Contribution rate

It might be logical to conclude that the higher your health insurance premiums, the higher the standard of care you receive. The reality, however, is often quite different – and there are numerous factors to consider before making a decision.

What will my health insurance premiums be?

Health insurance premiums are often also referred to as contributions (Beiträge) because the concept underpinning health insurance in Germany is based on solidarity. For all intents and purposes, premiums and contributions are coterminous in this context.

Working out what your health insurance premiums/contributions will be depends above all on which insurance system you choose. For eligibility conditions and other details of the two schemes, see our Expat Guide article.

Contribution rates in the public health insurance (GKV) system

In public (statutory) health insurance, policyholders’ premiums are based on their income.

  • Premiums calculated using a basic contribution rate of 14.6% of your gross monthly income, plus an average surcharge of 1.1% levied by your insurance provider. Premiums are calculated and deducted as part of monthly payroll processes.
  • Premiums are capped by the premium assessment ceiling (Beitragsbemessungsgrenze) of €58,050 p.a. (2021). If you earn more than this, your premiums will not continue to rise.
  • Your employer will contribute 50% of your total public health insurance premium (basic rate + surcharge). This means you could pay up to €367.98 per month for public health insurance.
  • Other costs: In the public health insurance system, everyone is required to pay an additional 3.05% of their gross monthly income for long-term care insurance (with an employer contribution of 50%).

Contribution rates in the private health insurance (PKV) system

In private health insurance, policyholders’ premiums are contractually agreed.

  • Premiums are not income-dependent and are instead based on the age at which you take out a policy and your health status. A healthy person who joins in their 20s will have far lower premiums than someone in their 50s.
  • Employers still contribute 50% of health insurance costs, but up to a limit. Employer contributions are capped at the maximum contribution for a publicly insured employee (€367.98 per month) – and policyholders must cover everything above this.

Other important factors

While the points above provide a basic overview of the two systems, there are other crucial points to bear in mind.

  • In the public health insurance system, policyholders have to make co-payments of €5-10 per prescription plus further co-payments for doctors’ appointments and hospital stays.
  • Many publicly insured people take out additional, top-up insurance policies (Zusatzversicherungen) as many public insurance providers do not cover dental and other treatments. This can see total health insurance costs gradually creep up.
  • The premium assessment ceiling can be adjusted at any time by German legislators and is rising sharply. In 2010, the ceiling was €45,000 – meaning the ceiling has increased by 25% in the last decade.

In truth, the pros and cons of the two systems are too detailed to explain in a single Wiki article. To help you make the right decision for you, we’ve put together an eBook that sets things out in clear, concise terms.


Am I eligible for the Expat Tariff / PKV tariff? Am I an expat in your definition?

If you are eligible for private health insurance and you are in Germany on a visa or a limited permit, we can offer you the Expat Tariff up to five years.

Does the health insurance work with my visa?

Ottonova is fully regulated by the BaFin and therefore fulfilling the requirements (§ 257 7Abs. 2a Satz 1 SGB V and the § 61 Abs. 5 SGB XI) for you to be able to apply for a visa with your ottonova insurance.

What is the Pflegepflichtversicherung and how does it work?

The long-term nursing care insurance "Pflegepflichtversicherung" is a mandatory insurance for everyone who lives in Germany. This insurance will cover you if you require long-term care and need external help.

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