Health insurance in Germany

• Employees earning more than 603 euros per month and up to the compulsory insurance threshold (Versicherungspflichtgrenze or Jahresarbeitsentgeltgrenze) of 77,400 euros per year (6,450 euros per month) in 2026 are compulsorily insured in a statutory insurer of their choice. Your employer registers you and deducts the contributions.
• Employees above the threshold are free to choose: stay in (or join) statutory insurance as a voluntary member, or take out private insurance. If you switch to private insurance, you generally cannot return to statutory insurance just because it becomes cheaper later.
• Self-employed people and freelancers are not compulsorily insured in the statutory system but must still be insured: either voluntarily in a statutory insurer, if they meet the conditions, or privately.
• Students at state-recognised universities are generally compulsorily insured in statutory insurance until they turn 30, at a special student rate.
• Spouses, registered partners and children with little or no income can usually be covered free of charge through a statutory member's family insurance (Familienversicherung).
• Minijobbers (up to 603 euros per month in 2026) are not insured through the minijob itself; they need cover through family insurance, studies, another job or their own insurance.

If you live in Germany and have no other cover, the law, depending on your previous insurance and residence status, either places you in statutory insurance from the first day without cover or obliges you to take out private insurance. Contributions or surcharges for the missing months may be charged later, so a gap is never "free".

• Contributions depend on income, not on age or health. In 2026 the general rate is 14.6 % of gross pay, plus an additional contribution (Zusatzbeitrag) that each insurer sets itself. The average additional rate for 2026 is 2.9 %. Employees and employers share both parts equally, so with an average insurer you pay about 8.75 % of gross pay.
• Income above 5,812.50 euros per month (69,750 euros per year, 2026) is not charged; this is the contribution ceiling (Beitragsbemessungsgrenze).
• Long-term care insurance (Pflegeversicherung) is run by the same insurer and charged on the same income: 3.6 % in total in 2026, of which employees usually pay 1.8 %. If you are 23 or older and have no children, a surcharge of 0.6 percentage points applies; parents of two or more children under 25 pay less.
• Benefits are largely the same at every insurer, because the law defines them: doctors and psychotherapists, hospital care, prescribed medicines, pregnancy and childbirth, preventive check-ups, and sick pay (Krankengeld). Insurers differ in their additional rate, in optional extra benefits written into their statutes (Satzungsleistungen), bonus programmes for preventive check-ups, optional tariffs (Wahltarife) and service.
• Family members are covered free of charge under family insurance if they qualify.
• Sick pay: after your employer has continued your salary for six weeks of illness, the insurer pays Krankengeld of 70 % of gross pay (up to the contribution ceiling), but no more than 90 % of net pay, for up to 78 weeks within three years including the employer-paid period.
• Co-payments are small and capped, for example 5 to 10 euros per prescription item. See the guide on pharmacies and prescriptions.

You show your electronic health card (elektronische Gesundheitskarte, eGK) at the practice, and the practice bills the insurer directly. Statutory insurers also provide an electronic patient record (elektronische Patientenakte, ePA) for every member who does not object; you manage it in your insurer's app.

• Premiums depend on your age at entry, your health and the benefits you choose, not on your income. You fill in a health questionnaire, and insurers can charge risk surcharges, exclude conditions or decline you (except in the Basistarif, see below).
• Every family member needs their own policy. There is no free family insurance, which matters if your partner does not work or you plan to have children.
• Premiums can rise over time, for example when costs develop differently from the insurer's assumptions.
• You usually pay bills yourself and claim reimbursement, depending on the policy.
• Employer subsidy: if you are an employee, your employer pays half of your premium, but no more than it would pay for statutory insurance at the contribution ceiling with the average additional rate (by our calculation about 509 euros per month for health insurance in 2026).
• Returning to statutory insurance is restricted. It is generally only possible if you become compulsorily insured again (for example as an employee below the threshold), and from age 55 it is largely excluded if you were not in statutory insurance during the previous five years.
• Every private insurer must offer a basic tariff (Basistarif) with benefits comparable to statutory insurance, without risk surcharges; its premium is capped at the maximum statutory contribution (1,017.19 euros per month for health insurance from 1 January 2026).

Private insurance can be cheaper for young, healthy, single people with high income, but it is a long-term decision. Get independent advice, for example from a consumer advice centre (Verbraucherzentrale), before signing, and compare the full benefit catalogue, not only the starting premium.

In statutory insurance, your spouse or registered partner and your children can be insured free of charge through your membership if they live in Germany, are not otherwise insured, and their own income stays low. In 2026 the limit is 565 euros per month of total income (one seventh of the official reference value), or 603 euros if the income comes from a minijob. The insurer checks the details.

Children are covered up to age 18, up to 23 if they are not working, and up to 25 while in school, training or university (longer after certain voluntary or military service, and without age limit for some children with disabilities).

If one parent is privately insured, earns more than the other parent and more than one twelfth of the compulsory insurance threshold (6,450 euros per month in 2026), children usually cannot be family-insured with the statutory parent and need their own insurance.

Register family members with your insurer as soon as they arrive; you will typically need their passports, a marriage certificate and children's birth certificates.

You may choose any statutory insurer that is open in the federal state where you live or work; nationwide insurers are open everywhere. No statutory insurer may refuse you because of your age, health or income.

Compare neutrally on:

• The additional contribution rate. The GKV-Spitzenverband list shows every insurer, its current additional rate and where it is open (92 insurers as of 5 October 2026). Differences of one percentage point add up over a year.
• Service in your language and channels: app quality, English-language information and phone support, online forms, branches in Berlin.
• Extras that matter to you: optional extra benefits, bonus programmes and optional tariffs. Note that some optional tariffs, such as a deductible tariff or sick-pay tariff for the self-employed, bind you for three years.

To join, apply online or in a branch, give your employer's details and upload a photo for your card. You receive a membership confirmation quickly; the card follows by post. Tell your employer which insurer you chose.

Switching later: you are normally bound to your insurer for 12 months. After that you can switch by applying to the new insurer, which informs the old one; you do not need to cancel yourself. If your insurer raises its additional rate, you can switch earlier using a special termination right.

For a national visa (for work, study or family reunification), German missions ask for proof of health insurance. Many applicants buy an incoming or travel health insurance policy that covers them from entry until their German insurance begins, for example until the first day of employment or until university enrolment. Check the exact requirement on the checklist of the mission that handles your application.

For a Schengen visa (short stays), German missions require travel medical insurance for the whole stay, valid in all Schengen states, with at least 30,000 euros of coverage and including repatriation.

A travel policy bought for the visa normally ends after a fixed period. The immigration office's requirements when you later apply for your residence permit can be stricter than those for the visa, so arrange German statutory or comprehensive private insurance as soon as you can. See the guide on residence permits at the Berlin immigration office.

As a self-employed person you pay the full contribution yourself.

• Voluntary statutory insurance: contributions are based on your actual income, with a minimum base of 1,318.33 euros per month in 2026. At the average additional rate this means at least about 223 euros per month for health insurance without sick pay, or about 231 euros with sick pay, plus long-term care insurance. At the contribution ceiling the health contribution is 1,017.19 euros per month. Access requires prior insurance periods: in general at least 24 months in the last five years, or 12 months immediately before, in statutory insurance. Newcomers who have never been insured in Germany often do not meet this condition; periods in EU/EEA countries or Switzerland may count.
• Private insurance is the usual alternative and the only option for many non-EU newcomers who start out self-employed.
• If you need sick pay, check that your policy includes it: in statutory insurance by choosing the rate with Krankengeld, in private insurance via a daily sickness allowance (Krankentagegeld).

Freelance visas and residence permits for self-employment usually require proof of adequate health insurance. See the guide on self-employment and freelancing.

• Students under 30 are generally insured in statutory insurance at a special rate: 87.38 euros per month for health insurance plus the insurer's additional contribution, plus long-term care insurance. With an average insurer the total is roughly 140 to 150 euros per month in 2026 (our calculation from the official rates; the exact figure depends on the insurer and whether the childless surcharge applies).
• Universities require proof of insurance for enrolment; your insurer provides it.
• You can apply to be exempted from statutory insurance at the start of your studies if you have suitable private cover. The exemption cannot be reversed for the rest of your studies.
• Students from the EU/EEA or Switzerland can often keep their home insurance and use their European Health Insurance Card. Ask your university which proof it needs for enrolment.
• From age 30, the student rate ends and you usually continue as a voluntary member at a higher contribution.

See the guide on studying in Germany.

The European Health Insurance Card (EHIC) covers medically necessary treatment during a temporary stay in another EU/EEA country or Switzerland, at public providers and on the same terms as locals. It is not meant for people who move their residence to Germany, and it does not cover planned treatment or repatriation.

If you move to Germany to work, you join German insurance like any other employee. If you will keep insurance in another EU country while living in Germany (for example as a posted worker or as a pensioner with a pension only from another EU country), ask your home insurer before you move which EU form you need so that you can use the German system. Ask a German statutory insurer as well.

Once you are insured in Germany, the EHIC printed on the back of your German card covers you on trips within Europe. For travel outside Europe, statutory insurance generally does not cover treatment, so consider private travel health insurance.

• Between arrival and the first working day. Cover your first days with incoming or travel insurance until your German insurance starts.
• When a job ends. Statutory membership automatically continues as voluntary membership unless you prove other cover within two weeks of the insurer's notice. People who receive unemployment benefit are compulsorily insured through the benefit.
• Non-working partners of privately insured people need their own policy; there is no free family insurance in private insurance.
• Late private insurance. If you were obliged to take out private insurance and apply more than one month late, the insurer charges a surcharge for each month without cover.
• Dental care. Statutory insurance pays fillings and root treatment, but for crowns, bridges and dentures it pays a fixed subsidy of 60 % of the standard treatment (70 % or 75 % if you have documented regular check-ups for five or ten years in a bonus booklet, Bonusheft). Private supplementary dental insurance can cover part of the rest.
• Travel outside Europe: buy travel health insurance.