Things to Consider When Choosing Health Insurance in Germany

Moving to Germany is exciting, but navigating the healthcare system? That can feel overwhelming. We understand—choosing the right health insurance is one of the first major decisions you'll face, and it's easy to feel lost in a sea of unfamiliar terms and options.

The good news is that once you understand the basics, making the right choice becomes much simpler. In this guide, we'll walk you through everything you need to know so you can move forward with confidence.

How the German Healthcare System Works

Germany has one of the oldest and most comprehensive healthcare systems in the world. The principle is simple: everyone contributes, and everyone is protected.

There are two main types of health insurance:

Public health insurance (Gesetzliche Krankenversicherung, or GKV) — A solidarity-based system where around 90% of residents are covered
Private health insurance (Private Krankenversicherung, or PKV) — An alternative option for those who meet certain income or employment criteria

Many people also use supplementary private insurance to enhance their public coverage with additional benefits.

Your Income Determines Your Options

Your earnings play a central role in which type of insurance you can choose.

If you earn below €77,400 per year (2026 threshold)

You're required to join the public health insurance system (GKV). This isn't a limitation—it's a system designed to protect you:

Premiums are based on your income (approximately 14.6% + an additional 1–2% depending on your provider)
Contributions are capped at the income ceiling (Beitragsbemessungsgrenze) of €69,750 per year
Your employer pays half of your premium

Example: If you earn at the maximum contribution level, your monthly premium would be around €430–€450, with your employer contributing an equal amount.

If you earn above €77,400 per year

You become eligible to choose private health insurance (PKV). Your premiums will be based on:

Your age when you join
Your current health status
The level of coverage you select

This makes timing important—the younger and healthier you are when you switch, the more favourable your rates.

What About Pre-Existing Conditions?

This is where the two systems differ significantly:

	Public (GKV)	Private (PKV)
Pre-existing conditions	Never an issue	May affect premiums or coverage
Acceptance	Guaranteed	Subject to health assessment

If you have a pre-existing condition, public insurance offers complete peace of mind—you'll never be denied coverage or charged more. Private insurers must accept you under German law, but they may charge a risk premium or offer more limited coverage.

Confused about health insurance in Germany? Get expert help.

What's Covered?

Public Health Insurance (GKV)

The statutory system provides comprehensive coverage, including:

Hospital care (as a ward patient)
GP and specialist visits
Prescription medications
Basic dental care
Pregnancy and maternity care
Sick leave certificates for your employer
Sick pay (Krankengeld) — up to 70% of your gross salary after your employer's continued payment period ends

Private Health Insurance (PKV)

Private plans cover everything in the public system, plus additional benefits you can tailor to your needs:

Single or double hospital rooms instead of shared wards
Direct access to specialists without a GP referral
Extended dental care including professional cleanings and higher reimbursements
Alternative treatments such as acupuncture or naturopathy
Shorter waiting times for appointments
Age-independent premiums — your rate doesn't increase simply because you get older

Family Coverage: Who's Included?

One of the biggest advantages of public health insurance is family insurance (Familienversicherung):

Your spouse and children can be covered at no additional cost
This applies if your family members earn less than €520 per month (the current mini-job threshold)

With private insurance, each family member needs their own policy—which can add up quickly if you have several children.

Can You Switch Between Systems?

Yes, but there are rules:

Switching from...	To...	Requirements
Public (GKV)	Private (PKV)	Earn above €77,400/year for at least 12 months, or be self-employed
Private (PKV)	Public (GKV)	Must earn below the threshold and be under 55 years old

Switching from private back to public becomes increasingly difficult after age 55. This is an important long-term consideration, especially if you're thinking about starting a family or anticipate changes in your career.

Why Getting This Right Matters

We often see newcomers treat health insurance as just another box to tick for their visa application. But this decision affects your finances, your access to care, and your family's security for years to come.

Here's what we recommend:

1. Avoid short-term "expat" policies — These often exclude pre-existing conditions and can leave you vulnerable

2. Think long-term — Consider where you'll be in 5, 10, or 20 years

3. Don't rush — Take the time to understand your options before signing anything

How We Can Help

Choosing health insurance shouldn't be stressful. At Stay, we provide clear, personalised guidance to help you find the right coverage for your situation.

Free, no-pressure consultations — We'll explain your options in plain English
Data-driven comparisons — See exactly how GKV and PKV stack up for your specific situation
Full support — We handle the paperwork so you can focus on settling in

You're not alone in this. We've been there too, and we're here to help.