Private health insurance cover in Germany
Compare the essentials of each level at a glance: BASIC, SMART, PRO and MAX. A general overview to give you an idea before talking to us.
The key points of each level
A quick look before getting into the comparison.
BASIC
Base cover with the tightest price-to-benefit ratio.
SMART
Better hospital cover and refunds without pushing up the premium.
PRO
Direct access to specialists and medication at 100%.
MAX
Single room, dental at 90% and no limits.
The key points of each level
A quick look before getting into the comparison.
BASIC
- Deductible 300 €/year
- Referral required
- Public hospital
- Medication 75%
- Dental prosthetics 60%
- Premium refund 300 €/year
- Glasses 125 €/2 years
- Parental break 6 months
- Worldwide cover
SMART
- No deductible
- Referral required
- Public + private hospital
- Medication 80%
- Dental prosthetics 80%
- Premium refund up to 1.500 €/year
- Glasses 150 €/3 years
- No parental break
- Worldwide cover
PRO
- No deductible or 300 €
- Direct specialist access
- Public + private hospital
- Medication 100%
- Dental prosthetics 80%
- Premium refund up to 1.700 €/year
- Glasses 300 €/2 years
- Parental break 6 months
- Worldwide cover
MAX
- No deductible or 300 €
- Direct specialist access
- Single room
- Medication 100%
- Dental prosthetics 90%
- Premium refund up to 1.800 €/year
- Glasses 600 €/2 years
- Parental break 6 months
- Worldwide cover
The cover that weighs most in the decision
A summary view of what people look at most when comparing plans. The full detail — progressions, fee factors, exclusions, waiting periods — we go through with you when we talk.
| Cover | Basic | Smart | Pro | ★ Max |
|---|---|---|---|---|
| Medical care | ||||
| Annual deductible | 300 € / year | No deductible | No deductible or 300 € | No deductible or 300 € |
| Direct access to specialists No medical referral |
Referral required | Referral required | ✓ Yes | ✓ Yes |
| Reimbursement of prescription medication | 75% | 80% | 100% | 100% |
| Hospital type | Public clinics only | Public and private | Public and private | Public and private |
| Hospital accommodation | Shared room | Max. 2 people | Max. 2 people | Single room |
| Hospital surgery | Doctor on duty | Free choice, incl. head physician | Free choice, incl. head physician | Free choice, incl. head physician |
| Specific cover | ||||
| Dental prosthetics Crowns, bridges, inlays |
60% | 80% | 80% | 90% |
| Psychotherapy With a licensed psychotherapist in Germany |
75% · up to 50 sessions/year | 80% · up to 50 sessions/year | 80%; from session 31 → 100% | 100% · no session limit |
| Glasses and contact lenses | 75% · max. 125 €/2 years | 150 €/3 years | 300 €/2 years | 600 €/2 years |
| Extra benefits | ||||
| Annual premium refund If no bills are submitted during the year |
300 € / year | Up to 1.500 € / year | Up to 1.700 € / year | Up to 1.800 € / year |
| Premium suspension during parental leave | ✓ Up to 6 months | Not included | ✓ Up to 6 months | ✓ Up to 6 months |
| Worldwide cover Trips up to 3 months |
✓ Yes | ✓ Yes | ✓ Yes | ✓ Yes |
Note. Indicative table with the cover that weighs most in the decision. Each plan includes other benefits (physical therapies, naturopath, preventive check-ups, surgical vision correction, progressive dental cover in the first years, among others) and nuances that depend on the company. The definitive terms are governed by the insurer's contract.
Behind every line there are nuances that don't fit in a table
Age, type of contract, family plans, medical history... every profile has different questions that deserve a specific answer. A comparison guides you, but it doesn't decide for you.
We talk with you, explain in English exactly what each level covers for your situation and answer any questions you have left. No long forms, no obligation, and no need to study a dossier first.
Common questions about cover and access to private insurance
What conditions do you have to meet to take out private insurance?
Access to private insurance isn't automatic. Several factors determine whether you can take it out: exceeding the set income threshold, not being required to stay in the public system, meeting the administrative deadlines and passing a health assessment.
Each case is analysed individually, so it's advisable to get advice before making a decision.
How does private insurance differ from public in price?
One of the biggest differences between the two systems is how the premium is calculated.
In public insurance, you pay according to your salary. In private insurance, by contrast, the price depends on your age, your state of health and the cover you choose.
This makes private insurance especially attractive for young, healthy profiles, since they can access more competitive prices.
What does private health insurance cover?
Private insurance stands out for its flexibility and for offering a greater level of personalisation.
Depending on the plan, you can access medical care with shorter waiting times, free choice of doctors and hospitals including private centres, treatment by the head physician and better hospital conditions.
It can also include cover for glasses, alternative treatments and high reimbursements on dental treatments. What's more, the terms are fixed by contract, which provides long-term stability.
What factors influence the price of private insurance?
Private health insurance can be a very good option for certain profiles, especially employees with high incomes, job stability and good health.
That said, it isn't a decision to make on price alone. It's important to look carefully at the cover, the long term and your personal needs before taking the step.
What income is taken into account to access private insurance?
The threshold that determines access to private insurance doesn't only take your base salary into account.
Recurring income such as extra payments is also included, as long as it's regular. This threshold is reviewed each year, so it can vary slightly.
What happens if my income falls in the future?
If at some point your income falls below the threshold again, in principle you'd have to return to the public system.
However, in certain situations there's the possibility of requesting a review and looking at alternatives depending on the specific case.
Are there advantages to starting young in private insurance?
People who access private insurance at an early age usually benefit in the long term.
They build up retirement reserves for longer, reduce the likelihood of risk surcharges and access more attractive premiums.
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