What does deductible mean in health insurance?

If you have looked into health insurance in Germany, you have probably heard of the terms “Selbstbehalt” or “Selbstbeteiligung”. These two words have the same meaning, i.e., meaning “deductible”.

In principle, health insurance in Germany covers the costs if you have to see a doctor or go to the hospital. This applies to statutory and private health insurance. With a deductible, you bear part of these costs yourself.

The deductible is the amount that you have to pay yourself if you need treatment or medication. If you opt for a deductible, your contribution to the insurance is cheaper. You agree with the health insurer that they will receive a lower premium, but that you will contribute to the costs in the event of illness. 

Do not confuse the deductible with the contribution: You pay the contribution to your health insurance monthly. You pay them whether you need the insurance or not. The deductible only applies if you actually get sick. 

The deductible in statutory health insurance

Many health insurance companies offer so-called optional tariffs with a deductible. A tariff is a kind of contract that you conclude with the insurer or the health insurance company.

With these optional tariffs, you bear part of your treatment costs yourself. In return, you will receive a premium as a reward from your health insurance company. This premium is limited by law to 600 EUR per year.

Your agreed deductible must always be higher than 600 EUR. This is also required by law. An optional tariff like this one is voluntary. It is cheaper, but if you get sick unexpectedly and have to see a doctor often, the costs can quickly become very high. Then the tariff is no longer worthwhile for you.

There is also premium reimbursement. With some health insurances, you get a month's worth of payment back if you don't see a doctor for a year. Here, you have no financial risk.

What types of deductibles are there in private health insurance?

Private health insurance companies offer different types of deductibles. For example:

  • the fixed deductible
  • the percentage deductible
  • the deductible for individual modules

With a fixed deductible, you pay your medical bills yourself up to a fixed amount in EUR per year. For example, if a deductible of 500 EUR has been agreed to, your health insurance only pays if your treatment costs exceed 500 EUR.

With a percentage deductible, you contribute a fixed percentage to the costs. For example, if you go to the doctor and get an invoice, you pay 20 percent of it yourself  – but only up to a maximum amount.Private health insurance sometimes consists of individual components. There are tariff modules for doctors, dentists, and hospitals. For example, if you have a component deductible, you only have to take part in dental treatment. 

When does a deductible make sense?

If you rarely or never see a doctor, a deductible may be worthwhile for you. This is how you save on your insurance premium. Make sure, however, that the deductible is not too high. You never know if you might suddenly get sick. Then you may have to pay a lot yourself and deplete any savings you have!