The Expat Guide to Health Insurance in Germany

If you're new to Germany, understanding the healthcare system is one of your first priorities—and rightfully so. Germany consistently ranks among the best healthcare systems in the world, and as an international resident, you have full access to it.

But here's the catch: health insurance is mandatory. You'll need to show proof of coverage when applying for your visa, and you're required to register within your first month of arrival.

This guide will walk you through everything you need to know.

Germany's Two Health Insurance Systems

You have two main options:

You can also combine public insurance with supplementary private coverage to access additional benefits like private hospital rooms or enhanced dental care.

Public Health Insurance (GKV)

Who's eligible?

• Employees earning below €77,400 per year are automatically enrolled
• Spouses and children can be covered at no extra cost if they earn less than €520/month
• Pensioners who previously contributed to the public system

What does it cost?

The contribution rate is approximately 14.6% of your gross income, plus an additional 1–2% depending on your provider. Your employer pays half, so your actual share is around 7.3–8%.

Contributions are capped at the income ceiling (Beitragsbemessungsgrenze) of €69,750 per year—meaning higher earners don't pay more above this threshold.

What's covered?

• GP and specialist visits
• Hospital care (shared ward)
• Prescription medications
• Basic dental care
• Pregnancy and maternity care
• Sick leave certificates for your employer
• Sick pay (Krankengeld): Your employer pays your full salary for the first 6 weeks of illness. After that, your insurer pays up to 70% of your gross salary for up to 78 weeks.

What's not covered?

• Prescription glasses and contact lenses
• Private hospital rooms
• Alternative treatments (acupuncture, naturopathy)
• Dental implants and cosmetic dentistry
• Consultations with private-only doctors

Private Health Insurance (PKV)

Who's eligible?

• Employees earning above €77,400 per year
• Freelancers and self-employed individuals (regardless of income)
• Students who opt out of public insurance

How does pricing work?

Private insurance premiums are based on:

• Your age at the time of joining
• Your health status (pre-existing conditions may affect rates)
• The coverage level you choose

Unlike public insurance, your income doesn't affect the premium—which can make private insurance more cost-effective for young, healthy, high-earning individuals.

What's covered?

Private plans are customisable, but typically include:

• Faster access to specialists and appointments
• Private or semi-private hospital rooms
• Broader dental coverage including professional cleanings
• Alternative treatments like osteopathy or acupuncture
• Access to English-speaking doctors and private hospitals

What to know before switching

• Each family member needs their own policy (no free family coverage)
• You pay the doctor directly, then submit claims for reimbursement
• Switching back to public insurance after 55 is extremely difficult

How to Apply for Health Insurance

If you're employed

Your employer will typically register you with a public insurance provider. However, you can choose your own provider—just inform your employer within two weeks of starting work.

If you're freelance or self-employed

You'll need to:

1. Take your passport and residence permit (Aufenthaltstitel) to a regional health insurance office

2. Complete the registration forms

3. Choose a provider that fits your needs

What to look for in a provider

• Contribution rate (for public) or premium (for private)
• Customer service quality and ease of contact
• Supplementary services offered
• Claims process and reimbursement speed

Which Insurance Is Right for You?

There's no one-size-fits-all answer. Your decision depends on:

• Your income and employment status
• Whether you have a family to cover
• Your health and any pre-existing conditions
• How long you plan to stay in Germany

If you're unsure, we're here to help. At Stay, we provide clear, personalised guidance to help you find the right coverage—without the stress.