The German Healthcare System
Health insurance is mandatory for all residents in Germany. Understand public vs private options and how to choose.
Three questions before choosing cover
- 1
What is your status?
Employment, study and existing cover affect eligibility.
- 2
Which route applies?
Check statutory, private or temporary-cover requirements.
- 3
What will it cover?
Compare total contributions, benefits and acceptance.
Insurance requirement
Health insurance is mandatory
Every resident in Germany must have health insurance coverage. This is required for visa applications, residence permits, university enrolment, and employment.
Public vs Private insurance at a glance
Public health insurance (Gesetzliche Krankenversicherung)
Statutory health insurance covers about 90% of residents.
How it works
Premiums are income-based (roughly 14.6% + supplementary, split with employer). Coverage is comprehensive and standardised across all public insurers. Family members can be covered for free.
Who is generally subject to compulsory public insurance
For employees, the 2026 annual earnings threshold is €77,400. Student insurance follows separate eligibility rules, including age and enrolment status. Exceptions and existing coverage can affect the route available to you.
Main providers
TK (Techniker Krankenkasse), AOK, BARMER, and DAK are the largest public insurers. Coverage is nearly identical — differences are in bonus programmes and digital tools.
Private health insurance (Private Krankenversicherung)
Available to certain groups — offers more flexibility but comes with trade-offs.
Who can use private insurance
Self-employed, freelancers, high-earning employees (above €69,300/year), and students who opt out of public insurance within their first 3 months.
Advantages
Shorter waiting times for specialists, broader coverage options, private hospital rooms, and potentially lower premiums for young, healthy individuals.
Important warnings
Switching back to public insurance is very difficult and sometimes impossible. Premiums increase with age. Family members need separate policies. Consider carefully.
How to choose
Key eligibility considerations for newcomers.
Student insurance
Eligible students can access statutory student insurance. Compare the insurer’s current additional contribution and long-term-care contribution. An exemption can have lasting consequences during your studies; confirm your eligibility and options before applying.
Employed workers
Your employer handles enrolment. Below the threshold you must use public; above it you may choose private. Most people stay with public insurance.
Freelancers and self-employed
You can choose either system. Public premiums are based on income (minimum ~€200/month). Private may be cheaper initially but increases with age.
Our recommendation
For most newcomers, public insurance is safer and simpler. Only consider private if you fully understand the long-term implications.
After arrival steps
Registering with an insurer
After your Anmeldung, confirm or activate your insurance. Your insurer will provide the confirmation letter needed for your residence permit.
Switching providers
Within the public system, you can switch insurers with 2 months notice. Switching from private to public is restricted and depends on employment status.