The health system in Germany, which apparently stems from the Bismarck era, is being stretched more and more, straining the social system. That results in ever increasing insurance donations, which are compulsory for Germans and expats alike.
The health insurance landscape is highly complex. Basically there are two to three routes available to expats.
At the time of writing, if an employee earns under approximately € 4.000 per month, that person is obliged to take up insurance from one of umpteen so-called heath or sickness funds (Krankenkasse) available under the state system.The employer pays half of insurance costs. Each insurance company has individual policies and coverage.
Employees earning more than the threshold can choose to sign up to the state scheme or take private insurance. Again, numerous companies are available, the employer pays up to half of insurance costs and each offers individual policies and coverage. The risk of a rise in fees is higher.
Foreign insurance coverage seems to be accepted by the state under certain circumstances. This may be a solution for freelancers and those in employment who can accept their employers perhaps not reimbursing half of the cost.