Health Insurance in Germany

How health insurance works in Germany: compare public vs private (GKV vs PKV), understand costs, and check if you qualify. Free calculator included.

12 min read Updated 2026-04-16

Written by Marco Maurelli

Reviewed by MyHealthcareBroker, licensed German insurance broker · 2026-04-16

Health insurance in Germany is mandatory for everyone — including expats and foreign nationals — from day one. Every resident must choose one of two systems:

90%
of Germans are on public health insurance
€77,400
gross income threshold for private health insurance
€280–380
typical private health insurance premium/month
€200–450
typical monthly savings vs. public insurance

Public vs private health insurance in Germany

Calculate your premium

Answer 4 quick questions. We'll show your exact public health insurance (GKV) cost and a realistic private health insurance (PKV) estimate side by side — based on 2026 rates.

Step 1 of 4

What's your employment situation?

Your health insurance options in Germany as an expat

When you arrive in Germany, you'll need health insurance from day one. Most foreigners and expats start on public health insurance (GKV) by default, but depending on your income and situation, private health insurance (PKV) may be significantly cheaper and better. Here's how to tell the difference.

Can choose private health insurance
  • Employee earning ≥ €77,400/year
  • Self-employed or freelancer (any income)
  • Civil servants (Beamte)
  • Students under 30
Must stay on public health insurance
  • Employee earning < €77,400/year
  • Unemployed (receiving ALG I/II)
  • Family members without income (free co-insurance on GKV)

Public health insurance in Germany (GKV)

Public health insurance (GKV, Gesetzliche Krankenversicherung) covers around 90% of people in Germany. Most employees are enrolled automatically when they start a job. Your contribution is a fixed percentage of your gross salary — in 2026, the combined rate with TK is around 20.9%, split equally between you and your employer. At €55,000/year your share is roughly €479/month. Contributions are capped once you earn above €69,750/year.

Key benefit: your spouse and children are covered for free if they have no income. Key limitation: no direct access to specialists, limited dental, no private hospital room.

Full guide: Public health insurance in Germany (GKV) →

Private health insurance in Germany

Private health insurance (PKV, Private Krankenversicherung) is available to employees earning above €77,400/year in 2026, and to all self-employed and freelancers regardless of income. Unlike GKV, your premium is based on your age and health at sign-up — not your salary. The earlier you join, the cheaper your premium for life.

Private health insurance Statutory health insurance
Under 30
~€205/mo
€602/mo
Save €270–320/mo
30–39
~€270/mo
€602/mo
Save €200–280/mo
40–49
~€350/mo
€602/mo
Save €100–200/mo
50+
~€485/mo
€602/mo
Similar cost

Private health insurance includes direct specialist access, private hospital rooms, and comprehensive dental. Downside: no free family coverage — each family member needs their own policy.

Full guide: Private health insurance in Germany →

Just arrived in Germany?

If you've just moved to Germany without a job lined up, you can't join GKV or sign up for private health insurance yet. You need a bridge policy — short-term expat insurance (€50–150/month) covers emergency and routine care, is accepted for visa applications, and holds you over until you're employed or registered as self-employed. Popular options: Feather, Expatrio, Care Concept.

EU citizens: your EHIC card only covers emergencies in Germany — not routine care. Don't rely on it as your main coverage once you're a resident.

Detailed guides by topic

Each guide below covers one topic in full — costs, comparisons, and step-by-step advice.

Is private health insurance worth it in Germany?

Your situationBest optionWhy
Employee, salary < €77,400GKVPKV not available
Employee, salary ≥ €77,400, age < 40PKVSignificant savings + better coverage
Employee, salary ≥ €77,400, age > 45DependsGet a comparison, savings shrink with age
Self-employed, good healthPKVGKV costs €900–1,300/month self-employed
Just arrived, no job yetExpat insuranceBridge until you have employment
Family with kids, salary < €100kGKVFree family coverage is a major advantage

How to get health insurance in Germany

If you're joining GKV as an employee

  1. Choose a provider: TK, Barmer, or AOK are all solid. Go to their website and fill in the application (TK has an English version).
  2. Receive your membership confirmation: the insurer sends you a letter within a few days.
  3. Give it to your employer: they handle the rest. Your first contribution is deducted directly from your paycheck.
  4. Receive your insurance card (Gesundheitskarte): arrives by post within 2–3 weeks.

If you're switching from GKV to PKV

  1. Check eligibility: confirm you've been above €77,400 for 12+ consecutive months (employees) or that you're self-employed.
  2. Get quotes: use an independent broker to compare 3–5 providers side by side. Do not go direct; premiums are identical and you get no advice.
  3. Complete the health questionnaire: be honest. Omitting pre-existing conditions can void your policy later.
  4. Sign the PKV contract: coverage typically starts the following month.
  5. Cancel your GKV: you need to give 2 months' notice. Your GKV cannot refuse the cancellation once you have a PKV confirmation.

If you're self-employed and new to Germany

  1. Register your business (Gewerbeanmeldung or Freiberufler registration at the tax office).
  2. Get PKV quotes, you qualify immediately, no waiting period.
  3. Or join GKV voluntarily, you'll pay the full 14.6%+ yourself (~€900–1,300/month). Most freelancers choose PKV.

Frequently asked questions

How much does health insurance cost per month in Germany?
For employees on GKV, the combined contribution rate in 2026 is around 14.6% of gross salary plus a fund-specific Zusatzbeitrag (TK charges 2.7%), split equally between you and your employer. At a €55,000 salary your share is roughly €479/month. For private health insurance (PKV), premiums depend on your age and health at sign-up — typically €160–250/month if you're under 30, rising to €420–550/month at age 50+. Use the calculator above for a personalised estimate.
How much does AOK cost per month?
AOK is a group of regional GKV providers, so the exact Zusatzbeitrag varies by region. In 2026, AOK rates range from roughly 2.0–2.8% on top of the base 14.6% GKV rate. At a €55,000 salary, your monthly share with AOK is typically €460–500. Your employer pays the same amount. AOK is the largest statutory insurer in Germany and a solid choice outside major cities.
What is the minimum income for private health insurance in Germany?
Employees must earn above €77,400/year (gross) in 2026 — the Versicherungspflichtgrenze (JAEG) — to opt out of GKV and join PKV. You also need to have stayed above this threshold for 12 consecutive months before switching. Self-employed and freelancers have no income threshold and can join PKV at any income level.
Is private health insurance worth it in Germany?
For a single person earning above €77,400, under age 45, and in good health — PKV is almost always cheaper than GKV and offers better coverage (specialist access, private hospital room, dental). For families, GKV is often better because it covers spouses and children for free. The break-even point shifts depending on your age at sign-up: the older you join PKV, the less you save.
Can expats and foreigners get health insurance in Germany?
Yes. All residents of Germany — including expats and foreign nationals — are required to have health insurance from day one. Employed expats are enrolled in GKV automatically. Expats earning above €77,400 or who are self-employed can choose PKV. Those who just arrived without employment can use short-term expat insurance (e.g. Feather, Expatrio) as a bridge until they're employed or registered.

Get a free comparison

The German health insurance market has over 40 private insurers with hundreds of plan combinations. Comparing them yourself takes weeks and requires understanding complex German contracts.

The smarter move: work with a specialist who is not tied to any single insurer, who advises in English, and who can tell you within 15 minutes whether PKV makes sense for your situation.

Get expert advice — in English

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