Moving to Germany as an expat can be exciting, but navigating the country’s health insurance system can be overwhelming. Germany has one of the best healthcare systems in the world, but it also has strict health insurance requirements. Whether you’re moving for work, study, or personal reasons, this guide will help you understand everything you need to know about health insurance in Germany.
Why Health Insurance is Mandatory in Germany
Germany has a universal healthcare system, meaning everyone must have health insurance—either public or private. If you’re planning to stay in Germany long-term (for work, study, or freelancing), having health insurance is not just recommended—it’s legally required. Without it, you won’t be able to get a residence permit, and you may face financial penalties.
Public vs. Private Health Insurance: What’s the Difference?
1. Public Health Insurance (Gesetzliche Krankenversicherung – GKV)
• Who qualifies? Employees earning less than €69,300 per year (2024), students, job seekers, and retirees.
• How does it work? Contributions are deducted from your salary (usually 14.6% of your gross income, shared between employer and employee).
• What’s covered? Doctor visits, hospital stays, medications, and preventive care.
• Providers: TK (Techniker Krankenkasse), AOK, Barmer, DAK, etc.
2. Private Health Insurance (Private Krankenversicherung – PKV)
• Who qualifies? Employees earning more than €69,300 per year, freelancers, self-employed individuals, and civil servants.
• How does it work? Premiums are based on age, health status, and chosen coverage.
• What’s covered? More personalized care, faster appointments, private hospital rooms, and access to specialized treatments.
• Providers: Allianz, AXA, Debeka, HanseMerkur, etc.
Health Insurance for Different Expat Groups
1. Employees
If you’re employed in Germany and earn less than €69,300 per year, you’ll be automatically enrolled in public health insurance. If you earn more, you can choose between public and private insurance.
2. Freelancers & Self-Employed
Freelancers must choose between public and private insurance. Public insurance is often expensive for self-employed people because they pay the full contribution (not shared with an employer). Private insurance can be cheaper but may increase in price with age.
3. Students
International students under 30 can get affordable public insurance (around €120 per month). Those over 30 must get private insurance, which varies in price. Some providers offer special expat/student insurance plans.
4. EU vs. Non-EU Citizens
• EU citizens: If you have an EHIC (European Health Insurance Card), you may be covered for short stays. For long-term stays, you must register with a German health insurance provider.
• Non-EU citizens: You must have German health insurance to get a visa or residence permit. Many choose temporary expat insurance before transitioning to public or private insurance.
How to Get Health Insurance in Germany
Step 1: Determine Your Eligibility
Decide if you qualify for public or private insurance based on your employment status, income, and nationality.
Step 2: Choose a Provider
Compare public providers (e.g., TK, AOK) or private insurers (e.g., Allianz, AXA). Consider costs, coverage, and English-speaking support.
Step 3: Apply for Insurance
• Public insurance: Fill out an online application, provide proof of employment, and receive confirmation.
• Private insurance: Get a personalized quote, provide medical history, and sign a contract.
Step 4: Receive Your Insurance Card
Once approved, you’ll receive a Gesundheitskarte (health insurance card), which you’ll need for doctor visits and treatments.
Temporary & Expat Health Insurance Options
If you’re new to Germany and not yet eligible for full insurance, you can get temporary expat insurance from providers like:
✅ Feather Insurance (English-friendly, flexible plans)
✅ Ottonova (private digital insurance for expats)
✅ HanseMerkur (good for freelancers & students)
These are great short-term solutions before transitioning to a long-term provider.
Common Health Insurance Mistakes Expats Should Avoid
🚨 Not getting insured before arrival – You may be denied a visa or residence permit.
🚨 Choosing private insurance without long-term planning – Private insurance is hard to leave once you enroll.
🚨 Forgetting about family coverage – Public insurance covers dependents for free; private does not.
🚨 Ignoring pre-existing conditions – Private insurers may reject or charge higher fees for existing health issues.
Conclusion: What’s the Best Health Insurance for Expats in Germany?
The best insurance depends on your situation:
✔ Employees: Public (GKV) is the easiest, but private (PKV) offers more benefits for high earners.
✔ Freelancers: Private (PKV) is often more affordable than public.
✔ Students: Public (if under 30); private if over 30.
✔ Short-term expats: Expat insurance is a good bridge until you qualify for regular insurance.
Understanding Germany’s healthcare system may seem complex, but with the right knowledge, you can make the best choice for your health and finances.
💡 Need help finding the right health insurance? Check out comparison tools like Feather or consult a broker for personalized advice.