German Healthcare System

Gesetzliche Krankenversicherung (GKV)

A comprehensive guide to Statutory Health Insurance in Germany. Understand the difference between Public (GKV) vs Private (PKV), contributions, and hospital access.

At a Glance: The German Dual System

System Type Dual: Public (GKV) & Private (PKV)
Primary Coverage Gesetzliche Krankenversicherung (GKV)
Beneficiaries ~90% of the population (73+ million)
Funding Employee & Employer Contributions (Split)
Key Providers TK, AOK, Barmer, DAK (Krankenkassen)
Emergency Number 112 (Life Threatening), 116117 (Doctor On-Call)

The German healthcare system is one of the oldest and most respected in the world, dating back to Bismarck's social legislation in 1883. It is characterized by a unique "Dual System" where health insurance is mandatory for all residents.

Most people (about 90%) are covered by the **Statutory Health Insurance (GKV)**, while high earners, civil servants, and self-employed individuals may opt for **Private Health Insurance (PKV)**.

GKV vs. PKV: What is the Difference?

Understanding which system you belong to is the first step.

GKV (Public)

  • Who: Employees earning below the threshold (€69,300/year approx), students, and pensioners.
  • Cost: Based on income (approx 14.6%).
  • Family: Non-working spouses and children are covered for FREE ("Family Insurance").
  • Billing: Doctor bills the insurance directly via chip card.

PKV (Private)

  • Who: High earners, self-employed, and civil servants (Beamte).
  • Cost: Based on age, health status, and risk (not income).
  • Family: Each member must pay a separate premium. No free family coverage.
  • Billing: You pay the doctor first, then get reimbursed.

Contributions: Who Pays What?

In the public system (GKV), the cost is shared. The general contribution rate is set by the government (usually around 14.6% of your gross income), plus an "Additional Contribution" charged by specific insurance funds.

The Split: In most cases, your employer pays 50% of the contribution, and you pay 50%. This is automatically deducted from your monthly salary slip (Payslip).

What is Covered by GKV?

The benefits are comprehensive and largely uniform across all "Krankenkassen" (Insurance Funds like TK, AOK, etc.).

  • Medical Treatment: Unlimited visits to GPs (Hausarzt) and Specialists (Facharzt).
  • Hospital Care: Inpatient treatment in public and approved private hospitals (closest available hospital).
  • Dental: Basic checkups and simple fillings are covered. Major work (crowns/bridges) usually requires a co-payment.
  • Sick Pay (Krankengeld): If you are sick for more than 6 weeks, the insurance pays about 70% of your gross salary for up to 78 weeks.
  • Pregnancy: Full coverage for prenatal care, delivery, and midwife services.

Zuzahlung (Co-payments)

While the system is robust, it is not entirely free at the point of service for everything. There are small co-payments designed to prevent overuse.

  • Prescriptions: You pay 10% of the drug cost (Minimum €5, Maximum €10).
  • Hospital Stay: You pay €10 per day for the first 28 days of a hospital stay per year.
  • Ambulance: Minimum €5, Maximum €10 co-payment for medically necessary transport.

The Electronic Health Card (Gesundheitskarte)

Upon registering, you receive an electronic health card (eGK) with your photo and a chip. You MUST bring this card to every doctor's appointment. The receptionist scans it to bill the insurance provider directly.

Note for Expats: The back of your German health card often serves as your EHIC (European Health Insurance Card), giving you emergency coverage when traveling within the EU.

Finding the right care can be challenging if you don't speak German fluently. Germany has official directories to help you find specialists and hospitals.

Search the German Hospital Directory

Use the official "Deutsches Krankenhaus Verzeichnis" to find hospitals by specialty, location, and quality reports.

Search Official Directory →

For doctors, visit 116117.de

Frequently Asked Questions

What happens if I lose my job?
If you lose your job and receive unemployment benefits (Arbeitslosengeld I), the labor office (Agentur für Arbeit) will pay your health insurance contributions. You remain covered.
Is dental cleaning (PZR) covered?
Professional teeth cleaning (Professionelle Zahnreinigung) is usually NOT fully covered by GKV. However, many insurers (like TK or AOK) offer a partial subsidy (e.g., €40-€60 per year) as a bonus benefit.
Can I switch from Private (PKV) back to Public (GKV)?
This is very difficult, especially if you are over 55. Generally, you can only switch back if your income falls below the mandatory threshold and you become an employee again. The system is designed to prevent people from using cheap private insurance when young and switching to public when old/sick.
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About the Founder & Mission

Digital Information Expert & Health Tech Blogger

Hi, I am Sandeep Jagdev, a Senior Digital Marketing Expert and the founder of HealthCardHospitalList.com. While I am not a doctor, my extensive experience in digital research allows me to bridge the gap between complex government data and the general public.

*Disclaimer: We are an information aggregator and guide. While we consult with medical experts for clarity, we are not a government body. Always verify final details with official hospital desks.*