Even if you had to find insurance on your own you probably have less than a dozen choices of provider in any given state . Well , to be honest , while you can choose your own sickness fund in Germany , the differences are small . As an employee , you pay the same premium for each of them . The coverage is also mostly fixed , because that ' s also regulated . A sickness fund only has to pay for economically viable , sufficient , necessary and meaningful services . And , IIRC , there ' s a general fund behind all of them , which is to ensure that no individual sickness fund is affected by moral hazard . However , there are some deductibles . The biggest difference is each fund ' s right to request extra money from you , called a additional contribution . However , due to the intense competition , almost none does that yet , as far as I know . But as a result , the number of funds is decreasing it ' s been 116 in 2016 , according to the latest stats . They fusion to minimize administrative costs . The advantage is that there ' s hardly any reason for any sickness fund to not provide coverage in any state or for your employer to care which one you want , so you can switch anytime . If you want better coverage or more services , there are two ways to get that 1 . You pay for so called individual health services . In other words , you pay the physician out of your own pocket for doing something extra . Most of these are not medically necessary but it provides the physician with additional money . 2 . You pay for an addon insurance which usually covers some of your deductibles . The most common one is for dentures , I believe . In other words , while the basic medical supply is covered by your sickness fund , there are ways to get better services if you want them . It ' s not a perfect system since there ' s a lot of historical baggage , but it basically works .