Medical reimbursement in Germany

Although there are some similarities between the public and private health insurance systems, how they reimburse medical expenses is a key difference.

The public health insurance system (GKV)

Reimbursement is straightforward for people with public health insurance because their doctor will bill their health insurance provider (gesetzliche Krankenversicherung or short GKV) directly. People with public health insurance do not have to pay when visiting their doctor – but they do have to make small co-payments for certain healthcare services, including:

The public system also tends to cover fewer treatments and services as standard. For example, people with public health insurance often take out additional private insurance policies (Zusatzversicherungen) to cover dental care, vaccinations and homeopathy.

The private health insurance system (PKV)

In the private system, you pay your doctor directly for their services. Therefore, some people worry that they have to pay medical bills upfront, but that's not the case:

  1. If you choose an efficient private health insurance (private Krankenversicherung or short PKV) your bill gets reimbursed before the money has to be at the doctor's office.
  2. When it comes to higher bills for example for an inpatient hospital treatment there is the possibility that the private health insurance provider pays the costs directly to the hospital.
  3. Just be sure to check with your provider that a treatment is totally eligible before you go ahead. With some treatments you even have to get in touch with your private health insurance to have the costs approved beforehand. If you need dental implants or other dentures, for example, you have to submit a treatment and cost plan.

Did you know that private insurance providers can cover more treatments and services than public providers, sometimes including non-prescription medications, private hospital rooms, and chief-physician treatments?

What makes the reimbursement process with ottonova special?

ottonova is Germany’s first fully digital private health insurance provider. This means you can manage your healthcare at your convenience using the ottonova app. When a doctor issues a bill, simply use the document upload function in the ottonova app – and we’ll start processing it straight away! So you can have eligible expenses reimbursed before the bill is due.


You can claim a part of the costs for private health insurance as ‘Vorsorgeaufwendungen’ expenses in your tax return, this is what the Citizen Relief Act (Bürgerentlastungsgesetz) has been saying since 2010, namely the part that is considered basic coverage. We certify how high this portion is each year and you do not have to calculate it yourself. The basic share corresponds to the benefits of the public health insurance.

The daily sickness allowance is an important insurance. When you get ill for a prolonged time and you cannot work, you normally lose your income. A daily sickness allowance insurance can help balance out this loss of income. The quantity of the daily sickness allowance is based on your net income and complements the additional money provided by the social security system.

As an employee, you are always guaranteed a wage continuation up to the 43rd day you’re ill with one illness. For this reason, it is practical to plan for your daily sickness allowance to start from the 43rd day.

For freelancers and self-employed professionals, the public wage continuation doesn’t apply – so therefore it’s even more advisable to plan for an insurance against the loss of potential income after the 43rd day.

At the moment we do not offer any money back if you don´t make usage of the insurance, as we want you to go and have your annual check-ups.

However, we offer reward points via our Health X program. Read more about Health X here.

Get a free consultation with us.

What tariff options do you have as an expat in Germany for private health insurance?

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