Health Insurance in Germany 2026Complete Guide for Expats
Health insurance is mandatory in Germany. This guide explains the difference between public (GKV) and private (PKV) insurance, costs, and how to choose the right option for you.
Health Insurance is Mandatory in Germany
Everyone living in Germany must have health insurance. This applies to employees, self-employed, students, and even unemployed residents. You cannot legally register your residence (Anmeldung) or work without proof of health coverage.
Public vs Private Insurance: Which One?
Germany has two parallel health insurance systems. Your employment status and income determine which you can choose.
GKV - Public Insurance
Gesetzliche Krankenversicherung
Who must join GKV?
- - Employees earning under 69,300 Euro/year
- - Students (with special rates)
- - Unemployed receiving benefits
PKV - Private Insurance
Private Krankenversicherung
Who can choose PKV?
- - Employees earning over 69,300 Euro/year
- - Self-employed and freelancers
- - Civil servants (Beamte)
2026 Income Thresholds
JAEG (Insurance Threshold)
69,300 Euro/year
Above this = can choose PKV
Contribution Ceiling (BBG)
62,100 Euro/year
Max income for GKV contribution calculation
Special Cases for Expats
Blue Card Holders
Automatically enrolled in GKV through employer. If salary exceeds JAEG, you can optionally switch to PKV.
Students
Special GKV rates available (approx. 110 Euro/month). Must be enrolled at a German university. Age limit: 30 years.
Freelancers
Can choose between GKV or PKV. In GKV, you pay both employer and employee portions (approx. 14-15% of income).
Key German Terms for Health Insurance
Understanding these terms will help you navigate the German healthcare system
Tip for Newcomers
If you're just arriving in Germany, GKV is usually the safer choice as it's easier to switch back to if needed. PKV can be difficult to leave once you're enrolled, especially as you get older. Consider PKV only if you're young, healthy, and plan to stay in Germany long-term.
Compare Health Insurance Options
Find the best health insurance for your situation. Compare GKV providers or get PKV quotes.
Cost Comparison
GKV Costs
Example: 4,000 Euro gross salary
~326 Euro/month (your share)
PKV Costs
Employer contributes up to
~421 Euro/month (2026)
Frequently Asked Questions
Common questions about health insurance in Germany for expats
Is health insurance mandatory in Germany?
Yes, health insurance is mandatory for everyone living in Germany. This applies to employees, self-employed, students, and even unemployed residents. You cannot legally reside in Germany without health coverage.
What is the difference between GKV and PKV?
GKV (Gesetzliche Krankenversicherung) is public statutory insurance with income-based contributions. PKV (Private Krankenversicherung) is private insurance with risk-based premiums. Employees earning under 69,300 Euro/year must join GKV, while those earning above can choose PKV.
How much does health insurance cost in Germany?
GKV costs approximately 14.6% of gross salary plus an additional contribution (Zusatzbeitrag) of around 1.7%, split between employer and employee. PKV premiums vary based on age, health, and coverage level, typically starting from 200-400 Euro/month.
Can expats get public health insurance?
Yes, expats who are employed in Germany and earn under 69,300 Euro/year are automatically enrolled in GKV. Self-employed expats and high earners can choose between GKV and PKV.
What does the JAEG threshold of 69,300 Euro mean?
The Jahresarbeitsentgeltgrenze (JAEG) is the annual income threshold. Employees earning above this amount can opt out of mandatory public insurance and choose private insurance instead. In 2026, this threshold is 69,300 Euro.
How do Blue Card holders get health insurance?
Blue Card holders are typically employed and automatically enrolled in GKV through their employer. If their salary exceeds the JAEG threshold, they can optionally switch to PKV.
We work with partners including CHECK24 and Tarifcheck. This comparison is free and non-binding. Last updated: January 2026. This is not legal or financial advice.
Find Your Health Insurance
Compare health insurance options and find the best coverage for your needs.