Expatriates Stack Exchange is a question and answer site for people living abroad on a long-term basis. It only takes a minute to sign up.
Sign up to join this community
I'm moving to Germany this summer and may not have a job solidified beforehand. In that case I'd need to take out a private insurance policy to hold me over until I'm working and on a statutory plan. I've read that it's difficult to switch from private to public and would like to know if I might face any difficulties.
I also have some old injuries. Would anyone be able to confirm that the state system accepts non-citizens with pre-existing conditions?
Thank you, Aaron W
It's indeed difficult to switch from private to public health insurance, but if your salary is below 60750€ a year (in 2019), public health insurance is your only option, and public health insurers can't refuse to cover you.
Source: https://allaboutberlin.com/guides/german-health-insurance
Seems to me that on arrival, your only options for health insurance coverage are travel health insurance, private German health insurance or (if you are from a EU country and until 3 months in Germany) the EHIC health insurance card. Travel health insurance seems the simplest and cheapest for a few months or even a year, but they often exclude people with pre-existing conditions.
I've read that it's difficult to switch from private to public and would like to know if I might face any difficulties.
It is not difficult if (and only if!) your eventual job in Germany is as an employee. Because for employees, there are only two ways of being health insured, and both cases allow you to become part of the public German health insurance system without issues:
You earn ≤4950 EUR/month. (This value is the so-called "Versicherungspflichtgrenze" for 2018, and changes slightly year after year.) If this is your case, you are obliged to be in the public German health insurance, means you are not allowed to choose private health insurance even if you wanted. So in this case, the public insurance has to take you.
You earn >4950 EUR/month. In that case, you have the right to voluntarily join the public German health insurance even without having been insured there before (source).
I also have some old injuries. Would anyone be able to confirm that the state system accepts non-citizens with pre-existing conditions?
If you're obliged to be in the public system as an employee, they have to accept you (and I've yet to hear of a case where they did not). If you can only voluntarily join the system (second case from above), I am not sure.
By default, one should always choose a public insurance.
If eligible, one can always switch to a private insurance
A travel insurance, covering the time into you start working, should be taken.
Difference in concept of public and private insurance
public (Gesetzliche):
younger (often, but not always healthier) share the burden of those who are more elderly and thus more often have chronic health conditions
private:
based on needs of insured persons
to cover the costs, which will change depending on envolving health conditions.
extras:
(not offered in the basic public services)
This system is based on the Gesetz, betreffend die Krankenversicherung der Arbeiter of the 15th of June 1883 and assumed that most peaple would be living in the country their whole life long. Thus, for most, everything balances out.
For expatriates, the question is valid for someone only remaining 5 years, whether such a solidarity contribution (which they may not later benefit from) is worthwhile.
My personal experience was, when the time came in my professional life that I could switch to a private insurance, I was strongly advised by elder colleagues not to do so. The status symbol was not worth the later cost.
For expatriates, with a family, this aspect should be taken more into consideration, than for a single person remaining for 5 years.
