01
Outpatient add-on
Glasses, check-ups, alternative practitioners, co-payments. Useful comfort, limited protection.
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Supplementary health insurance: topping up German public cover
If you are in German public health insurance, you are well covered for medical treatment, but not for everything you may be used to. Supplementary policies from private insurers add specific benefits such as a private hospital room, a senior consultant or better sick pay. They make sense where a gap could cost you real money, not as a bundle of small refunds.
The question almost everyone asks first
What does German public health insurance not cover?
Public insurance pays for treatment that is sufficient, appropriate and economical. It does not pay for a private hospital room or your choice of senior consultant, most dental crowns and implants beyond a fixed subsidy, glasses for adults with normal eyesight problems, alternative practitioners, or professional teeth cleaning. Sick pay from your fund covers only part of your salary after six weeks. Supplementary insurance targets exactly these gaps.
How German hospitals work for public patients
As a public patient you are treated by the doctor on duty and usually share a room with one or two others. Medical quality is the same, but you do not choose who operates on you. A hospital supplement pays for so-called elective services (Wahlleistungen): a private or semi-private room and personal treatment by the head of department, billed under the private doctors' fee scale.
This is the German equivalent of what many people from the US or UK think of as private hospital cover. Check whether the plan also pays in private clinics that do not accept public patients, and whether it covers bills above the maximum rate of the fee scale.
Sick pay: the gap most newcomers miss
German employers continue your full salary for six weeks of illness. After that, your public fund pays sick pay of 70 percent of gross salary, capped at 90 percent of net pay and calculated on at most €5,812.50 a month in 2026. If you earn more, the gap grows quickly.
Self-employed members of a public fund receive no sick pay at all unless they opt in with their fund. A private daily sick pay policy, starting from a day you choose, can be the most valuable supplement you buy.
What to know before you sign
Supplements only cover future problems. Treatment that a doctor has already recommended is excluded, even if it starts after you sign. Most plans ask about your health, and conditions you already have may be excluded.
In the first three policy years, the insurer may terminate a supplementary policy at the end of an insurance year. After that, ordinary termination by the insurer is excluded by law. Plans calculated with ageing reserves cost more at first but rise less with age than plans priced by age bands.
What is covered
- Private or semi-private hospital room
- Treatment by the senior consultant (Chefarzt)
- Free choice of hospital without extra charges
- Alternative practitioners (Heilpraktiker) and osteopathy up to an annual limit
- Glasses and contact lenses, usually every two years up to a set amount
- Check-ups and vaccinations not paid by the public fund, including some travel vaccinations
- Co-payments for prescriptions and therapies
- Daily sick pay after the six weeks of continued salary
- Daily hospital cash per day in hospital
What is not covered
- Treatment recommended or started before the policy began
- Benefits during waiting periods
- Cosmetic treatment
- Costs already paid by your public fund
- Amounts above the plan's annual limits
- Excluded pre-existing conditions
Who needs it
- Employees earning well above €5,812.50 a month, whose public sick pay falls far below their net income
- Self-employed members of a public fund who have no income if they fall ill
- Anyone who wants a private room and the consultant of their choice in hospital
- People used to osteopathy or alternative treatments at home
Who can do without
- Anyone with comprehensive private health insurance, which usually includes these benefits
- People who could easily pay small bills such as glasses themselves
Wheel of misfortune
Spin the wheel of bad luck
Six things that really happen. The wheel picks yours and shows who pays.
Cost:
Budget policy
Strong policy
See all six cases
- Private room after giving birth, often 100 € or more per night. Budget policy: pays in part, Strong policy: pays. Basic hospital add-ons pay for a two-bed room. Only the single-room option covers a room to yourself.
- Freelancer off sick for two months, several thousand euros of lost income. Budget policy: pays in part, Strong policy: pays. Sick pay from day 43 covers only the last weeks. A policy starting from day 8 or 15 pays almost the whole time.
- Broken arm on holiday in Thailand, a few thousand euros. Budget policy: pays, Strong policy: pays. Public insurance does not pay outside the EU and a few partner countries. A travel policy covers this for a small annual premium.
- Osteopath for back pain, roughly 60 to 120 € per session. Budget policy: pays in part, Strong policy: pays. Small plans cap alternative treatment at a few hundred euros a year. Stronger plans pay more sessions.
- Glasses with thin varifocal lenses, roughly 500 to 1,200 €. Budget policy: pays in part, Strong policy: pays in part. Even good plans give a fixed budget for glasses, usually every two years.
- Knee surgery already scheduled, several thousand euros in extras. Budget policy: does not pay, Strong policy: does not pay. Treatment recommended before your policy starts is never covered. Buy the cover while nothing is planned.
What it costs
Premiums vary widely because very different products share the name. A basic outpatient plan costs a fraction of a hospital plan with private room and consultant.
What drives the premium
- Age when you sign up
- Pricing with or without ageing reserves
- Scope: semi-private room only or private room plus consultant
- Amount of daily sick pay and the day it starts
- Health status and any surcharges
- Annual limits for outpatient benefits
We do not show example premiums because plans differ too much in scope and pricing method. Your premium is fixed in the quote after the health questions.
The policy levels on the market
02
Hospital add-on
Semi-private or private room, senior consultant, free choice of clinic. The main difference to public cover.
03
Income add-on
Daily sick pay or hospital cash. Protects money rather than treatment, often essential for the self-employed.
How to recognise a good policy
| Criterion | Minimum standard | Strong policy | Why it matters |
|---|---|---|---|
| Fees above maximum rate | up to 3.5 times the standard fee | beyond that with fee agreements | Senior consultants often agree higher fees in writing. |
| Private clinics | not covered | extra costs in private clinics covered | Some specialised clinics do not accept public patients. |
| Pricing method | age bands without reserves | with ageing reserves | Decides whether the premium stays affordable in retirement. |
| Waiting periods | three and eight months | waived | A planned operation may otherwise fall into the waiting time. |
| Sick pay start | from day 43 | selectable from day 4 to 43, with increase option | For the self-employed the gap begins on day one. |
| Termination waiver | legal right in the first three years | insurer waives it from the start | Otherwise a costly first claim could end your cover. |
| Worldwide validity | Germany only | also during stays abroad | Expats often spend weeks in their home country. |
Insurers on the German market
Supplementary plans are sold by German private health insurers, some also through partnerships with public funds that offer their members discounted terms. The list is a market overview of well-known insurers.
| Insurer | Background |
|---|---|
| DKV | health insurer of ERGO Group, partnerships with public funds |
| ERGO | part of Munich Re, also sold directly online |
| HanseMerkur | partner of several public health funds |
| Allianz | agents and brokers |
| Barmenia | part of Barmenia Gothaer group |
| Signal Iduna | mutual insurer, agents and brokers |
| Continentale | mutual insurer, agents and brokers |
| ARAG | part of the family-owned ARAG group |
From the BaFin register
42
42 insurers supervised by BaFin, the German regulator, are licensed for this class of insurance. (Krankenversicherer)
Show all 42 names from the register
- Allianz Private Krankenversicherungs-Aktiengesellschaft
- ALTE OLDENBURGER Krankenversicherung AG
- ALTE OLDENBURGER Krankenversicherung von 1927 Versicherungsverein auf Gegenseitigkeit
- ARAG Krankenversicherungs-Aktiengesellschaft
- Augenoptiker Ausgleichskasse VVaG (AKA)
- AXA Krankenversicherung Aktiengesellschaft
- Barmenia Krankenversicherung AG
- Bayerische Beamtenkrankenkasse Aktiengesellschaft
- Concordia Krankenversicherungs-Aktiengesellschaft
- Continentale Krankenversicherung a.G.
- Debeka Krankenversicherungsverein auf Gegenseitigkeit Sitz Koblenz am Rhein
- DEVK Krankenversicherungs-Aktiengesellschaft
- DKV Deutsche Krankenversicherung Aktiengesellschaft
- ENVIVAS Krankenversicherung Aktiengesellschaft
- ERGO Krankenversicherung AG
- Generali Deutschland Krankenversicherung AG
- Gothaer Krankenversicherung Aktiengesellschaft
- Hallesche Krankenversicherung auf Gegenseitigkeit
- HanseMerkur Krankenversicherung AG
- HanseMerkur Krankenversicherung auf Gegenseitigkeit
- HanseMerkur Speziale Krankenversicherung AG
- HUK-COBURG-Krankenversicherung AG
- INTER Krankenversicherung AG
- Landeskrankenhilfe V.V.a.G.
- LIGA Krankenversicherung katholischer Priester Versicherungsverein auf Gegenseitigkeit Regensburg
- Lohnfortzahlungskasse Leer VVaG
- LVM Krankenversicherungs-AG
- Mecklenburgische Krankenversicherungs-Aktiengesellschaft
- MÜNCHENER VEREIN Krankenversicherung a.G.
- NÜRNBERGER Krankenversicherung Aktiengesellschaft
- ottonova Krankenversicherung AG
- praenatura Versicherungsverein auf Gegenseitigkeit (VVaG)
- Provinzial Krankenversicherung Hannover AG
- R+V Krankenversicherung Aktiengesellschaft
- SIGNAL IDUNA Krankenversicherung a.G.
- SONO Krankenversicherung a.G.
- Süddeutsche Krankenversicherung a.G.
- UNION KRANKENVERSICHERUNG AKTIENGESELLSCHAFT
- uniVersa Krankenversicherung a.G.
- Versicherer im Raum der Kirchen Krankenversicherung AG
- vigo Krankenversicherung VVaG
- Württembergische Krankenversicherung Aktiengesellschaft
Source: BaFin company database, retrieved 18 September 2026. Insurers from other EU countries selling through a branch or without a German office are not included.
Legal basis and sources
Products and add-ons
Hospital supplement
Room upgrade and consultant treatment, separately or combined.
Outpatient supplement
Alternative practitioners, glasses, check-ups and co-payments, usually with annual limits.
Daily sick pay
A fixed daily amount after continued salary ends, or from a chosen day for the self-employed.
Hospital cash
A fixed amount per day in hospital regardless of costs. Nice to have, not enough on its own.
Travel health insurance
A separate policy for trips abroad, essential outside Europe because public cover stops at the EU border.
Myth or truth
True or false?
Five things people say about this insurance. Guess first, then see the answer.
As a public patient in Germany I can't see a private doctor.
This is false.
False. You can, but you pay the bill yourself unless you have a supplement that covers it. Ask for the price before the appointment.
My employer keeps paying my full salary for the first six weeks of illness.
This is true.
True, under the Continued Remuneration Act, once you have worked there for four weeks. After that, public sick pay takes over at a lower rate.
Premiums for supplementary insurance stay the same for life.
This is false.
False. Most supplements can rise with age or with the costs of the tariff. Plans calculated like life insurance rise less with age, but still follow costs.
A public patient can pay for the senior consultant out of pocket.
This is true.
True. Hospitals offer this as an optional service you sign for on admission. The insurance just pays the bill for you.
Public insurance pays to fly me home if I fall ill abroad.
This is false.
False. Repatriation is never covered by German public insurance. Only a travel policy pays for the flight home.
Common mistakes
- Buying a combination plan that refunds barely more than it costs
- Assuming public sick pay replaces your full salary
- Signing after the dentist or doctor has already recommended treatment
- Keeping a cheap age-band plan into retirement
- Relying on public cover during trips outside Europe
Questions and answers
Frequently asked
Can I get a private hospital room as a public patient?
Yes, either by paying the hospital yourself or through a hospital supplement. The supplement also covers treatment by the senior consultant, which public insurance does not pay for.
Does German public insurance pay for glasses?
For adults only in exceptional cases, such as severe visual impairment. Children and young people under 18 get lenses paid, frames are always your own cost. Supplements typically pay a fixed amount every two years.
Is sick pay enough in Germany?
For average earners it covers most of the net salary after six weeks. If you earn more than €5,812.50 a month, the cap reduces it sharply. Self-employed people in public insurance get nothing unless they choose sick pay with their fund.
Will the supplement pay for treatment I already need?
No. Anything a doctor recommended before the start date is excluded. Sign up while no treatment is pending.
Do I need health insurance for trips abroad?
Yes, outside the EU. Your European Health Insurance Card only works in EU and EEA countries and Switzerland, and even there only for public-standard care. Travel health insurance costs little and covers medical repatriation.
Can I cancel a supplementary policy?
Yes, usually at the end of each insurance year with three months' notice. If you cancel and sign up again later, new health questions and waiting periods apply.
Are there supplements without health questions?
Yes, mainly basic outpatient plans and some hospital plans with longer waiting periods. Benefits are then usually limited and existing conditions remain excluded.
Can I use supplementary insurance with the European Health Insurance Card?
They work independently. The card gives you public-standard care in other EU countries, a private supplement or travel policy pays what the card does not.
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