Everyone should have statutory health insurance (“gesetzliche Krankenversicherung”, GKV) and is usually required to by law – at least in Germany. But what if you could save up to several hundred euro every year in just a few steps?
Everyone who has statutory health insurance can change their health insurance company every twelve months. You should make use of this right to change! Because the health insurance companies now differ considerably in their contributions and voluntary additional benefits – and switching is very easy.
What is statutory health insurance in Germany?
Statutory health insurance companies manage the financing of the German healthcare system on behalf of the state. They provide preventive health care and coverage for treatment of injuries and illnesses for their members.
According to the Social Security Code, the mission of statutory health insurance is to “maintain, restore or improve the health of the insured.”
But health insurance companies vary significantly in their contributions. The lowest additional contribution of a health insurance company is 0.35%, the highest is 2.5% (January 2022).
Although about 90 to 95 percent of the health insurance benefits are identical, it is worthwhile before a health insurance change nevertheless to compare the offers with bonus programs and freiwilligen auxiliary achievements. This is because the statutory health insurers differ considerably in some cases.
How does statutory health insurances work?
Statutory health insurance in Germany is based on the solidarity principle, forming a solidarity community for their insured members, within which the same benefits are available to all members. To this end, the insured member pay a proportionate share of their income into a common pot, the health comapny. From this company, all members receive the same range of benefits as needed – regardless of the amount they have paid in. Sick and destitute members of the community benefit most from this system.
However, since even today high-performing and healthy members, for their part, can come into phases of life through age, births, injuries and illnesses in which they must and can fall back on the solidarity principle, a general equalization within the system is provided for. The “equal benefits for all” principle means that no benefits can be taken out of or added to the statutory health insurance system. Together with
- the accident insurance,
- long-term care insurance,
- pension insurance and
- unemployment insurance.
Statutory health insurance is part of the social insurance system in Germany.
Good to know: You are covered by health insurance at all times, even during the change, and an insurance gap is excluded by law. In addition, you can easily return to your old health insurance company at a later date - for example, if the new statutory health insurance company increases its contribution rate. In this case, you even have a special right of termination and can apply for a new change before the 12 months term has elapsed.
What is the heathcare fund?
On January 1, 2009, the Health Fund was introduced as part of the Act to Strengthen Competition in Statutory Health Insurance (“GKV-Wettbewerbsstärkungsgesetz”), which brings together the contributions of health insurance fund members, the shares of employers and social insurance carriers, and a federal subsidy. Money from the Health Fund is transferred to the statutory health insurance funds to finance the preventive care and treatment of their insured members.
Who is covered by statutory health insurance?
In Germany, compulsory health insurance has applied to all citizens since January 1, 2009. Similar to the fact that every vehicle owner must provide proof of motor vehicle liability, every person must have health insurance. Membership in one of the statutory health insurance companies is mandatory for everyone, unless they are classified as exempt from insurance or already have other coverage in the event of illness. 73 million insured persons or 90 percent of the population in Germany are members of a statutory health insurance company or have statutory health insurance through family insurance. Persons subject to compulsory insurance in the statutory health insurance system include:
- Pensioners
- Trainees
- Employees with an annual income below the compulsory insurance limit
What does “voluntarily insured” mean?
Self-employed persons, freelancers, civil servants and students from the age of 30 or who already for 14 semesters as well as employees whose income is above the compulsory insurance limit are also subject to compulsory insurance.
However, they can choose whether to be insured voluntarily in a statutory health insurance or opt for private health insurance. Anyone who has dropped out of compulsory insurance but wishes to remain voluntarily insured under statutory health insurance must inform their statutory health insurance company of this within a period of three months, after which their membership entitlement will expire.
Statutory health insurance for the self-employed
Even the self-employed can take out voluntary health insurance and benefit from favorable statutory rates. This is particularly recommended
- for rather low or irregular incomes, for example in the start-up phase
- for existing illnesses and treatments
- to co-insure spouses or children
What is covered by statutory health insurance?
Every statutory health insurance company offers the same legally prescribed benefits in terms of
- free choice of doctor,
- doctor and dentist visits,
- check-ups,
- remedies and cures,
- vaccinations,
- hospitalization,
- sick pay,
- preventive services
- cures
In the end, the packages offered by the healthcare companies are 90 to 95 percent the same. However, with bonus programs, voluntary additional benefits and attractive supplementary insurances, the health insurers try to make their profiles distinguishable in the remaining 5 to 10 percent of their offerings. There are considerable differences in these areas, which insured persons should definitely take into account when switching health insurers.
Additional benefits of statutory health insurance companies
Preventive medical checkups
Often, statutory benefits for preventive examinations can only be claimed from statutory health insurers after a certain age. When it comes to skin cancer screening, breast cancer screening or colonoscopies, some health insurers offer these services to younger members.
Dental services
Subsidies for professional dental cleanings
Costs for professional dental cleaning can be covered by your health insurance up to a certain amount per year. Often a maximum limit is set by the statutory health insurance companies – however, there are also providers who cover the treatment costs in full. The prerequisite for this is often treatment by a specified dentist.
Discounted dentures
In general, statutory health insurers offer a minimum level of care. Depending on the individual benefit package, costs for dentures can also be covered up to a predefined amount.
Caution: In order for subsidies to be granted, many health insurance companies require patients to visit certain doctors or dental laboratories. Proof of regular preventive care is also often mandatory.
Osteopathic benefits
Some health insurance companies will reimburse you for osteopathic services up to a certain amount per year. Osteopathic treatment is intended to activate the body’s self-healing powers through manual therapy.
Costs for osteopathy can also be covered by your health insurance up to a certain annual amount. Osteopathic treatments include, for example, manual therapies to identify and treat movement restrictions in muscles, tendons, bones but also organs.
Attention: The coverage of costs is limited to a maximum amount per year. It is best to find out whether and how much your health insurance will cover in advance of your treatment.
Homeopathy Treatments
Costs for homeopathy can be covered by your statutory health insurance up to a certain annual amount. Homeopathic treatments include, for example, globules, the intake of herbal ingredients and minerals or the application of herbal ointments.
Attention: Whether your statutory health insurance covers the costs and to what extent, depends individually on the tariff benefits offered. While some health insurances cover the treatments completely, other health insurances only provide subsidies for medications. It is therefore best to find out in advance whether your statutory health insurance company will cover the costs of homeopathic treatments and, if so, what the annual limit is.
Bonuses and reward programs
An active and healthy lifestyle is often rewarded by numerous health insurance companies. Members can collect points through bonus programs, which in turn can be exchanged for premiums. Such bonus programs include, for example, health courses, preventive examinations or individual participation in programs, for example to stop smoking.
The rewards are largely in the form of vouchers, non-cash rewards or cash benefits.
Costs and contributions of the statutory health insurance companies
The general contribution to statutory health insurance per insured person is 14.6% of gross monthly earnings plus an additional contribution, which the statutory health insurers can set themselves. Increased competition among the 76 statutory health insurers will result in a range of around 17.1% for the overall health insurance contribution in 2022.
Family members such as spouses or children with no income of their own can be co-insured with their spouse or a parent free of charge.
Health insurance contribution with and without sick pay
For most people insured by the statutory health insurance in Germany, the general contribution rate applies with entitlement to sickness benefits paid by the health insurance company from the seventh week of a long-term illness. In addition, there is a reduced contribution rate without entitlement to sick pay.
This lower contribution rate can be used by self-employed persons or students, for example. However, self-employed persons with voluntary statutory health insurance also have the option of protecting themselves against loss of earnings due to illness from the seventh week onwards by opting for the general insurance contribution rate.
They can only cover sickness-related absences before the seventh week via supplementary health insurance tariffs or private insurance. For pensioners, the general health insurance contribution rate applies, although they do not receive sick pay.
Statutory health insurance – contributions and income thresholds 2022
| Insured group | Contribution |
| General contribution rate with entitlement to sickness benefit from the 43rd day | 14.60% |
| Reduced contribution rate without entitlement to sickness benefit | 14.00% |
| Contribution rate from pensions | 14.60% |
| Contribution rate from statutory pension | 14.60% |
| Nursing care insurance | 3.05% |
| Nursing care insurance for childless persons | 3.30% |
| Contribution assessment ceiling | Amount |
| Monthly income | 4,837.50 Euro |
| Annual income | 58,050.00 Euro |
Statutory health insurance – health insurance contributions for voluntarily insured persons
| Group of persons | Entitlement to sickness benefit | Contribution amount per month |
| Employees earning above the compulsory insurance limit | yes | 706.28 Euro¹ ² |
| General (minimum assessment basis: 1,096.67 Euro) | no | 153.53 Euro¹ |
| Self-employed (minimum assessment basis: 1,096.67 Euro) | no | 153.53 Euro¹ |
| Self-employed (minimum assessment basis: 1,096.67 Euro) | yes | 160.11 Euro¹ |
| Maximum contribution for self-employed persons | no | 677.25 Euro¹ |
| Maximum contribution for self-employed persons | yes | 706.28 Euro¹ |
| Maximum contribution for other voluntarily insured persons | no | 677.25 Euro¹ |
| Voluntarily insured students | no | 153.53 Euro¹ |
In general, you can say that if you earn little, your contribution amount will drop. However, as a rule, your contributions will not fall below a certain amount, because the legislator has defined a so-called minimum assessment basis. You can think of this as a kind of fictitious minimum income that the statutory health insurance company applies and calculates their contribution rates on, even if you earn less.
¹ In addition, statutory health insurance companies can levy an additional contribution on their members.
² Employer contribution subsidy: 384.58 Euro
Maximum contribution of the statutory health insurance
The health insurance contribution always corresponds in percentage terms to the levied contribution rate of the health insurance company , i.e. it is more for a higher gross income than for a lower one. However, a cap applies above a certain contribution assessment limit.
The amount of this limit is adjusted every year to the general income development. The portion of income above this limit is no longer included in the calculation of contributions. With this measure, the legislator is trying to make it more attractive for high earners to remain in the solidarity system of the statutory health insurance companies and thus to slow down the migration of financially strong members to private health insurance. The assessment limit differs from the compulsory insurance limit.
Who pays the statutory health insurance?
The general contribution rate of 14.6% of gross wages is shared by the employer and the employee, who each pay half of the contribution to the health insurance company.
For the employee, an income-related additional contribution is added, which varies from health insurance company to health insurance company. On average, this additional contribution rate has been around 1.1 percent in recent years, rising to 1.3 percent in 2021.
Differences to private health insurance
Anyone who exceeds the compulsory insurance limit or is self-employed can take out private health insurance. The advantages of private health insurance include:
- the assumption of the costs for all approved medications,
- the possibility to choose chief physician treatments,
- freedom of therapy for the doctor and
- preferential treatment for private patients in the health care system, for example, for appointments.
For young insured persons, the premiums in private health insurance can even be lower than in statutory health insurance. It is only at an older age that the premiums usually become significantly more expensive, because in private health insurance the amount of the premium is determined by the insured risks.
Switching from private to statutory health insurance
While the wide range of benefits and the sometimes lower optional tariffs of private health insurance (“private Krankenversicherung”, PKV) initially promise many advantages, sometimes the costs of private health insurance become too high for privately insured persons over time.
Particularly from the favorable amounts of the legal health insurance for pensioners some insured ones would like to profit nevertheless also and look for the change back into the solidarity system of the legal health insurance companies. But a return to the statutory health insurance only works in exceptional cases. Strategies to make a change possible can be:
- Employees can come below the annual earnings limit with their gross income due to part-time work or sabbaticals. As a result, they automatically fall under the responsibility of the GKV.
- Self-employed persons only have the option of switching to a salaried main job that is below the annual earnings limit.
Caution: You should not wait until the end of your working life to take these measures: From the age of 55, the chances of switching to statutory health insurance (GKV) decrease.
Statutory health insurance: Cancellation and change
Change of health insurance company by ordinary termination
A regular change of health insurance company itself is not difficult: you only need to write a registration for your new insurance company. In addition, the change is also common without a cancellation at the old health insurance company, since this comes automatically.
Attention: Since health insurance is mandatory in Germany, the termination is only complete when your membership certificate from the new insurance company is received by the old insurance company within the notice period.
Cancellation period
This notice period is two months. So, if you want to cancel on January 1, your cancellation letter must be received by your health insurance company by October 31. You must observe the minimum contract period of 12 months, which applies to all statutory health insurance companies. Only after the end of this term is it possible to change health insurers. Elective tariffs often have their own, longer contract terms. You will find your minimum term in your insurance contract.
Health insurance change with special notice
If your statutory health insurance company increases the previous additional contribution or introduces a new additional contribution, this means a special right of termination for the insured – even if you have not yet reached the minimum contract term. If, on the other hand, the insurance company reduces or completely eliminates additional benefits, special termination is not possible.
Notice period
Even in the case of special termination, a notice period of two months applies. Your letter of termination must be received by the insurance company by the end of the month in which the new additional contribution is due for the first time. In most cases, health insurance companies change the additional contribution at the turn of the year. The insurance company must notify you of your special termination right before it levies an increased additional contribution. If you receive this notification too late, this extends the special cancellation period according to Section 175 (4) SGB V (German Social Code). This gives you the right to cancel retroactively.
Good to know: The special termination right also applies to elective tariffs; only elective health insurance tariffs can only be terminated at the end of the minimum term. In the case of extraordinary termination, state the reason for termination: "Due to the additional contribution charged by you, I am exercising my special right of termination pursuant to Section 175 (4) Sentence 5 of the SGB V."
How does the health insurance comparison work?
While the general health insurance contribution of 14.6%is the same for every statutory health insurance fund, the providers differ in the amount of the additional contribution. With an average of 0.9%, the range of additional contributions extends from 0.3% to 1.7%. Even with a view to the contribution level, the current offers should be compared before changing health insurers.
Those who attach importance to certain services will also notice major differences between the statutory health insurance providers. In addition to the statutory minimum care, health insurance companies sometimes offer voluntary benefits. They differ not only in the additional treatments covered, but also in the extent to which costs are covered.
- Calculate savings
You can calculate your contribution rates for all statutory health insurance companies to compare them. For this, you only need your occupational group (employee, self-employed, and so on) and your monthly gross income. - Select important benefits
After the price comparison, you should also compare the additional benefits offered by the different statutory health insurance companies. For example, you specify that you want your health insurance to cover outpatient naturopathic procedures or professional dental cleanings. - Choose a new health insurance
After you have compared the costs and the benefits, you can choose a new health insurance company that meet all your requirements.
Summary
- As soon as you need your own membership in a public health insurance, e.g. because you start working in Germany, make sure you know which health insurance you choose
- In addition, in some cases, health insurance companies offer additional benefits and services that may be of interest to you.
- When switching to a new health insurance company, be aware that there is a 3-month notice period and an 18-month switching “lock” after you start your new health insurance.
- If you are finally with your desired health insurance company, it is worthwhile to compare the additional contributions year after year, because they can change annually.
Frequently asked questions
How can I change health insurance companies?
If you have been insured with your health insurance company for 12 months or longer, or if the health insurance company increases the additional contribution, you can switch. The notice period is two full calendar months. To change your health insurance company, you must choose a new health insurance company. The new health insurance company will then take care of the deregistration with your old health insurance company for you. You can take out insurance with any health insurance company that is open for your federal state. A health check is not required.
With what notice period can I terminate my health insurance?
If you have already been insured with your health insurance company for at least 12 months, you can change at any time. A notice period of two months to the end of the month applies. For example, if you give notice of termination to your old health insurance company through your new health insurance company in October, the termination will take effect on December 31. As of January 1, you can then switch to a new insurance company.
Do I have a special right of termination in the event of a premium increase?
If the health insurance company increases the additional contribution, you have a special right of termination. In this case, you can cancel even if you have not yet been insured with your health insurance company for 12 months. Here, too, a notice period of two months applies.
Can I change health insurance company when I change employer?
Since 01.01.2021, you no longer have to stick to a commitment period when changing employer. You can then directly choose a new insurance fund of your choice and change immediately. Your deregistration with your previous health insurance fund will be taken over by the newly chosen health insurance fund. The prerequisite is that employees choose a new comapny up to 14 days after starting work.
I already have a pre-existing condition. Can I still switch?
Yes, you can change health insurance companies even if you have a pre-existing condition. The statutory health insurance is a solidarity insurance. The health condition of an insured person is therefore irrelevant. Provided that you are subject to compulsory insurance or can take out statutory insurance voluntarily, the health insurance company you have chosen must accept you. You can choose between all health insurance funds that are available in your federal state in Germany.
How does the family insurance of health insurance companies work?
If you have statutory health insurance, you can insure your children or your spouse or partner free of charge under certain conditions.
First and foremost, the partner or children must not be self-employed on a full-time basis or have a monthly income of more than 470 Euro or, in the case of a mini-job, more than 450 Euro (as of 2022). If they earn their own money, then they are forced to insure and pay contribution rates themselves.
If a parent has private health insurance, it depends on their income whether family insurance is possible for a child. If they earns more than the legally insured partner and his or her income is above the compulsory insurance limit, the child cannot be co-insured free of charge.
What are the differences between the individual statutory health insurance funds
The individual health insurance funds differ from one another primarily in the amount of the additional contribution, the voluntary additional benefits and their bonus programs and optional tariffs.
Depending on their financial situation, each health insurance company levies an additional contribution. As an employee, you must pay half of this additional contribution, while the employer pays the other half.
Around five percent of the benefits provided by a health insurance fund also differ from one another. As voluntary additional benefits, some health insurance companies offer subsidies for homeopathic or osteopathic therapies, for example, or pay for additional preventive medical checkups.
With bonus programs, health insurers reward health-conscious behavior by giving out cash or non-cash bonuses. In addition, many health insurers offer elective tariffs under which an annual deductible or a premium refund can be agreed.
Where can I find all statutory health insurance companies in Germany?
Here you can find a comprehensive list of all statutory health insurance companies in Germany.
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