Expat Health Insurance in Germany (2026): Your Options, Costs and Visa Rules

Every resident of Germany needs health insurance from day one, whatever their nationality. As an expat you have up to three options: a short-term expat (bridge) plan, public health insurance (gesetzliche Krankenversicherung, GKV) or private health insurance. Which one you can use depends on whether you already have a job, how you are employed and what you earn.

Expecting a child? Your insurance interacts with Elterngeld, and Kindergeld is paid regardless of your insurer.

This guide shows which option fits your situation, what each costs in 2026 and what the visa office expects.

Your three options at a glance

Bridge and private premiums are indicative market ranges from provider and comparison pages, not quotes. Public figures are calculated from the 2026 statutory rates.

Do you need German health insurance as an expat?

Yes. Insurance is mandatory from the day you live or work in Germany, and there is no uninsured grace period. There is no nationality, language or minimum residency requirement for public or private health insurance. What matters is your employment type and, for employees, your salary.

• Employed in Germany: you are insured from your first working day. Under the threshold that means public health insurance.
• EHIC from another EU country: it covers temporary stays and medically necessary treatment. It does not replace German insurance once you live here.
• Travel insurance: it is built for short trips. It is accepted only in limited cases and is generally not enough for a long-term residence permit.

Just arrived: expat (bridge) insurance

An expat plan covers you while you settle in, for example while you look for work, before your contract starts or while you wait for a decision. It is the cheapest option, with prices from roughly €70 to €140 a month at some providers. The cover is narrower than a full policy and it has limits.

Eligibility, age limits and the maximum duration differ by provider (it varies by provider), so read the conditions before you buy. Once you start a job, you move to public health insurance, or to private health insurance if you qualify. Plan that switch in advance.

Public health insurance for expats

Public health insurance is compulsory for employees earning under €84,150 a year, apprentices and people receiving unemployment benefit. In 2026 the general rate is 14.6% of gross salary, split equally with your employer (7.3% each). Each fund adds an additional rate (Zusatzbeitrag). The official average is 2.9%, also split equally, so you pay 1.45%. Care insurance is 3.6% of salary in total (1.8% each for you and your employer). A childless employee aged 23 or older pays 2.4%, because the 0.6% childless surcharge falls on the employee alone.

The contribution only applies to income up to €5,812.50 a month (€69,750 a year). That caps what you pay.

These figures use the average additional rate. Actual rates vary by fund, from about 2.2% to 4.4% in January 2026 lists, so check your fund. If your fund raises its rate, you can leave early. Otherwise you can change funds after 12 months, with two months' notice.

Self-employed and voluntary members pay both halves. At the 2026 minimum income base of €1,318.33 a month, the contribution is about €270 to €286 a month. The maximum is about €1,192 to €1,261 a month, depending on whether you want sick pay (Krankengeld) and have children.

Students in public student insurance pay about €143 to €148 a month in 2026, depending on the fund. Compulsory student insurance ends at the end of the semester in which you turn 30 (extensions apply for some reasons); after that you can usually continue voluntarily, often at the minimum contribution. You can opt out in favour of private cover only within three months of enrolment, and that choice is irrevocable for your whole course of study.

Public insurance also covers a spouse and children at no extra premium through family insurance, provided they have no or only low income and meet the other conditions. For more detail see our public health insurance guide.

Private health insurance for expats

Private health insurance has no nationality requirement. You can choose it if you are:

• an employee earning more than €84,150 a year (the 2027 threshold, called the Jahresarbeitsentgeltgrenze or JAEG, or €7,012.50 a month; it was €77,400 a year in 2026)
• self-employed or a freelancer, at any income
• a civil servant (Beamte)
• a student who has taken the exemption

If you start a new job with a contract already above the threshold, you can opt for private health insurance immediately. If you cross the line during employment, you generally become exempt at the end of the calendar year, provided you are also expected to exceed next year's threshold.

The 2027 figure was approved by the federal cabinet and still needs Bundesrat approval, expected in November 2026.

Premiums depend on your entry age, health, deductible and plan, not on income. For a healthy employee in their 30s, comparison sites typically show roughly €370 to €560 a month before the employer subsidy. Treat that as indicative. Private insurers also add a statutory 10% surcharge from age 21 to 60 to build old-age reserves, usually already included in the quoted premium.

Employer subsidy. Employers pay half of your private premium, up to a cap. In 2026 the cap is €508.59 a month for health insurance and €104.63 for care insurance, so €613.22 combined. It is also limited to half of your actual premium.

Family caveat. A spouse and children need their own private policies. For a family with one earner, public insurance can end up cheaper. Compare before you decide.

Switching back to public insurance later is difficult, and from age 55 it is largely blocked. Treat private health insurance as a long-term decision. Full details: who qualifies for private health insurance and private vs public.

Providers for expats

Germany has dozens of private health insurers. For expats, three things matter more than price: English-language support, cover if you move again and how claims are handled.

Full comparison: Best private health insurance in Germany →

Visa and residence permit requirements

Section 2(3) of the Residence Act requires adequate health insurance for a residence permit, meaning cover equivalent to the public system. In practice:

• Schengen and short-stay visas: travel insurance with at least €30,000 of cover.
• Visa application and the period before employment: expat or incoming plans are often accepted.
• Some job-seeker and language-course visas: accepted at the discretion of the authority.
• Long-term residence permits: German public or private health insurance. Travel insurance is generally not enough.

Practice varies by Ausländerbehörde, so confirm with yours. For private health insurance, make sure the policy confirmation states cover in Germany.

Step by step, by situation

If you are arriving without a job

1. Before you travel: take out an expat plan and keep the confirmation for your visa.
2. On arrival: complete your Anmeldung and open a bank account.
3. When you get a job: your employer registers you with a public fund, or you use the private route if you qualify.

If you want private health insurance and qualify

English-speaking doctors, pre-existing conditions and leaving Germany

English-speaking doctors. Public funds and private insurers with English service can usually point you to English-speaking doctors, and many practices in large cities list the languages they offer. Ask your insurer or consultant before you book.

Pre-existing conditions. Public health insurance does not ask health questions. Private health insurance does, and bridge plans commonly exclude existing conditions. If you have a condition, speak to a consultant before you apply, because a refused application can follow you.

If you leave Germany. You can cancel private health insurance with the notice period in your contract, check your policy terms. Some plans include cover abroad. If you may return, an Anwartschaft (dormant policy) keeps your entry terms for a reduced fee.

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