Germany has one of the best health insurance systems in the world. For expats new to the country, however, it is also one of the most confusing. Statutory or private? What does the employer pay? What does it cost per month? What should be considered in the case of pre-existing conditions? This guide answers the most important questions.
The German health insurance system at a glance
In Germany, there are two pillars of health insurance: statutory health insurance (GKV) and private health insurance (PKV). Both cover basic medical care, but they differ considerably in contributions, benefits, and access requirements.
Anyone who works in Germany and earns a salary below the annual income threshold (2024: 69,300 euros gross) is compulsorily insured under the GKV. The contribution amounts to around 14 to 15.5 percent of gross salary, with the employer covering half. Those who earn more can choose private insurance or remain in the GKV.
Statutory health insurance (GKV) |
Private health insurance (PKV) |
|
Contribution basis |
Percentage of salary |
Risk-based contribution (age, health) |
Employer contribution |
Yes, 50 percent |
Yes, up to half of the GKV contribution |
Family insurance |
Children and partner free of charge |
Each person extra |
Benefits |
Standard coverage |
Often more extensive |
Access |
Compulsory below the income threshold |
Only above the income threshold or for the self-employed |
Which option is right for expats?
For most expats employed in Germany, the question is quickly answered: anyone below the income threshold is automatically subject to GKV coverage. The employer registers the employee, you choose a health insurance fund (Krankenkasse), and the contribution is deducted directly from the salary. Not much effort involved.
Those above the threshold or who are self-employed have a choice. The GKV is often cheaper for families with children, since children and non-working partners are co-insured free of charge. The PKV can be cheaper for young, healthy individuals with high incomes, but it has one important drawback: switching back to the GKV later in life is difficult and expensive.
What to do before your first day of work?
Anyone who doesn't yet have a German employment contract or is between jobs needs a bridging solution. Options include: voluntary GKV membership, a private international health insurance policy that applies temporarily, or a private short-term policy for the transition period. Being without health insurance in Germany is not legally permitted and can become costly.
Which health insurance fund should you choose?
There are many health insurance funds (Krankenkassen) within the GKV. Benefits are largely standardized by law, but there are differences in additional services, customer service, and international offerings. Aspects of interest to expats include: Is there English-speaking customer service? Are services abroad reimbursed? Are digital sick notes available?
Well-known options with good English-language services include TK (Techniker Krankenkasse), Barmer, and DAK, among others. It's worth comparing the offerings.
Conclusion
The German health insurance system is complex, but well organized for most employed expats. The employer covers half, and the GKV is solid. If you're still looking for accommodation to get started: Furnished apartments in Berlin can be booked without a SCHUFA check and are ideal for the beginning.
Frequently asked questions
1. Am I required to have health insurance as an expat in Germany?
Yes, health insurance is mandatory in Germany. Anyone employed and earning below the income threshold is automatically covered under statutory insurance. Everyone else must arrange their own insurance.
2. What does health insurance cost in Germany?
Under the GKV, the contribution rate is around 14 to 15.5 percent of gross salary. The employer covers half. So as an employee, you effectively pay around 7 to 8 percent of your gross salary.
3. Can I co-insure my family under German health insurance?
Under the GKV, spouses and children without their own income can be co-insured free of charge. Under the PKV, each family member pays their own contribution.
4. What should I do if I don't have a job yet?
A private international health insurance policy or voluntary GKV membership can bridge the time until your first day of work.
5. Which health insurance fund is recommended for expats?
TK, Barmer, and DAK offer good English-language services. It's best to compare directly and pay attention to international customer service and digital features.
Guide: Expat Guide Berlin