Health insurance in Germany is generally compulsory. The right type of insurance depends on whether you are employed, self-employed, studying or joining a family member.
Most residents are covered by statutory health insurance, known as gesetzliche Krankenversicherung or GKV. Some people can choose private health insurance, known as private Krankenversicherung or PKV.
This guide explains the differences, the 2026 income thresholds and the practical steps for choosing and joining a health insurance provider.
The Two Health Insurance Systems
Germany has two main types of health insurance:
- Statutory health insurance (GKV): Public health insurance provided by a Krankenkasse
- Private health insurance (PKV): Insurance provided by a private company
Most people in Germany have statutory health insurance. Whether you can choose private insurance depends on your job, income, and personal situation.
Statutory Health Insurance
Employees whose income is below the legal threshold are normally insured through the GKV. Students, trainees, pensioners, and other groups may also be covered by it.
You can usually choose your own statutory provider. Well-known providers include TK, Barmer, AOK, DAK-Gesundheit, and hkk.
All statutory providers cover essential medical care, but their additional contribution rates, optional services, bonus programmes, and English-language support can differ.
Private Health Insurance
Private health insurance may be available to:
- employees earning above the legal income threshold;
- many self-employed people;
- civil servants;
- certain students.
The price depends on factors such as your age, health, and chosen coverage. A private insurer may ask health questions before accepting you.
Private insurance can offer additional services, but it is not automatically the better choice. Premiums can change over time, family members usually need separate policies, and returning to statutory insurance may be difficult.
Compare the long-term costs and conditions carefully before choosing PKV.
GKV or PKV: What Should You Consider?
Private health insurance can look attractive when you are young, healthy and earning a high salary. However, the cheapest option today may not remain the cheapest option later.
Before choosing PKV, consider:
- premiums are based partly on age, health and coverage rather than only income;
- each family member normally needs a separate paid policy;
- you may have to pay medical invoices before receiving reimbursement;
- premiums can increase over time;
- returning to statutory insurance may become difficult, particularly after the age of 55;
- changing employment status or reducing working hours does not always make switching simple.
GKV may be more suitable if you want income-based contributions, expect to insure eligible family members, or prefer doctors to bill the insurer directly.
PKV may suit some high-earning employees, self-employed people or civil servants, but the decision should be based on long-term costs rather than the initial monthly premium.
If you are uncertain, seek independent advice rather than relying only on an insurance salesperson.
Which Health Insurance System Applies to You?
Your employment status and income determine whether you must use statutory insurance or may choose private insurance.
Employees
In 2026, employees earning up to €77,400 gross per year, or €6,450 per month, are generally required to have statutory health insurance.
Employees earning above this insurance threshold may usually choose between voluntary statutory insurance and private health insurance. Earning above the threshold does not mean that you must switch to private insurance.
Self-employed people
Self-employed people can often choose between voluntary statutory insurance and private insurance. However, they normally pay the full contribution themselves because there is no employer to share the cost.
Students
Students are usually eligible for reduced statutory student insurance. Choosing private insurance at the beginning of a degree can affect the entire period of study, so obtain independent advice before requesting an exemption from statutory insurance.
Civil servants
Civil servants often receive a government contribution toward medical expenses, known as Beihilfe. Private insurance may therefore work differently for them than it does for regular employees.
Families
Statutory insurance may cover an eligible spouse and children without an additional contribution through Familienversicherung. Private insurance normally requires a separate paid policy for every family member.
How Much Does Health Insurance Cost?
How Much Does Statutory Health Insurance Cost in 2026?
The standard statutory contribution rate is 14.6% of contributable gross income. Each Krankenkasse also charges its own additional contribution, called Zusatzbeitrag.
For 2026, the official average additional contribution rate is 2.9%. The actual rate can be higher or lower depending on the provider.
Employees and employers normally split both the standard contribution and the additional contribution equally. Contributions are calculated only up to the 2026 contribution ceiling of €69,750 per year, or €5,812.50 per month.
Long-term care insurance, called Pflegeversicherung, is charged separately. Its rate depends partly on whether you have children.
The insurance threshold and contribution ceiling are not the same:
- €77,400 per year: determines whether an employee may choose private insurance;
- €69,750 per year: maximum income used to calculate statutory health insurance contributions.
Both limits usually change each year, so always check the current official figures.
Can Your Family Be Insured With You?
Under certain conditions, a spouse, registered partner, and children can be included in statutory family insurance without an additional contribution.
This is called Familienversicherung. Income limits and other conditions apply, so ask your Krankenkasse to check your family’s eligibility.
Private insurance does not offer free family insurance. Each family member normally needs a separate policy.
How to Choose a Krankenkasse
When comparing statutory health insurance providers, check:
- the additional contribution rate;
- English-language customer service;
- local offices and online services;
- bonus and prevention programmes;
- extra dental or travel benefits;
- services for pregnancy and families.
You can use CHECK24 to compare different Krankenkassen, their contribution rates, and additional benefits. However, you should also check the provider’s official website before making your final decision.
The main statutory benefits are regulated by law, so customer service and additional benefits can make an important difference.
How to Change Your Statutory Krankenkasse
Members of statutory health insurance generally have the right to choose another eligible Krankenkasse.
In most cases:
- Apply for membership with the new Krankenkasse.
- The new provider informs your previous provider electronically.
- You normally do not need to send a separate cancellation letter.
- Tell your employer about the new provider if requested.
A standard change generally has a two-month notice period, and members are usually bound to their provider for at least 12 months. Different rules may apply if you selected an optional tariff.
If your Krankenkasse increases its Zusatzbeitrag, you may have a special right to change providers. Check the applicable deadline and apply to the new provider promptly.
How to Join
You can usually apply directly on the provider’s website. You may need:
- your passport or identity card;
- your German address;
- your employment or university details;
- your tax identification number, if available;
- your social security number, if available;
- a passport photo for your health insurance card;
- information about your previous insurance.
If you start a job, tell your employer which Krankenkasse you have selected. The provider normally confirms your membership electronically.
Do not wait too long to arrange insurance. In some cases, compulsory coverage can apply retrospectively, and unpaid contributions can build up.
Using Your Health Insurance
After joining a statutory provider, you receive an electronic health card called an elektronische Gesundheitskarte.
Take this card to medical appointments. Doctors who treat statutory patients normally bill the Krankenkasse directly.
Some services are not fully covered. You may still have to pay for:
- part of the cost of prescription medicine;
- certain dental treatments;
- glasses for most adults;
- private hospital rooms;
- treatment by a senior hospital doctor;
- optional services known as IGeL.
Always ask whether a treatment is covered before agreeing to pay for an extra service.
Privately insured patients often receive an invoice first and then request reimbursement from their insurer. The exact process depends on the policy.
Finding a Doctor
You can usually choose your own general practitioner, known as a Hausarzt, and contact many specialists directly.
Doctolib is a useful website and app for finding doctors and booking appointments online. You can search by location and medical speciality and check whether the doctor accepts statutory or private insurance.
Not every doctor uses Doctolib, so you can also search online or contact a medical practice directly.
When booking, ask whether the practice accepts statutory patients:
Nehmen Sie gesetzlich versicherte Patienten auf?
For urgent but non-life-threatening medical problems outside normal opening hours, call 116117. In a life-threatening emergency, call 112.
Health Insurance for New Arrivals
The right insurance depends on why you came to Germany and whether you work, study, look for work, or join family members.
EU citizens staying temporarily may be able to use a valid European Health Insurance Card. However, it is not a permanent replacement for German insurance when Germany becomes your main place of residence.
People from outside the EU may need proof of suitable health insurance for a visa or residence permit. Short-term travel insurance may not be sufficient for long-term residence.
If you are unsure, contact a Krankenkasse or an independent advice centre before your previous insurance ends.
Quick Checklist
When arranging health insurance in Germany:
- check whether you qualify for GKV or PKV;
- compare providers and additional contribution rates;
- use CHECK24 as a comparison tool;
- consider the long-term costs before choosing private insurance;
- apply before starting work or studies;
- tell your employer which provider you selected;
- keep your health insurance card with you;
- use Doctolib to search for doctors and appointments;
- ask before paying for optional medical services;
- call 116117 for urgent non-emergency care and 112 for emergencies.
Final Tip
Do not choose health insurance based only on the lowest monthly price. Check the coverage, customer service, family situation, and long-term consequences before making your decision.
Related Guides
- How to Register Your Address in Germany
- How to Get a German Visa and Residence Permit
- How to Understand Salaries in Germany
Official Sources
- Federal Ministry of Health: Statutory Health Insurance Contributions
- Federal Government: Social Insurance Thresholds for 2026
- Federal Health Portal: Changing Your Krankenkasse
- Federal Health Portal: Health Insurance in Germany
Published: 7 August 2026
Last updated: 30 August 2026