The German health system has its origins in the era of Bismarck. Since then populations have risen, technology has advanced and medications are more widespread. Fortunately residents, including those in Rhine Ruhr, live longer, strain the social system and create perpetually increasing insurance fees.
Health insurance lis compulsory for Germans and expats alike. The health system is highly complex with some two or three options available to foreigners relocating to the country.
If an employee earns under approximately € 4.000 per month (at time of writing), that person is obliged to sign up to insurance from one of many so-called heath or sickness funds (Krankenkasse) available under the state system. Employers pay half of the insurance costs. Each insurance company has several individual policies and levels of coverage.
Employees earning more than the threshold are free to either sign up to the state scheme (freiwilig) or take out private insurance. Alternatives are available here too, the employer pays up to half of insurance costs and each offers individual policies and coverage. The risk of a rise in policy fees can be higher.
Foreign insurance coverage appears to be accepted by the state only under certain circumstances. This may be a solution for freelancers and those in employment who accept that their employers may not reimburse half of the cost in such cases.