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Starting a new life in Germany? How exciting! But let’s be honest—there are a few important decisions to make along the way, and one of the biggest is health insurance. Germany has two main options: public health insurance (Gesetzliche Krankenversicherung or GKV) and private health insurance (Private Krankenversicherung or PKV). Figuring out which one is right for you can feel a bit overwhelming at first, but don’t worry—we’re here to help!
Whether you’re starting a new job, running your own business, or settling in with your family, understanding how each system works is key to making the best choice for you and your loved ones. In this guide, we’ll walk you through the basics of GKV and PKV, so you can feel confident and prepared when it comes to your healthcare in Germany.
German Healthcare System
Germany’s healthcare system is a bit unique—it offers two main options: public health insurance (Gesetzliche Krankenversicherung or GKV) and private health insurance (Private Krankenversicherung or PKV). Both ensure that everyone gets the care they need, but they differ in cost, benefits, and who can join. As an expat, you’ll need to choose the one that fits your income, job, and family situation.
Here’s the thing: health insurance is mandatory in Germany. You’ll need to show proof of coverage when you register your address or apply for a visa.
Germany’s healthcare system ensures universal coverage through two models:
- Public insurance (GKV): Covers about 90% of residents. Costs are based on your income.
- Private insurance (PKV): Covers 10% of residents. Costs depend on age, health, and coverage level.
2025 Update: Higher earners (€73,800+/year) will see a slight increase in their public health contributions, but a cap ensures they won’t pay excessively.
Public Health Insurance (GKV)
Eligibility Requirements for Expats
Who Can Join?
- Employees earning below €73,800/year (automatically enrolled).
- Self-employed workers (optional, but recommended for affordability).
- Families: Covers spouses & children for free.
What’s Covered?
- Doctor visits & specialists (no limits)
- Hospital stays & surgeries
- Prescriptions (small co-pay required)
- Maternity & mental health care
- Preventive check-ups & vaccinations
Cost Calculation: Your contribution is 14.6% of your gross salary, split with your employer. That means you’ll pay around 7.3%. If you’re self-employed, though, you’ll cover the full 14.6% yourself. But don’t worry—there’s a cap to keep things fair. Even if you’re a high earner, your monthly contributions won’t go above around €800.
Example (2025 Rates):
- Salary: €40,000/year
- Total GKV Contribution: 14% of €40,000 = €5,840 per year.
- Your Share (50%): ~€2,920/year (€243/month)
- If you’re married and have children, they will be covered under your GKV policy at no extra cost.
Why Choose GKV?
Affordable for lower-to-middle earners- Free family coverage (attractive option for expats with children and non-working spouses)
- No age or health-based pricing
Cons:
Longer wait times for specialists- Limited coverage for extra care
- Income-based contributions (High earners can end up paying a substantial portion of their income toward health insurance)
Private Health Insurance (PKV)
Eligibility Requirements for Expats
Who Can Join?
- Employees earning above €73,800/year threshold
- Self-employed, civil servants & freelancers
- International students (over 30 years old)
- Expats who have a private insurance plan from their home country may also be eligible to continue with a PKV provider in Germany.
What’s Covered?
- Faster access to specialists
- Private hospital rooms
- Customized dental, vision, & global coverage (advantage for expats frequently traveling or working abroad)
- Additional wellness & alternative treatments
Cost Calculation: Premiums depend on age, health, and chosen coverage.
Example (2025 rates for a 30-year-old expat):
- Basic Plan: €300-€400/month
- At 50 years old: ~€600-€800/month
- Family Plan (Spouse + 2 Kids): €1,000+/month
y at no extra cost.
Why Choose GKV?
- Flexibility and customization
- Faster access to care
- Higher quality of care
- No waiting times for elective procedures
- More control over coverage levels
Cons:
- Expensive premiums
- Rising costs with age
- Separate coverage for family members
For example, a younger expat might pay a relatively low premium, but the cost can rise significantly in later years, especially if they develop health issues. This makes PKV more appealing to young, healthy expats but less advantageous over time.
Companies such as Ottonova, Feather Insurance, and DR-Walter offer comprehensive coverage plans for expats in Germany.
Additional Costs
- Co-pays (GKV): For some treatments, you might have small co-pays. For example, a GP visit could cost around €10, and a prescription might cost about €5 – €10.
- Add-ons (PKV): If you want extra coverage (like dental or vision), this could add €50 – €100 or more to your monthly premium, depending on what’s included.
Key Differences Between Public and Private Health Insurance
Making the Right Choice
Factor | Public (GKV) | Private (PKV) |
Cost Structure | Based on income | Based on age & health |
Family Coverage | Free for dependents | Must pay separately |
Specialist Wait Times | Longer | Shorter |
Coverage Flexibility | Standardized | Customizable |
Best for… | Families, lower-income workers | High earners, young professionals |
Choosing between GKV and PKV depends on your income, employment status, and family situation. Here are some key considerations:
- Low-income earners: If you earn below €73,800/year, GKV is the most affordable and comprehensive option.
- High-income earners: If your income exceeds the GKV threshold, PKV may be a good option for you. But, keep in mind the rising premiums as you age.
- An international student over the age of 30: private health insurance
- An international student under the age of 30: public health insurance
- An apprentice or intern: public health insurance
- Enrolled in a preparatory or language course in Germany: private health insurance
- Families: If you have a family, GKV is generally the more affordable option, as it covers dependents without extra cost.
- Self-employed expats: Self-employed individuals can choose between GKV and PKV. If you’re young and healthy, PKV may seem appealing, but consider the long-term costs and potential difficulties if you need to switch back to GKV later.
Note: The enrollment process for the GKV, is slightly different for international students and freelancers or self-employed workers because they have to start the process themselves.
If you are not sure which one is right for you, you can use the Health Insurance Comparison Tool to compare both options and find the best solution for your needs.
Now that you’ve got the lowdown on health insurance, why not let Wunderflats take care of the rest? We’re here to help you find a cozy, fully furnished apartment so you can focus on staying healthy and happy. Your perfect home is just a click away — explore our properties today!
What’s New in 2025
Recent changes to Germany’s public health insurance (GKV) system have slightly increased the contributions for high earners and people without children.
- High earners: Those who earn more than €73,800/year will now pay a bit more toward their health insurance. However, there’s a cap on how much you can pay. In 2025, the ceiling for contributions is around €5,512.50 per month for high earners.
- Long-Term Care Insurance: The contribution rate for long-term care insurance has gone up by 0.2 percentage points. This change affects both GKV and PKV policyholders.
- Electronic Patient Records (ePA): Starting in January 2025, Germany is rolling out electronic patient records.
How to Enroll in Germany Health Insurance Coverage
Step 1: Check Your Eligibility
First, find out if you’re eligible for public health insurance (Gesetzliche Krankenversicherung – GKV) or if private health insurance (Private Krankenversicherung – PKV) is a better fit for you. You can use this recommendation tool to check which type of insurance you’re eligible for.
Step 2: Register with Local Authorities
If you’re planning to stay in Germany for more than three months, you’ll need to register your address at the local registration office (Einwohnermeldeamt) within two weeks of your arrival.
Step 3: Prepare Your Documents for GKV
- Proof of Passport or National ID Card
- Residence in Germany (Meldebescheinigung)
- Proof of Employment or Self-Employment
- Visa or Residence Permit (for Non-EU Citizens)
- Previous Health Insurance Information
- Bank Account Information
- Proof of Income (for Self-Employed or High-Income Workers) (e.g., tax returns or bank statements)
Step 4: Research Health Insurance Providers
Take some time to research different health insurance providers that cater to expats. You can look for reputable and established insurers with English-speaking customer service:
Here, you can find a list of some of the best health insurance companies in Germany:
Step 4: Apply for Your Insurance
For Public Health Insurance (GKV): You can choose your public insurance provider. You’ll submit an application and let your employer know which provider you’ve chosen.
For Private Health Insurance (PKV): Contact your chosen insurer to ask about the application process and submit the required documents, like your passport and proof of residency.
Step 5: Get Your Insurance Card
Once you’re approved, you’ll receive your health insurance card (Versichertenkarte) if you have GKV or a policy certificate if you have PKV.
Step 6: Pay Your Premiums
- For GKV: If you’re employed, your premiums will be deducted automatically from your salary.
- For PKV: You’ll need to make regular payments according to your policy terms.
Step 7: Keep Your Insurance Updated
If your situation changes—like your income, job, or residence status—make sure to inform your insurer so your coverage remains up-to-date.
That’s it! With these steps, you’ll be all set to enjoy the healthcare benefits Germany has to offer.
Health insurance sorted? Great job! Now, let’s make finding your new home just as easy. At Wunderflats, we’ve got fully furnished apartments ready to welcome you. Take a look and start your German adventure with a smile!
FAQ
Here are some simple tips to help you keep your costs down as an expat in Germany:
- Stick with Public Health Insurance (GKV): If you’re eligible for private health insurance but don’t really need the extras.
- Higher deductibles: Some health insurance plans let you choose a higher deductible (called Selbstbeteiligung). By doing this, you can lower your monthly premiums. Just make sure you can afford the deductible if you end up needing medical care.
- Supplementary insurance: If a full private health plan feels too expensive, consider getting a basic plan and adding supplementary coverage for things like dental or vision care.
- Get professional advice: Don’t hesitate to talk to an insurance advisor who specializes in expat health insurance.
If you’re a freelancer, self-employed, or earn over €73,800 a year, you have the option to choose between public and private health insurance in Germany.
If you’re employed by a German company and earn less than €73,800 a year, you’ll need to stick with public insurance. However, you can still choose to get private insurance on top of that if you’d like.
For international students over the age of 30 or those in preparatory or language courses, public insurance isn’t available, so private insurance is the only option for them.
Yes, in Germany, you can have both private and statutory health insurance at the same time. But, if you do, you’ll need to pay premiums to both insurance companies. You can only use one insurance provider for each healthcare service or treatment, so you’ll need to decide which one you’ll claim from.
Unfortunately, you can’t cancel your private health insurance in Germany whenever you want. There are specific rules and regulations around canceling it.
Yes, private health insurance in Germany does cover pre-existing conditions! Insurance companies can’t deny you based on a medical condition. However, your monthly premiums might be higher.
No, it’s not a replacement for full health insurance. Also, you can use EHIC only if you’re planning to spend up to 3 months in Germany, but not longer. It’s typically used for short stays, such as for tourism or temporary work.
Resources to help you with health insurance options in Germany
- GKV-Spitzenverband: The official website of the National Association of Statutory Health Insurance Funds in Germany
- Federal Ministry of Health: Provides detailed insights into Germany’s health insurance system
- Private Krankenversicherung (PKV): The official site for private health insurance in Germany
When it comes to choosing health insurance in Germany, it’s all about finding the right fit for your lifestyle.
Take your time, consider what matters most to you, and don’t be afraid to ask for help along the way. With the right health insurance, you’ll be all set to enjoy your new life in Germany!
Now that you’ve got the lowdown on health insurance, why not make the rest of your move just as easy?
At Wunderflats, we specialize in helping expats like you settle into Germany stress-free. Our fully furnished apartments are designed to feel like home from day one. Explore our properties today and let Wunderflats take care of the details.
