Health Insurance in Germany — GKV or PKV?

Insurance is MANDATORY

In Germany, everyone must have health insurance (Versicherungspflicht) — from the first day of stay. Without it, you cannot register for work, and often cannot register your residence or extend your residence permit.

Two systems: GKV and PKV

GKV (Gesetzliche Krankenversicherung) — public

• For whom: employees with income up to €77,400/year (Versicherungspflichtgrenze 2026); below this limit GKV is mandatory
• Cost: standard contribution 14.6% + Zusatzbeitrag from the insurance fund (avg. ~2.5%) + Pflegeversicherung (~3.4–4%). Employer pays half
• Advantages: family members without income covered for free (Familienversicherung), fixed range of benefits
• Disadvantages: longer waiting times for specialist appointments

Popular health insurance funds (Krankenkasse): TK, AOK, Barmer, DAK. The basic premium is the same — they differ in Zusatzbeitrag and service quality. You can switch funds after 12 months, and if Zusatzbeitrag increases, you have Sonderkündigungsrecht.

PKV (Private Krankenversicherung) — private

• For whom: those earning over €77,400/year (for 3 years), civil servants, freelancers
• Cost: depends on age and health (€200–800/month)
• Advantages: faster appointments, higher standard
• Disadvantages: becomes more expensive with age, each family member pays separately, difficult to return to GKV

How to register?

If you work on an employment contract:

1. Choose a health insurance fund (GKV) and fill out the application online
2. Give your employer your insurance number — the premium will be deducted from your salary
3. You'll receive an electronic health card (eGK) — show it to your doctor

If you're a freelancer or student:

• Freelancer: GKV voluntary (you pay the full premium) or PKV
• Student: affordable studentische Krankenversicherung until age 30

What does insurance cover?

✅ Doctor visits, hospital, operations
✅ Prescription medications (€5–10 copay)
✅ Pregnancy and childbirth, rehabilitation

❌ Dentist only partially (crowns, implants — you pay extra)
❌ Glasses for adults, alternative medicine

Special situations

• Minijob does not provide insurance — you must be insured through another source
• Family: when bringing family members, they must also have insurance (Familienversicherung in GKV or their own)
• EHIC card from EU countries works temporarily — when you start work, you need German insurance