Can you choose between public and private insurance in Germany?
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Can you choose between public and private insurance in Germany?

Choosing health insurance in Germany isn’t always easy. While there may be many reasons why one would choose public health insurance over private, your range of choice ultimately comes down to employment.

Why does employment have so much bearing on which health insurance type to choose?

Well, for starters: If you’re employed and earning less than around €5,550 per month, then you must be publicly insured. The law in Germany is strict on this, so there’s simply no getting around it. Anyone earning any more than this threshold can then have the option to choose private insurance.

Good to know: Being compulsorily obligated to sign up for public health insurance only applies to employed persons. If you are self-employed, then you have the option to sign up for private health insurance at any income level.

What are the benefits of choosing public over private insurance?

If you’re able to choose between the two options, then you might find public health insurance beneficial for the following reasons:

  • It’s easy. Once you get signed up for public health insurance, you nearly never have to think about it again. Unlike private insurance, all pre-existing conditions are covered, and your premiums don’t go up overtime as you get older (see below for more details).
  • You have dependents. If you already have children, or you’re thinking about having them then public insurance makes a lot of sense for you. That’s because children and any other dependents (e.g. spouse) will be covered for free.
  • The price stays consistent, even as you get older. Although public health insurance is often more expensive than private, the benefits of paying for such a policy will pay off when you get older. Unlike private health insurance which can get really expensive as you age (generally after 55) public health insurance remains the same price over time.

What are the benefits of choosing private insurance over public?

Again, if you’re in the position to be able to choose between the two systems, here are a few reasons that private insurance might make sense for you:

  • It’s generally cheaper than public health insurance. This is due to the fact that the premiums based on your risk rather than a percentage of your income. If you are young and healthy, then you can expect to pay significantly less than public insurance.
  • You might get money back for being healthy and not making any claims. This of course depends on your insurer, but most major companies offer some rebates to their members for staying healthy.
  • You don’t plan staying in Germany long-term. This is a major deciding factor for choosing between public and private. Since private can get very expensive as you get older, it can make sense to choose it if you know for certain that you won’t grow old in Germany. 
  • Better service & treatment than public health insurance. While this point is rather contentious, many people have reported that wait times for certain things are reduced. Also, the option to choose more advanced operations and new techniques is more available. 
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