Out-of-pocket expenses

Out-of-pocket expenses are any payments that individuals make for their healthcare, including any payments at the point of use, deductibles, coinsurance, and co-payments.

Expenses in the German healthcare system

When it comes to financing the healthcare system, Germany takes a completely different approach than for example the US. Everyone living in Germany contributes to a safety net of affordable care for all. This also keeps out-of-pocket expenses to a minimum.

For more details, check out our explainer on the German healthcare system.

Payments under public health insurance

Public health insurance offers the same basic level of healthcare to everyone living in Germany but is bound by the principle of cost-efficiency. When it comes to out-of-pocket expenses, there are some key things to remember.

  • People with public health insurance can expect to make co-payments of €10 per quarter for seeing their doctor.
  • Prescription medicines are covered by public health insurance, subject to a co-payment of €5 10. Over-the-counter medicines are not covered.
  • Dental care often involves high co-payments under public health insurance. Many publicly insured people thus take out supplementary dental insurance (Zahnzusatzversicherung).

Payments under private health insurance

Private health insurance policies usually include a deductible, which the policyholder is usually free to choose. This is the share of your healthcare costs you commit to pay. This system enables private insurers to offer more extensive and higher quality coverage. The legal annual out-of-pocket maximum in Germany is €5,000.

No two private insurance plans are the same, but here are some key points:

  • Private insurance policies usually cover a wider range of treatments and services than public insurance.
  • Private policies often cover dental and visual care as standard.
  • Some insurers – like ottonova – cover the cost of approved over-the-counter medicines.

What makes ottonova special?

ottonova is Germany’s first fully digital private health insurance. We give you control over your healthcare and offer a range of tariffs – including a special expat tariff. This means you can select the right coverage for your needs and choose your deductible. ottonova also reimburses from the first invoice on, which is special as many other PKVs don't do that.


Can I use the insurance in my home country when I`m travelling back for vacation (or moving back)?

With our tariffs you have world-wide travel coverage. The Expat Tariff covers you up to two months in a row outside the EU and in our Business- or First Class Tariffs you will be covered up to six months in a row outside the EU. 

If you move away from Germany, you will not need German health insurance anymore.

Why is the enrollment in German?

The initial online enrollment is in German due to legal requirements. However, we are doing this together on the phone and we will of course help you through step by step. So no worries! 


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, which also includes our Expat tariff of course. 

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