Services.