How to get health insurance as an expat in Germany (2026)

What you need to know

Health insurance is mandatory in Germany. Every resident - including expats - must have either public (gesetzliche Krankenversicherung, or GKV) or private (private Krankenversicherung, or PKV) health insurance. This guide explains how the system works, who qualifies for which type, what it costs, and which providers cater to English-speaking expats. Last verified: 2026-03-24.

The German health insurance system at a glance

Feature	Public (GKV)	Private (PKV)
Who must join	Employees earning under EUR 69,300 per year (2026 threshold)	Employees earning above EUR 69,300, self-employed, freelancers, civil servants
Monthly cost	~14.6% of gross salary (split 50/50 with employer) plus supplementary contribution (avg. 1.7%)	Varies by age, health, and coverage level
Family coverage	Free for non-earning spouse and children	Each family member needs their own policy
Coverage level	Standardised across all public insurers	Customisable - choose your coverage
Switching	Can switch between public insurers freely	Switching back to public is difficult after age 55

Public health insurance (GKV)

Who qualifies

If you are employed in Germany and earn less than the Versicherungspflichtgrenze (mandatory insurance threshold) of EUR 69,300 per year (2026 figure), you must be enrolled in public health insurance. This is automatic - your employer registers you with a public insurer (Krankenkasse).

You can choose which Krankenkasse to join. If you do not choose, your employer will register you with the default option. There are around 95 public health insurers in Germany, and you are free to switch between them with a one-month notice period.

What it costs

The base contribution rate is 14.6% of your gross salary, split equally between you and your employer (so you pay 7.3%). On top of this, each Krankenkasse charges a supplementary contribution (Zusatzbeitrag) averaging around 1.7% in 2026, also split between employee and employer.

For an employee earning EUR 50,000 per year, the monthly cost works out to approximately EUR 340 from the employee's side (including the supplementary contribution). There is an income ceiling (Beitragsbemessungsgrenze) of EUR 62,100 in 2026 - contributions are capped at this level even if you earn more.

What is covered

Public insurance covers a standardised package mandated by law, including: doctor visits, hospital stays, prescription medication, mental health treatment, maternity care, preventive screenings, dental check-ups (with partial coverage for major dental work), and sick pay after six weeks of illness.

The coverage is the same regardless of which Krankenkasse you choose. The main differences between public insurers are the supplementary contribution rate and any bonus programmes they offer (like cashback for gym memberships or preventive health activities).

Family coverage

One significant advantage of GKV: a non-earning spouse and children are covered for free under Familienversicherung (family insurance). This makes public insurance particularly cost-effective for families where one partner works and the other does not.

Private health insurance (PKV)

Who qualifies

You can opt for private health insurance if you earn above the Versicherungspflichtgrenze (EUR 69,300 in 2026), or if you are self-employed, a freelancer, or a civil servant. Students can also choose private insurance under certain conditions.

For employed expats earning above the threshold, switching to private is optional - you can choose to stay in public insurance voluntarily.

What it costs

Private insurance premiums depend on your age at entry, health status, and the coverage level you choose. A healthy 30-year-old might pay EUR 250 to 400 per month for a comprehensive plan. A 50-year-old could pay EUR 500 to 800 or more.

Unlike public insurance, premiums are not income-based. This means private insurance is often cheaper for young, healthy, high earners, but can become expensive as you age. Providers build age reserves (Altersruckstellungen) to cushion premium increases over time, but costs still tend to rise.

What is covered

Private plans are customisable. A typical comprehensive plan covers everything in public insurance plus: single rooms in hospitals, chief physician treatment, full dental coverage, alternative medicine, and faster specialist appointments. You can adjust your coverage and deductible to manage costs.

Important warnings for expats

Switching from private back to public insurance is very difficult once you are over 55. If your income drops below the threshold, you may be stuck in private insurance with premiums that increase as you age. This is one of the most important decisions expats in Germany face, and it is worth careful consideration before opting out of public insurance.

If you have a family, remember that private insurance requires a separate policy for each family member. For a family of four, this could mean paying four individual premiums rather than getting free family coverage under public insurance.

Insurance providers for expats

Several providers specifically cater to English-speaking expats in Germany:

Feather

Feather is a Berlin-based digital insurance broker that helps expats navigate the German insurance system in English. They offer consultations, sign-up support, and claims handling for health, liability, legal, dental, disability, and household insurance. Feather does not underwrite policies themselves but acts as a broker connecting you with German insurers.

Allianz

Allianz is Germany's largest insurance company and offers both public-supplement and private health insurance plans. As a major international insurer, Allianz has English-speaking support and a wide network of partner doctors and hospitals across Germany and Europe.

Ergo

Ergo, a subsidiary of Munich Re, is one of Germany's largest insurance groups offering health, life, property, and travel insurance. Regulated by BaFin, Ergo provides both public supplement plans and full private health insurance options.

GetSafe

GetSafe is a Heidelberg-based digital insurer popular among young professionals and expats. It offers personal liability, household contents, legal, and dental insurance through a mobile-first platform with an English-language interface. While GetSafe does not offer full health insurance, it is useful for the supplementary coverages every German resident needs.

Which type is right for you?

Your situation	Likely better option	Why
Employed, earning under EUR 69,300	Public (GKV)	Mandatory, straightforward, family-friendly
Employed, earning over EUR 69,300, with family	Public (GKV, voluntary)	Free family coverage saves significantly
Young, single, high earner	Private (PKV) - consider carefully	Lower premiums now, but rising costs with age
Self-employed or freelancer	Depends on income and family	Private can be cheaper short-term; public offers stability
Planning to leave Germany eventually	Private (PKV)	No lock-in to the German public system
Over 45, planning to stay long-term	Public (GKV)	Avoids rising private premiums in later years

Steps to get insured as a new expat

If you are employed

Your employer will ask which Krankenkasse you want to join. If you earn below the threshold, you must choose a public insurer. Popular options with English-language support include TK (Techniker Krankenkasse), Barmer, and AOK. Research their supplementary contribution rates - the difference can save you EUR 10 to 30 per month.

If you are self-employed or freelancing

You must arrange your own insurance before registering at the Burgeramt (citizens' office). You can choose public or private. For public insurance as a freelancer, the minimum contribution is based on an assumed income of around EUR 1,178 per month, resulting in a minimum payment of approximately EUR 210 per month (including supplementary contributions).

Documents you will need

To sign up for health insurance in Germany, you typically need: your passport, your Anmeldung (registration certificate from the Burgeramt), your employment contract or proof of self-employment, and your tax ID (Steuerliche Identifikationsnummer). Some digital brokers like Feather can guide you through the process in English.

Common mistakes expats make

Choosing private insurance without understanding the long-term cost implications is the most common mistake. Private premiums increase with age, and switching back to public after 55 is nearly impossible. Another frequent error is not having insurance arranged before the Anmeldung - you need proof of insurance for your residence registration.

Some expats also overlook supplementary insurances that are standard in Germany: personal liability (Haftpflichtversicherung), which covers accidental damage you cause to others and is considered essential, and household contents insurance (Hausratversicherung) for rented apartments.

Explore insurance options

Browse the full range of insurance providers available in Germany and across Europe on the Capmap insurance directory.

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: 2026-03-24.

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Disclaimer

This article is for educational purposes only and does not constitute financial, tax, or investment advice. Capmap.eu is an independent comparison platform - we do not provide personal recommendations. Always verify current fees, rates, and regulations with the provider or a qualified adviser before making financial decisions. Information was accurate at the time of writing but may have changed.