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German Healthcare: What is the Dual-Payer System?
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German Healthcare: What is the Dual-Payer System?

If you’ve recently moved to Germany then you might be surprised to find out that health insurance isn’t free for everyone. Unlike in the UK and other European countries, Germany has a dual-payer system.

Don’t know what that means? We break it down for you:

What is a dual-payer system?

In a dual-payer, or two-tier system, the government is the primary purchaser of healthcare, but a secondary—usually privatised—healthcare offering also exists. In Germany, broadly speaking, there are two health insurance options: public or private.

The first tier: Public health insurance

Public, or gesetzliche Krankenversicherung, is state insurance that is provided by over 110 individual not-for-profit Krankenkassen, or “sickness funds.” The Techniker Krankenkasse (better known as just TK) is just one of the many individual state funded health insurance companies. Each of these health funds is operated by contributions from both its members and the German government.

How much does it cost?

Individual contributions are generally determined by salary. If you are employed, your employer will be responsible for paying half of your contribution.

Are you a freelancer from outside the EU? Check out our expat health insurance plan.

The second tier: Private health insurance

Private insurance, or private Krankenversicherung, operates entirely outside of the world of public health insurance. These institutions don’t receive any money from the German state, but do abide by certain regulations mandated by German law.

If you’re employed, you’ll generally only be able to buy private insurance if you earn over a certain monthly threshold (around €5.000 a month). This limit does not apply to self-employed individuals.

Want to know more about your health insurance options? Click here.
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