Health Insurance in Germany
Just like registering your address in Germany (the Anmeldung), having valid health insurance is mandatory. In fact, most expats must prove that they have German-compliant health insurance before a visa or residence permit can be issued.
Health Insurance
In Germany, health insurance is called Krankenversicherung, and there are two main systems:
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Public (state) health insurance
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Private health insurance
Let’s break them down so you can decide which option is right for you.
Gesetzliche Krankenversicherung – State public health insurance
The majority of employees in Germany are insured through the public health insurance system, known as Gesetzliche Krankenversicherung (GKV).
Public health insurance is mandatory for employees earning up to €77,400 per year (2026 threshold) before taxes. It is the most common form of health insurance in Germany, with over 70 million people enrolled.
What does public health insurance cover?
GKV provides comprehensive coverage, including:
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General practitioner and specialist visits
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Inpatient and outpatient hospital treatment
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X-rays and diagnostic tests
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Most medical treatments and prescription medications
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Sick leave benefits and rehabilitation
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Basic dental care
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Pregnancy care and childbirth
Family coverage
One of the biggest advantages of public health insurance is free family coverage (Familienversicherung).
Non-working spouses and dependent children are insured at no extra cost, making GKV especially attractive for families.
Cost of public health insurance
There are over 100 public health insurance providers (Krankenkassen) in Germany. While additional benefits may vary, the cost structure is standardized:
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14.6% of your gross salary, plus
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An average supplemental contribution (varies by insurer)
If you are employed, your employer pays roughly half of your monthly contribution.
Krankenversicherung – Private insurance
Only about 10% of residents in Germany choose private health insurance, but it can be an attractive option for certain expats.
You may be eligible for Private Krankenversicherung (PKV) if you:
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Earn more than €77,400 per year (2026)
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Are self-employed or freelance
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Work as a civil servant (Beamter)
How are private insurance premiums calculated?
Private insurance premiums are not income-based. Instead, they depend on:
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Your age
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Your health status
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The level of coverage you choose
Who is private insurance best suited for?
Private health insurance often works well if:
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You are young, single, and earning a high income
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You want more extensive coverage and faster access to specialists
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You are comfortable paying medical bills upfront and claiming them back later
However, PKV is usually less cost-effective for families, as:
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Partners and children are not included for free
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Each family member requires a separate premium
Advantages of private health insurance
Private insurance often offers:
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Shorter waiting times for specialists
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Access to certain doctors and clinics that only treat private patients
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Broader treatment options and higher reimbursement levels
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Better dental coverage
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A higher likelihood of finding English-speaking doctors
There are around 40 private health insurance companies in Germany, each offering different benefit and pricing structures.
Important: Once you switch to private health insurance, returning to the public system can be very difficult—especially after the age of 55.
Public vs. Private: Key Differences
With private insurance, you usually:
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Pay the doctor or hospital bill upfront
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Submit the invoice to your insurer for reimbursement
With public insurance, you:
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Pay only small co-payments (e.g. prescriptions)
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Do not need to pay medical bills upfront
Dental care is a common difference:
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Public insurance covers only basic dental treatment
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You should expect to pay 20%–70% of many dental costs yourself
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Private insurance typically covers a much wider range of dental services
Which Health Insurance Is Right for You?
Choosing health insurance in Germany is a very personal decision. You should consider:
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Your income level
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Your family situation
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Your health and age
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Your long-term plans in Germany
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Your comfort with the German healthcare system and language
No matter which option you choose, having valid health insurance is essential for:
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Employment in Germany
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Applying for a residence permit or visa
Need Help Choosing?
Health insurance rules in Germany can be complex—especially for expats. The most important thing is to understand exactly what you’re covered for and what costs you may face in the long term.
If you’d like personalised advice, we’d be happy to arrange a free consultation with our trusted, independent brokers who specialise in expat health insurance.
Just let us know—we’re happy to help.
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