Reforms to the German healthcare system have been highlighted by Jelf international, as Germany aims to keep healthcare costs under control.
Over 280,000 employees work for UK controlled countries in the UK, and private prepaid health insurance plans account for 40% of private expenditure on health in Germany.
Employees with a salary below €53,550 (£39,417) are automatically enrolled in the German state system, those with salaries above may opt out and select Private Medical Insurance (PMI) instead.
Employees must prove to their employer that their PMI policy at least meets the level of cover offered by the German state health insurance.
Employers and employees can also opt out of German state health insurance if the employee is going abroad from a UK HQ and the work is time limited.
Employees with a global medical policy, and a contract formed outside Germany (eg with a UK HQ) are also exempt.
The European Health Insurance Card offers medical treatment under the same terms as German citizens for short term visits.
Jelf has warned employers to consider if they can rely on the health insurance card and travel insurance if their staff are spending a lot of their time in Germany.
Other considerations include the difference in benefit levels between the UK and Germany and whether employees will be outside Germany for long periods or have dependents outside Germany.
Doug Rice, managing director of Jelf International said: "Despite having put reforms in place, Germany's healthcare system continues to be under pressure, and successive governments have tried to reduce outgoings by cutting the proportion of the cost covered for treatments such as dental and vision care.
"Therefore, many higher earners or professionals are preferring to hold a PMI policy that also covers treatment outside of Germany and is more in line with the benefit levels they are accustomed to in their home country."