German Health Insurance Guide for International Students

Stuff you need to know if you’re coming to Germany as a student on a visa.

In this article we’ll talk about German student insurance. After reading the article you might have an idea if it makes sense for you, personally, to sign up for a so called incoming insurance or rather register for statutory health insurance.

(If you like my content why not buy me a coffee or follow me on YouTube?)

Any questions? Write them as they come in the comments below.

Congrats! You got accepted to a University and now your student journey is about to take off! For your visa you had to show proof of some kind of health insurance. So you probably chose some temporary incoming insurance. So far so good.

health insurance in Germany is mandatory

But now your University asks for proof of health insurance!?

First let’s look at some legal requirements: Everybody in Germany needs to obtain some kind of health coverage. Actually, persons from outside the European Union that hold a residence permit or a visa need to fulfil some criteria for the health insurance:

You need to hold an appropriate health insurance. That means in particular the following:

the health insurance should

- be more or less comparable to the statutory health insurance coverage

- Not have a retained amout exceeding 1200 EUR per year

- Not include a cap on yearly reimbursements

- Not exclude people above a certain age

For incoming students in particular it is okay if the health insurance has a termination date. It is common practice for the immigration authorities to accept incoming insurances at the beginning as it is often not possible to obtain public health insurance right after arriving in Germany.

But once you register at a public acknowledged university and you are younger than 30 years you have the right to register with any public health insurance provider in the student insurance tariff. In 2024 the monthly contribution for the student tariff (including the mandatory care insurance) is around 130 EUR.

There are several public insurance providers available. Yearly medical check-ups, such as dental, dermatological and gynaecological check-ups are free. You do not pay extra for doctor visits as well as several other screenings. Even psychotherapy is free, assuming you get a therapy spot. Co-payments have a yearly cap. This cap is even lowered for people with chronic diseases. Co-payments are usually charged for medication, over night hospital stays, physio therapy and similar therapies.

At the beginning of your studies in Germany you are allowed to withdraw from the obligation for public insurance for the duration of your studies. That means that you are free to choose a private insurance instead.

But before you do that, please consider some important points:

1. Exclusion of pre-existing conditions

All private insurances exclude pre-existing conditions. Those insurances that specifically do not ask for a health questionnaire in the beginning might actually be the worst. Imagine some time after signing up with the insurance you get diagnosed with diabetes. The insurance might claim that the disease has already existed or developed before the insurance contract was valid and therefore not cover the related expenses.

If you develop a disease and the insurance covers it, any condition related to the disease will be excluded the next time the insurance contract gets renewed.

Let’s look at one example: You go for a hike with your friends and get biten by a tick. You develop borreliosis and later suffer from syptoms of swollen joints and heart problems. The private insurance covers the treatment of borreliosis and the after-effects until the contract ends – which is usually after one year. When the insurance contract is renewed all long-term-consequences of the tick bite are not included anymore. You need to pay the treatments out of your own pocket.

private insurances exclude pre-existing conditions

2. Exclusion of pregnancy care, birth and post-partum care

Most private incoming insurances exclude pregnancy care, birth and post-partum care. For those of you who can potentially get pregnant that might be an important point. Even though you do not plan to get pregnant you never know what might happen in the future.

3. Limited ways to get appropriate coverage

If you already declined your way to the public health coverage it is not possible to undo it while you are studying your programme.

In case you need a more encompassing health coverage while still studying your university programme, you could only change to the so called Basistarif in a German private health insurance. The Basistarif costs nearly 1.000 EUR per month and includes all pre-existing conditions. The price can be lowered if you are willing to cover excess payments between 300 to 1.200 EUR per year.

One option to still change to public insurance would be to change your residence permit to a working permit and quit your studies so you can find a vacancy as an employee. However, knowing Germany authorities this is very bureaucratic and takes quite some time. Those steps should only be taken with professional support by a lawyer or a specialized advice center.