Moving to Germany is an exciting step. However, figuring out the healthcare system can feel a bit more complicated. Health insurance is one of the first important decisions you'll have to make as an international resident, and it's normal to feel unsure at the beginning.
The good news is that once you understand how the system works, choosing the right health insurance becomes much easier. In this guide, we'll explain everything you need to know so you can make an informed decision and move forward with confidence.
Germany has one of the oldest and most comprehensive healthcare systems in the world. The principle behind the system is simple: people contribute to it, and in return they receive access to healthcare when they need it.
There are two main types of health insurance in Germany:
In addition, many people choose supplementary private insurance to complement their public coverage and access additional services.
Your earnings play a central role in which type of insurance you can choose.
In this case, you'll need to join the public health insurance system (GKV). While it may sound restrictive at first, the system is designed to provide strong protection and predictable costs. Here's how it works:
Example: If your income reaches the contribution ceiling, your monthly premium will typically be around €430-€450, with your employer contributing roughly the same amount.
Once your income passes this threshold, you become eligible to choose private health insurance (PKV) instead of the public system. Private insurance works a little differently. Your premium is calculated based on:
Because of this, timing matters. The younger and healthier you are when you join private insurance, the more favourable your premiums are likely to be.
This is one of the biggest differences between the two systems:
| Public (GKV) | Private (PKV) | |
|---|---|---|
| Pre-existing conditions | Never an issue | May affect premiums or coverage |
| Acceptance | Guaranteed | Requires a health assessment |
If you have a pre-existing condition, public health insurance provides full protection: you can't be denied coverage or charged more because of your health.
Private insurers must still accept applicants under German regulations, but they may apply a risk surcharge or offer coverage with certain limitations.
The public system provides comprehensive, reliable coverage, including:
Private insurance includes everything covered by the public system, but often with additional benefits and more flexibility. Depending on your plan, this may include:
One of the biggest advantages of public health insurance is family insurance (Familienversicherung). With GKV:
With private insurance, each family member needs their own individual policy, which can increase costs if you're covering a partner or have several children.
Switching between public and private health insurance is possible, but it comes with strict 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 much harder 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.
We often see that international residents treat health insurance as just another box to tick for their visa application, but The choice you make affects your finances, 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 and exposed.
2. Think long-term. Consider where you’ll be in 5, 10, or even 20 years.
3. Don't rush. Take the time to understand your options before signing anything.
Choosing health insurance shouldn't be stressful. At Stay, we provide clear, personalised guidance to help you find the right coverage for your situation. This is how we can help: