Health Insurance in Germany

Germany is known for its high quality of life, robust infrastructure, and strong healthcare system. It’s one of the most influential countries in Europe with one of the world’s largest economies. So, it’s no wonder expats from around the world are living and working in Deutschland – and there’s much more to this fabulous destination than financial and commercial interests. Germany also boasts stunning landscapes, like the Rhine Valley and the Black Forest, as well as cosmopolitan cities such as Frankfurt, Berlin, Munich and Cologne, bringing a wealth of unique cultural experiences.

Germany offers a comprehensive and high-quality healthcare system that combines both public and private options, ensuring that expats have access to essential medical services and coverage tailored to their needs.

In Germany, there is a universal multi-payer healthcare system in place. This combines two different types of health insurance – law-enforced and private.

Those in lower-income brackets benefit from compulsory cover, which is known as a sickness fund. People who receive higher incomes may opt in to this system or can choose private insurance instead. Alternatively, a combination of the two is available.

The purpose of Germany’s statutory health insurance is to ensure people receive what is ‘medically necessary’ regardless of their income. The medical benefits provided by statutory cover include hospital care as a ward patient with the doctor on duty at the nearest hospital to you, out-patient care with registered doctors and basic dental care.

Expats wanting access to private hospitals and surgeons, private hospital rooms, alternative medical care and comprehensive dental and optical cover for expats will need to invest in specific private health insurance.

Healthcare in Germany is widely regarded as one of the best systems in the world. Germany benefits from modern hospitals, advanced medical technology, and highly trained healthcare professionals. There are often short waiting times for urgent care, and ample access for specialised treatments.

General practitioners (hausärzte) are usually the first point of contact for non-emergency health concerns. They’ll coordinate referrals to specialists when needed. Expats will need to register with their local GP when they move to Germany. If you don’t speak German or aren’t fluent enough to cover healthcare, you can see if your local GP speaks English or you can find a local translator to accompany you.

Pharmacies (apotheken) are widespread and accessible, though some medications may require a prescription from your GP.

Dental work in Germany can be extremely expensive and very few expats have the funds to pay for treatment outright. Beyond the basic level of care, Germany’s statutory health insurance does not cover all scenarios and relevant treatment and this can be costly.

Expats who do not have supplementary health insurance could see themselves having to pay between 30% to 80% of the final cost. For this reason, many expats and German nationals alike opt to invest in private comprehensive healthcare cover.

Every single resident in Germany, including new arrivals, will need to have health insurance. It is mandatory for every citizen and there are two types available in the country: private health insurance through a company or statutory health insurance provided by the government.

Expats in Germany can only have access to statutory health insurance if they are employed by a German company. Most employers will pay half of an expat’s health insurance fees every month, whether they opt for statuary or international health insurance. Expats in Germany who are self-employed or do not work must take out a private health insurance policy as they are not eligible for statutory protection.

When looking for health insurance in Germany as an expat, you can choose from a local provider or an international policy. The benefits of an international policy is that they will often include benefits specifically designed for expats, such as medical evacuation and multilingual support, that won’t always be included in a local policy.

There are a number of different visas that may be suitable for expats looking to live and work in Germany. The Employment Visa will require a job offer from a German employer. This will often be for a role in a field with skill shortages, such as IT, engineering, or healthcare. You will typically need to have specialist skills, qualifications, and/or experience to qualify.

There is also a Job Seeker Visa available. This will allow you to live in Germany for up to six months while you search for a job. To qualify, you’ll need to prove you have sufficient funds to support yourself for the duration of your stay.

Another option is the Freelance Visa. This is suitable for freelancers, entrepreneurs, or self-employed expats. To qualify, you’ll need to provide a viable business plan and show your business will make an economic contribution. You’ll also need to show you have sufficient funds to support yourself.

To apply for a German visa, you’ll first need to determine which visa type is suitable for your needs. You’ll then need to collect and prepare your documents, which should include:

You’ll need to book an appointment at your nearest German embassy or consulate for a visa application. At the appointment, you’ll submit your documents, provide biometrics (including your fingerprints) and attend a short interview. During the interview, you’ll be asked a range of questions including about your skills, experiences, goals, and motivations for moving to Germany.  

You’ll also need to pay a visa fee, which is typically around €75 or more. Depending on the type of visa you’re applying for, there may be some additional fees.

Long-term visas can take a few weeks to process, so you should aim to apply in good time. If your denied, you will have the opportunity to apply again if you wish, but you should first work at improving your supporting documents to boost your chances of success.

Germany’s working culture is renowned for its emphasis on efficiency, structure, and professionalism. The German workplace often values a results-driven approach, where productivity and meeting objectives take precedence over long hours or informal workplace interactions. This focus on efficiency reflects the value placed on meticulous planning, thorough preparation, and clear communication.

Punctuality is a cornerstone of German work culture. Arriving on time for meetings and adhering to deadlines is seen as a sign of respect and reliability. Germans tend to have a formal approach to workplace relationships, especially at the beginning. People will typically use titles and surnames until a closer rapport is established. There is a clear hierarchy in many organisations, although employees at all levels are encouraged to contribute their expertise.

Work-life balance is another important aspect of working life in Germany. The standard workweek is typically 35–40 hours, and there is a strong emphasis on respecting personal time outside work hours. Paid annual leave is generous, with employees entitled to at least 20 days, although many employers offer more.

Germany’s employment laws are designed to protect workers and ensure fair treatment. They encompass various areas, including contracts, wages, working hours, and benefits.

Employment contracts will typically be in a written format, although verbal contracts are legally valid. Written contracts must outline the salary, working hours, job duties, and notice periods. There is usually a probation period that lasts six months, during which termination is easier for both parties. The minimum notice period is four weeks, which will increase with the employee’s length of service.

Employees in companies with more than 10 workers who have been employed for over six months are protected under the Protection Against Dismissal Act. This means that employers must have valid reasons for termination.

Pregnant employees will be entitled to up to 14 weeks of paid maternity leave, amounting to six weeks before the birth and eight weeks after. Parents can take up to three years of parental leave, and there is some financial support available through the German government’s parental allowance scheme. This is available until the child reaches three years of age, although 12 months can be transferred to be used between the child’s third and eighth birthday.

Taxation in Germany for expats can be complex, but understanding the basics is essential for compliance and to optimise your financial situation.

Germany has six tax classes that determine the rate based on marital status, dependents, and employment circumstances. For instance, single individuals fall into Class I, while married couples may benefit from Classes III and IV. Sometimes, an individual may request to be put into a specific class. The class is used to assess how much income tax will be deducted, as well as which benefits the individual will qualify for.

If you’re an employed worker who is taxed at the source, you generally do not need to file a return unless you have additional income or qualify for deductions (e.g., childcare, work-related expenses). Filing a return can often be beneficial for partial-year residents or those with tax-deductible expenses​​. The annual deadline for filing tax returns is 31 July, extendable to 31 December if you use a tax advisor.

Expats may be eligible for deductions related to relocation, housing, or childcare. Tax advisors (steuerberater) or online tools can simplify the filing process​ for you and provide specific guidance for your circumstances.

Germany has agreements with many countries to avoid double taxation, including the UK, helping to ensure income is taxed only once between your home country and Germany.

Germany applies a progressive tax system ranging from 0% for annual incomes up to €11,604 to 45% for earnings exceeding €277,826. Middle-income earners face rates between 14% and 42%​. Social security contributions (e.g., for healthcare, pension, and unemployment) are mandatory and deducted alongside income tax​.