Around 90 percent of all Germans are members of a statutory health insurance fund. As an employee with a monthly salary of up to 5,550 euros (or 66,600 euros per year / as of 2023), you must take out statutory health insurance. If your income exceeds this limit for at least one year or if you are professionally self-employed, you can switch to private health insurance. Even if you are a civil servant entitled to benefits, you are usually covered by private health insurance.

Health insurance funds are allowed to charge an additional contribution
Since 1 January 2015, all people with statutory health insurance have initially paid the same contribution rate for their health insurance. This standard contribution is 14.6 per cent of gross income. Employers and employees each pay half of this, i.e. 7.3 per cent. However, this standard contribution rate is not enough to cover the expenses of the health insurance funds. The statutory health insurers are therefore allowed to levy an additional contribution. Since 2019, the additional contribution has again been financed on a parity basis, i.e. half by employers and half by employees. If, for example, the insurance fund charges an additional contribution of 1.0%, the employer retains 7.8% of the gross income as the employee contribution and transfers this amount together with the fixed employer contribution of 7.3% plus half of the additional contribution (0.5%) to the health insurer.

Your family is also insured
The benefits provided by the statutory health insurers are almost identical. They pay for what is medically necessary, and depending on the insurer, there are additional benefits such as cost coverage for homeopathic treatments, special health checks and more. By the way, your family members with no income or only a low income are covered by your statutory health insurance free of charge - unlike in private health insurance, which requires a separate contribution for each family member.

As an employee, you decide yourself which statutory health insurance fund you want to join. You can choose between general local health insurance funds, substitute health insurance funds, company health insurance funds and guild health insurance funds. Local health insurance funds and substitute health insurance funds are open to legally insured persons from all over Germany. Some company and guild health insurance funds only accept employees from certain companies and occupational groups or limit their activities to certain regions by statute.

You can cancel immediately if you pay a higher additional contribution
As an insured person, you can easily change your statutory health insurance fund; the regular notice period is two months to the end of the month. If the insurance fund levies an additional contribution for the first time, increases the additional contribution or reduces the premium paid out, you also have a special right of termination and can even cancel within one month. The insurance fund must inform you about a change in the additional contribution in good time so that you can change to another statutory health insurer before the new contribution is due.

The basic benefits provided by statutory health insurers are largely the same. What is medically necessary is paid for by all insurers - except for the prescription fees and co-payments for outpatient and inpatient therapies, which have to be paid by the insured person. However, expensive and particularly gentle treatment procedures are often reserved for clients of private insurers.

The health insurance funds offer different extras
For statutory health insurance customers, the extra services offered are particularly important when it comes to deciding on a particular health insurer: many insurers also pay for acupuncture and naturopathy, health courses or special vaccinations in addition to basic medical care. In addition, the statutory health insurers offer special optional tariffs - for example, GP tariffs without a practice fee and tariffs with premium reimbursement if an insured person does not make use of medical services for a year.

Since 2015, a general contribution rate of 14.6 per cent of gross salary has applied in the statutory health insurance system, of which employers and employees each pay half. If a health insurance fund cannot make ends meet, it can levy an additional contribution, which must be shared by the employee and the employer. If the health insurance fund levies this additional contribution for the first time or increases the previous additional contribution, you can immediately switch to another, preferably cheaper, health insurance fund.

Contribution only up to the assessment ceiling
When calculating contributions to statutory health insurance, the so-called contribution assessment ceiling applies. Your contribution to statutory health insurance is calculated at most according to this amount - even if you actually earn more. In 2023, the income threshold is 5,550 euros per month, which corresponds to a gross annual income of 66,600 euros.

Example: You earn 4,950 euros per month as a person with statutory insurance. Your health insurance fund charges the general contribution of 14.6 percent up to the current assessment ceiling, which is 706.28 euros. Half of this amount - plus any (individual) additional contribution due - is deducted from your gross salary.

You can change to another statutory health insurance fund as soon as you have been a member of your previous health insurer for at least 12 months. The statutory notice period of two full months to the end of the calendar month after next applies.

Since 1 January 2021, the federal government has simplified the process of changing health insurers: in order to cancel, it is sufficient to submit a membership application to your new health insurer, who will take care of the cancellation with the previous health insurer for you.

If your health insurance fund levies an additional contribution for the first time, increases the additional contribution or restricts its benefits, you have a special right of termination and the 12-month commitment period does not apply.

Your statutory health insurance only pays for basic medical care. If you want first-class benefits, it is best to opt for private supplementary health insurance as a statutory health insurance patient.

Design the supplementary cover according to your personal needs
You decide which benefits you want to cover in your supplementary health insurance according to your personal needs. Depending on the tariff, outpatient benefits (e.g. doctor's visits, glasses, psychotherapy), dental benefits (e.g. orthodontics, high-quality dentures) and benefits for hospital stays (e.g. one-bed room, treatment by a chief physician) can be insured.

Important: As a rule, you cannot claim the benefits of your private supplementary health insurance immediately after taking out the policy. You can expect waiting periods of several months before your supplementary insurer will pay for expensive dentures or high-quality glasses. So find out in good time.

Private health insurance offers many advantages. As an employee, you only have to remain covered by statutory health insurance if you earn no more than 5,550 euros per month (or 66,600 euros per year / as of 2023). As soon as your income exceeds this limit for at least one year, you are allowed to switch to a private health insurer. This can be worthwhile especially if you are healthy and do not have to insure any family members. 

Even if you cannot or do not want to switch to a private health insurer, you should not do without extra benefits: With a private supplementary health insurance, you can significantly improve your medical care and adapt your insurance cover to your own personal needs.