The Basics of Health Insurance in Germany
The German healthcare system operates on a dual structure, consisting of statutory health insurance (Gesetzliche Krankenversicherung – GKV) and private health insurance (Private Krankenversicherung – PKV). Each type of insurance has different contribution requirements, eligibility criteria, and benefits.
Statutory health insurance covers the majority of residents, especially employees earning below a specific income threshold. Private health insurance, on the other hand, is typically available to high-income earners, self-employed individuals, and civil servants who opt out of the public system.
How Monthly Contributions Are Calculated in Statutory Health Insurance
For those covered under statutory health insurance, contributions are based on a percentage of their gross income, up to a contribution ceiling set annually by the government. In 2024, the contribution ceiling is €62,100 per year or €5,175 per month.
- General Contribution Rate: The standard contribution rate for statutory health insurance is 14.6% of gross income, with employers and employees each covering 7.3%.
- Additional Contribution: Health insurance providers may charge an additional contribution, averaging 1.6%, which is also split equally between employer and employee.
- Long-Term Care Insurance (Pflegeversicherung): An additional 3.4% (or 4.0% for childless individuals over 23) is deducted for long-term care insurance.
Example Calculation for Employees
For an employee earning €4,500 per month:
- Standard Contribution (14.6%): €4,500 × 14.6% = €657 (shared equally between employer and employee: €328.50 each)
- Additional Contribution (1.6%): €4,500 × 1.6% = €72 (shared equally: €36 each)
- Long-Term Care Insurance (3.4%): €4,500 × 3.4% = €153 (employee pays €76.50, employer pays €76.50)
Total employee contribution: €441 per month Total employer contribution: €441 per month
Health Insurance Contributions for Self-Employed Individuals
Self-employed individuals can either opt for statutory or private health insurance. If they choose statutory health insurance, their contributions are calculated based on their income, but they must cover both the employer and employee portions themselves.
For example, a self-employed person earning €3,000 per month would pay:
Total contribution: €588 per month
Private Health Insurance Contributions
Unlike statutory insurance, private health insurance contributions are not based on income but on factors such as age, health condition, and chosen coverage level. Monthly premiums can vary significantly, ranging from €200 to over €1,000 per month.
Advantages of Private Insurance:
However, private insurance can become expensive with age and pre-existing conditions.
Health Insurance for Expatriates and International Students
Expatriates working in Germany must enroll in either statutory or private health insurance. Many employers automatically register their employees in the statutory system. For those who are self-employed or freelancers, private insurance may be the preferred choice.
International students are generally required to have health insurance and are often eligible for lower statutory insurance contributions (approximately €120 – €160 per month).
Government Support and Exemptions
Understanding monthly health insurance contributions in Germany is essential for residents to manage their healthcare costs effectively. Employees benefit from employer contributions, while self-employed individuals must cover the full amount themselves. Private insurance provides alternative options but comes with varying costs and eligibility requirements. By staying informed, individuals can choose the best insurance plan to suit their needs and ensure comprehensive medical coverage in Germany.