German Health Insurance —
Complete Guide for Foreigners
Mandatory for everyone in Germany — you cannot live or work there without it. Public vs private explained, major providers compared, and exact costs by situation.
Cost at a glance (2025)
Employed (€3,000/mo gross)
You pay — employer matches €124
~€124/mo
Student (under 30)
Subsidised student rate
~€130/mo
Self-employed
Full contribution — no employer share
~€500–900/mo
Covered as family member
Spouse/children under €505/mo income
€0/mo
Top pick for expats: TK (Techniker Krankenkasse) — best English support, digital app, and expat resources.
Guide by
Abdullah
Creator of Ankommo · Based in Germany
I moved to Germany and built Ankommo to help others navigate the same process I went through. I offer 1-on-1 video consultations on visas, Ausbildung applications, citizenship requirements, and German language — in English, Urdu, or German.
Book a 1-on-1 consultationMandatory
For everyone living in Germany
14.6%
Of gross salary for public insurance
~120/mo
Student rate (subsidised)
Public vs private health insurance
Most people in Germany — including almost all foreigners — are in public health insurance (GKV). Private insurance (PKV) is only available if you are self-employed, a civil servant, or earn above €73,800/year.
Public (GKV)
Most peopleWho: Employees, students, unemployed, low earners
Cost: ~14.6% of gross salary (employer pays half) + ~1.5% Zusatzbeitrag
Pros
- Same price regardless of health condition
- Dependants can be covered for free
- Nationwide acceptance
- Employer pays 50% of premium
- Easy to switch providers
Cons
- No choice for most employees (mandatory)
- Higher cost for healthy high earners
- Longer waits for some specialist appointments
Private (PKV)
High earners onlyWho: Self-employed, civil servants, high earners (>€73,800/year)
Cost: Risk-based — age, health, chosen coverage level. Typically €300–€700/month
Pros
- Faster specialist access
- Better hospital room options
- More comprehensive coverage
- Cheaper when young and healthy
Cons
- Premiums rise significantly with age
- Pre-existing conditions may be excluded
- Dependants are NOT covered for free
- Hard to switch back to public later
Major public insurance providers compared
All public providers cover the same legally required benefits. Differences are in their Zusatzbeitrag (supplemental rate), digital services, and optional extras.
| Provider | Zusatzbeitrag | English | App |
|---|---|---|---|
TK (Techniker Krankenkasse) Best digital experience, strong English support, popular with expats and tech workers. | 1.8% | Yes | Excellent |
Barmer Large nationwide network, strong customer service, good supplemental benefits. | 1.8% | Partial | Good |
AOK Largest provider — varies by region. Competitive Zusatzbeitrag in some states. | 1.1–1.7% | Limited | Varies |
DAK-Gesundheit Often the cheapest of the major providers in terms of Zusatzbeitrag. Decent digital tools. | 1.7% | Limited | Good |
KKH One of the lowest Zusatzbeiträge. Fewer supplemental benefits but covers the legal minimum. | 1.4% | Limited | Basic |
Rates as of 2025. Zusatzbeitrag changes annually — check current rates at krankenkasseninfo.de.
How much does it cost — by situation
Employed (earning €3,000/month gross)
You pay ~€124, employer pays ~€124. Employer contribution is mandatory.
~€247/month
Student (under 30, at German university)
Subsidised student rate. Available until age 30 or end of 14th semester.
~€120–€140/month
Self-employed
You pay the full contribution (no employer share). Minimum income base applies even if you earn less.
~€450–€900/month
Unemployed (receiving Bürgergeld)
The Jobcenter pays your health insurance contributions while you receive Bürgergeld (citizen income).
€0
Family member of insured employee
Spouse and children can be covered for free under family insurance (Familienversicherung) if they earn below €505/month.
€0
How to register for health insurance
Choose a public provider
Compare Zusatzbeitrag rates and services. TK and Barmer are popular choices for expats due to English support and strong digital tools.
Complete the registration form
Fill in your name, address, date of birth, and start date. Most providers now offer online registration in minutes.
Provide your documents
Upload or send: your passport, Meldebescheinigung, and (for employed people) your employment contract or start date confirmation.
Receive your insurance certificate
The provider sends a Versicherungsbescheinigung. Give this to your employer immediately — they need it to register payroll deductions.
Receive your health card (Krankenversicherungskarte)
Your health card arrives by post within 2–4 weeks. Until then, your certificate confirms coverage.
Frequently asked questions
- Is health insurance mandatory in Germany?
- Yes. Health insurance (Krankenversicherung) is legally mandatory in Germany for everyone living or working there. You cannot legally live in Germany without health insurance. Uninsured people can face large backdated premium bills covering the uninsured period.
- What is the difference between public and private health insurance in Germany?
- Public health insurance (gesetzliche Krankenversicherung / GKV) is income-based and covers almost everyone. Private health insurance (private Krankenversicherung / PKV) is risk-based, often cheaper for young healthy high earners but can become expensive with age. Only the self-employed, civil servants, and high earners above the Versicherungspflichtgrenze (€73,800/year in 2025) can choose PKV.
- How much does health insurance cost in Germany?
- Public health insurance costs 14.6% of gross salary (split equally between employer and employee) plus a Zusatzbeitrag of around 1.0–1.8% depending on the provider. Students pay a subsidised rate of around €120–€140/month. The self-employed pay the full 14.6% plus Zusatzbeitrag themselves.
- Which public health insurance provider is best in Germany?
- TK (Techniker Krankenkasse) and Barmer are consistently rated highest for customer service, digital services, and English-language support. AOK is the largest provider and varies by region. All public providers cover the same legally required benefits — differences are in supplemental services, digital tools, and additional benefits.
- Can I keep my foreign health insurance in Germany?
- Generally no — foreign health insurance is not accepted as a substitute for German statutory or private health insurance. EU citizens with an EHIC (European Health Insurance Card) are covered for emergencies but need to get German insurance for long-term residence. Travel insurance also does not count.
Sort your German before you register
Health insurance forms and letters are in German. Ankommo takes you from A1 to B1 — free to start.
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