What are the main differences between Public health insurance and Private health insurance?
Public health insurance (GKV) and Private health insurance (PKV) both provide comprehensive medical coverage in Germany, and both are accepted by doctors and hospitals nationwide. The two differ in the following areas:
How quickly you get an appointment: Private health insurance usually gets you an appointment sooner, because many doctors reserve a share of their slots for privately insured patients. Public health insurance can involve longer wait times, particularly with specialists.
Dental coverage: Private health insurance includes more comprehensive dental treatment on most plans. Public health insurance covers dental care only at a basic level, so a separate dental add-on is recommended.
Pregnancy care: Public health insurance and Private health insurance both provide cover for pregnancy-related medical care.
Income protection while you're sick: Public health insurance and Private health insurance both offer income protection (Krankengeld), but when payments start depends on whether you're employed or self-employed.
If you're employed, your employer pays your salary for the first 42 days of sick leave under both Public health insurance and Private health insurance, and income protection starts on day 43. Public health insurance pays a fixed statutory amount, while Private health insurance lets you choose the daily amount.
If you're a freelancer or self-employed, no employer covers those first 42 days. Under Public health insurance, income protection isn't included automatically — you have to elect it for a higher contribution rate, it then starts on day 43, and you're bound to that choice for 3 years. You can add an optional tariff (Wahltarif) to start payments earlier. Under Private health insurance, you choose both the daily amount and the day payments begin, starting as early as day 22.
Type of insurance card: Public health insurance issues a physical insurance card that you present at the doctor's office. Private health insurance issues a digital insurance card, with a physical card available on request.
Cost of covering dependents: Public health insurance covers your dependents at no additional cost. Private health insurance covers dependents at an additional premium per person.
How premiums are paid: Public health insurance premiums are deducted automatically from your gross salary and shown on your pay slip. Private health insurance premiums are debited from your bank account at the start of each month, and your employer reimburses their share alongside your salary.
How you get treatment paid for: With Public health insurance, you show your card and the doctor bills your provider directly, so there's no claim to submit. With Private health insurance, you receive the invoice, file a claim, and are reimbursed within 3–4 weeks.