Health Insurance in Germany
The complete guide to health insurance in Germany for expats — GKV vs PKV, costs, eligibility, and how to get the best deal. Includes a free savings calculator.
Health insurance in Germany is mandatory for everyone. But at higher income levels, you have a choice — and that choice can save you hundreds of euros every month.
This guide explains exactly how the German health insurance system works, who can switch to private insurance, and how much you could save. No jargon, no sales pitch — just the facts.
GKV vs PKV — calculate your costs
Enter your details to see your exact GKV contribution alongside a typical PKV premium. Side by side.
Your health insurance options in Germany
When you arrive in Germany, you'll need to choose a health insurance plan. There are three main options:
Public health insurance (GKV)
GKV stands for Gesetzliche Krankenversicherung — statutory health insurance. About 87% of people in Germany are in GKV. It's the default option.
How much does GKV cost?
Your contribution is calculated as a percentage of your gross salary — not a flat fee. The current total rate is 14.6% + a supplemental charge (Zusatzbeitrag) averaging around 1.7%, split 50/50 between you and your employer.
| Situation | Who pays | Approximate monthly cost |
|---|---|---|
| Salaried employee (€80k/year) | You + employer (50/50) | ~€450/month (your share) |
| Self-employed | You pay everything | ~€900–1,300/month |
| Student | You | ~€130/month |
| Unemployed / ALG I recipient | Job centre | €0 (covered) |
There is a contribution ceiling (Beitragsbemessungsgrenze) of €5,812.50/month (2026) — your contributions are capped at this salary level regardless of how much you earn.
What does GKV cover?
- Doctor visits and specialist appointments
- Hospital stays
- Prescription medication (with co-pay)
- Mental health and psychotherapy
- Dental check-ups (basic)
- Maternity and childbirth
- Sick leave pay (Krankengeld) from day 43
- Family members (spouse + kids) for free
- Emergency care in EU countries
- Vaccinations and cancer screenings
- Glasses and contact lenses (adults)
- Advanced dental treatments
- Travel vaccinations
- Cosmetic procedures
- Alternative medicine (homeopathy etc.)
- Private hospital room
- Chief physician treatment
Pros and cons of GKV
- Simple — just sign up and you're covered
- Family members covered for free (no extra cost)
- Cannot be rejected for pre-existing conditions
- Employer pays half your contribution
- Easy to switch back if circumstances change
- Contribution rises with your salary
- Long waiting times for specialist appointments
- No private room in hospital
- Self-employed pay full 16.3% alone
- Less personalised coverage options
Private health insurance (PKV)
PKV stands for Private Krankenversicherung. Instead of paying a percentage of your salary, you pay a risk-based premium — based on your age, health, and the coverage level you choose.
This is why PKV is usually much cheaper for healthy, high-earning people: your premium doesn't increase just because you got a raise.
Who can get PKV?
- A salaried employee earning ≥ €77,400/year gross
- Self-employed or freelancing (any income level)
- A civil servant (Beamter)
- A student in certain situations
- Earning below €77,400 as an employee
- Unemployed or receiving ALG I
- Under 18 (in most cases)
Nationality doesn't matter. You don't need a German passport or permanent residency to get PKV — just meet the income threshold or be self-employed.
How much does PKV cost?
PKV premiums are highly individual. The main factors are your age at the time you join, your health history, and the coverage level you select. Here are typical ranges for a healthy person with good coverage:
| Age when joining | Typical PKV premium | vs GKV at €80k | Monthly saving |
|---|---|---|---|
| 25–30 | €200–280/month | ~€640/month | ~€360–440 |
| 30–35 | €260–340/month | ~€640/month | ~€300–380 |
| 35–40 | €320–420/month | ~€640/month | ~€220–320 |
| 40–45 | €380–500/month | ~€640/month | ~€140–260 |
The younger you are when you switch, the lower your premium — and the lower it stays. Waiting costs money.
What does PKV cover?
PKV plans are highly customisable, but a good plan typically includes significantly more than GKV:
- Chief physician treatment in hospital
- Private or two-bed hospital room
- Shorter waiting times (usually same week for specialists)
- Better dental coverage (crowns, implants, orthodontics)
- Vision coverage (glasses, laser eye surgery)
- Alternative medicine (osteopathy, acupuncture)
- International coverage (outside EU)
- Sick pay from day 1 (optional)
Pros and cons of PKV
- Premium doesn't rise with your salary
- Faster appointments, better access
- Better hospital conditions
- More comprehensive coverage options
- Significant savings at higher incomes
- Cannot be cancelled due to illness
- Premiums rise with age
- Dependants are not automatically covered
- Health questionnaire required at sign-up
- Switching back to GKV is harder
- You pay bills first, then claim back
Which option is best for you?
| Your situation | Best option | Why |
|---|---|---|
| Employee, salary < €77,400 | GKV | PKV not available |
| Employee, salary ≥ €77,400, age < 40 | PKV | Significant savings + better coverage |
| Employee, salary ≥ €77,400, age > 45 | Depends | Get a comparison — savings shrink with age |
| Self-employed, good health | PKV | GKV costs €900–1,300/month self-employed |
| Self-employed, low income | GKV (artist fund) | Künstlersozialkasse may reduce costs |
| Just arrived, short-term | Expat insurance | Bridge until you have a job/residence |
| Family with kids, lower salary | GKV | Free family coverage is a major advantage |
How to switch from GKV to PKV
Confirm your gross annual salary exceeds €77,400. If you're self-employed, you're eligible regardless of income.
Do not go directly to one insurer — they'll only show you their own products. Use a broker who compares all major PKV providers.
PKV requires you to disclose your medical history. Pre-existing conditions may affect your premium or result in exclusions — this is normal.
Once your PKV application is approved, you have proof of insurance. Only then cancel your GKV — give 2 months' notice.
Your PKV starts from the agreed date. Inform your employer so they can adjust the subsidy they pay towards your premium.
Timing tip: The best time to switch is January 1st (you need to cancel GKV by October 31st). But you can switch any time of year — it doesn't have to be January.
Common questions
Get a free comparison
The German health insurance market has over 40 private insurers with hundreds of plan combinations. Comparing them yourself takes weeks and requires understanding complex German contracts.
The smarter move: work with a specialist who is not tied to any single insurer, who advises in English, and who can tell you within 15 minutes whether PKV makes sense for your situation.
The team at MyHealthcareBroker specialises exclusively in PKV for English-speaking expats in Germany. Free consultation, all major providers compared, advice in English.
- ✓ Not tied to any single insurer
- ✓ 20+ years experience in the German PKV market
- ✓ Advice in English
- ✓ Completely free