Best health insurance in Germany for expats (2026)
Updated 19 May 202610 min read
Germany requires all residents to have health insurance, either through the public statutory system (GKV) or private insurance (PKV). Most expats earning under EUR 69,300 per year must join the public GKV system, which costs around 14.6% of gross salary plus a supplementary contribution. Self-employed expats and higher earners can opt for private insurance through providers like Allianz, Ergo, or AXA. Feather is a Berlin-based digital broker specialising in expat coverage, offering English-language support and guidance through Germany's insurance system. Supplementary insurance for dental and vision can be added regardless of which main plan you choose.
The table below shows key characteristics of the main insurers available to expats:
| Provider | Type | Best for | Key feature |
|---|---|---|---|
| Feather | Digital broker | Expat support | English-language guidance |
| Allianz | PKV (private) | Global coverage | World's largest insurer |
| Ergo | PKV (private) | Comprehensive coverage | Munich Re subsidiary, BaFin regulated |
| AXA | PKV (private) | Expat-friendly | Strong international presence |
| Generali | PKV (private) | Multi-line coverage | Italian multinational, established 1831 |
| GetSafe | Digital insurer | Younger expats | Mobile-first, simple policies |
| APRIL International | Specialist broker | Expat health insurance | 130k+ expats, health and travel focus |
Germany operates a mandatory health insurance system that applies to all residents. Unlike some countries where insurance is optional or only for specific groups, living in Germany means you must have active health coverage. The system is divided into two distinct branches: public statutory insurance (GKV) and private insurance (PKV), and understanding which applies to you is the first step to securing proper coverage.
The choice between GKV and PKV depends mainly on your employment status and income level. Generally, employed individuals earning below the income threshold (EUR 69,300 in 2026) must participate in the public system. Once you exceed this threshold or become self-employed, you gain the option to switch to private insurance. Pensioners and students have their own regulations, though most student insurance falls within the public system at subsidised rates.
All insurers operating in Germany are regulated by BaFin (Bundesanstalt für Finanzdienstleistungsaufsicht), ensuring a consistent standard of consumer protection and financial stability across the market. This regulation makes Germany one of the most reliable health insurance systems in Europe.
The public statutory system (GKV - Gesetzliche Krankenversicherung) covers approximately 90% of Germany's population. It is a social insurance model where contributions are income-based, meaning you pay a percentage of your gross salary rather than a fixed premium. This creates a fundamentally different cost structure compared to private insurance, where premiums depend on your health status and claims history.
The current contribution rate is approximately 14.6% of gross salary, split equally between employee and employer. On top of this, there is an additional supplementary contribution (Zusatzbeitrag) averaging around 1.7%, though this varies slightly between different public insurance funds. Your employer covers half of both the base rate and the supplementary contribution, reducing your net cost significantly. For someone earning EUR 50,000 annually, the combined cost is around EUR 7,300 per year, with the employer paying about EUR 3,650.
All major public GKV funds offer the same core benefit package mandated by law. The difference between them lies in supplementary services, digital platforms, and customer service quality. While major funds like Techniker Krankenkasse (TK) and AOK offer strong reputations, they are not available through Capmap's platform listing.
Public insurance covers general practitioners, hospital stays, medications, physiotherapy, and dental treatment (though major dental work may have cost-sharing). It does not cover purely cosmetic procedures. Once you meet an annual deductible (usually EUR 0 to EUR 200 depending on the fund), most services are covered with minimal out-of-pocket costs. Prescription medications typically require a EUR 10 co-payment, regardless of the drug's actual cost.
Eligibility for GKV is automatic if you are employed and earning below the income threshold. You do not need to apply or undergo health assessment. Your employer deducts contributions from your salary and remits them to your chosen fund. This automatic protection is one of GKV's major advantages for newly arrived expats.
Private health insurance (PKV - Private Krankenversicherung) is available to self-employed individuals, business owners, civil servants, and employees earning above the income threshold. Unlike GKV, PKV premiums are based on your age, health status, and coverage level at the time of enrollment. Once you enter PKV, premiums typically increase with age and inflation, and returning to GKV is extremely difficult (only possible before age 55 or in exceptional circumstances).
The main advantage of PKV is choice and customization. You can select different coverage levels, deductibles, and benefits tailored to your needs. Top-tier plans may include direct access to specialists without referrals, faster appointment availability, and coverage for alternative medicine. However, this flexibility comes at a higher cost than GKV for most people, especially as you age.
Key PKV providers available to expats:
Private insurance typically costs between EUR 200 and EUR 500 per month for standard coverage, depending on age and deductible choices. A young, healthy 30-year-old might pay EUR 200-250 monthly, while someone aged 50 could pay EUR 400-500 for the same coverage level. This makes PKV more expensive than GKV for most people, but it offers superior benefits and specialist access.
Navigating Germany's health insurance system as an expat can be daunting, especially if German is not your first language. Several specialised providers and brokers cater specifically to this challenge.
Feather is a Berlin-based digital broker founded specifically to serve expats. They offer guidance in English throughout the entire insurance process, from understanding the difference between GKV and PKV to helping you select the right provider. Feather arranges comprehensive coverage including health, liability, legal protection, dental, and disability insurance. For expats without strong German language skills, Feather's English-language support is invaluable.
APRIL International is a French specialist in expat health insurance, trusted by over 130,000 expats worldwide. They offer bespoke health and travel insurance designed for international residents in Germany. APRIL's focus on expats means they understand the specific challenges of living abroad and can design coverage that bridges any gaps in the standard system.
If you are self-employed or earning above the threshold and prefer direct PKV enrollment, Allianz and Ergo are among the most expat-friendly options. Both have English-language websites and customer service, making the enrollment process straightforward. Allianz especially appeals to expats who maintain international lives, as their global presence simplifies coverage coordination across countries.
Regardless of whether you choose GKV or PKV, supplementary insurance (Zusatzversicherung) is highly recommended for comprehensive protection. The public system covers basic dental treatment, but major dental work such as crowns, bridges, and implants involves substantial out-of-pocket costs. Supplementary dental insurance typically covers 50-80% of these expenses and costs EUR 10-20 per month.
Vision insurance is similarly valuable if you require glasses or contact lenses regularly. The public system does not cover routine eye exams or corrective devices for adults, and a quality pair of glasses can cost EUR 200-400. Vision supplementary insurance covers eye exams and contributes toward frames or lenses.
Providers like GetSafe and Feather specialise in bundling supplementary policies with your main insurance, making it simple to add dental and vision coverage. Many PKV plans already include dental and vision at higher tiers, so check your selected plan carefully before purchasing supplements.
Wellness and prevention coverage is another popular supplement in Germany. These policies reimburse gym memberships, fitness classes, and preventive health courses, encouraging you to maintain good health proactively.
The table below illustrates typical annual costs for different insurance pathways, based on a EUR 50,000 annual salary:
| Insurance type | Annual cost (estimate) | Deductible | Copayments |
|---|---|---|---|
| GKV (public) | EUR 3,650 (employee pays) | EUR 0-200 | EUR 10 per prescription |
| PKV basic (age 30) | EUR 2,400-3,000 | EUR 500-1,000 | Variable by plan |
| PKV standard (age 30) | EUR 3,000-4,200 | EUR 250-500 | Minimal |
| PKV premium (age 30) | EUR 4,500-6,000 | EUR 0 | None |
| PKV basic (age 50) | EUR 4,800-6,000 | EUR 500-1,000 | Variable by plan |
These figures are approximate and based on 2026 rates. Actual costs vary depending on the specific insurer, coverage tier, and individual health profile. Always request current quotes directly from providers before making a decision.
If you are employed and earning below EUR 69,300: You are required to join GKV. There is no choice here, but you can select which public fund to join based on their digital services and reputation. Research reviews and compare the supplementary services offered by different funds before deciding.
If you are self-employed or earning above the threshold: You have a choice between GKV and PKV. Consider your age and expected healthcare needs. Younger, healthy individuals often find PKV cheaper, while older individuals or those with chronic conditions may save money staying in GKV. Remember that switching from PKV back to GKV is extremely difficult after age 55.
If you speak limited German: Strongly consider using Feather or APRIL International to navigate the system. Their English-language support and expat-focused approach will save you time and prevent costly mistakes.
If you need global coverage: Consider Allianz or AXA if enrolling in PKV, as both offer international policy coordination. For GKV, supplementary international travel insurance through APRIL bridges any gaps in coverage when travelling.
Calculate your break-even point: If you are eligible for both GKV and PKV, create a spreadsheet comparing the costs. For GKV, use the formula: (gross salary × 14.6%) + (gross salary × 1.7%) = annual cost. Divide by 12 to get your monthly cost. For PKV, request quotes from at least three providers. The cheaper option is not always the best if coverage differs significantly.
Check for existing coverage: If you were covered under a previous employer's plan in another country, verify whether your pre-existing conditions are recognised in Germany. Some private insurers offer waiting periods for certain conditions.
Health insurance in Germany is mandatory, reliable, and well-regulated, making it one of Europe's strongest systems. For employed expats, the choice is straightforward: join the public GKV system and select a fund based on service quality. For self-employed individuals and high earners, the PKV option provides flexibility and potentially better specialist access, though at higher cost.
The key to a smooth transition is planning early. Connect with a broker like Feather before or immediately upon arrival, enrol in insurance before starting work, and add supplementary dental and vision coverage to avoid unexpected costs. Germany's insurance system is designed to protect you, but only if you understand it and enrol correctly.
Whether you choose public or private insurance, Germany's regulatory environment ensures consumer protection and transparent pricing. Take time to compare options, request quotes, and select the plan that matches your health needs and budget.
This article is educational content, not financial advice. Always do your own research before making financial decisions. Fees and features may change -- verify current details on the platform's official website. Last verified: 2026-03-25.
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Compare Allianz and APRIL International and AXA and Ergo and Feather and Generali and GetSafeWritten by Capmap Editorial · Independent financial guides for expats in Europe.