Health Insurance in Germany: GKV vs PKV — Types, Costs & How to Get Covered
If you’re moving to Germany for work, study, or family reunification — health insurance is one of the first things you’ll need to sort out. Without it, you can’t get a visa, start a job legally, or renew your residence permit.
This guide covers everything you need to know about health insurance in Germany: the difference between public and private coverage, what it costs, which add-on policies are worth considering, and answers to the most common questions.
Do You Need Health Insurance to Enter Germany?
Yes — health insurance is mandatory for most German visa types. You’ll need it for:
- EU Blue Card (work visa)
- Chancenkarte (Opportunity Card)
- Student visa
- Schengen tourist/short-stay visa
The German consulate requires proof of valid health coverage when you submit your visa application.
Depending on your purpose of stay, there are two types of coverage:
- Incoming insurance (entry-level temporary coverage)
- Permanent health insurance in Germany
Incoming Insurance (Entry Coverage for Germany)
Incoming insurance is temporary health coverage for foreigners entering Germany. It bridges the gap between your arrival date and the start of your employment or permanent insurance enrollment.
Its primary purpose is to satisfy visa requirements and ensure you’re legally covered upon entry.
Standard incoming insurance for Germany typically covers:
- Emergency medical care
- Inpatient hospital treatment
- Accidents
- Emergency medical transport
- Emergency hospitalization
Where to Get Incoming Insurance for a German Visa
Recommended providers:
These policies are accepted when submitting your application to the German consulate or embassy.
Permanent Health Insurance in Germany
Once you start living and working in Germany, you’ll need to enroll in permanent health insurance. Germany runs two parallel systems:
- Public health insurance (GKV — Gesetzliche Krankenversicherung)
- Private health insurance (PKV — Private Krankenversicherung)
This dual system has been in place for decades and covers virtually the entire population.
Public Health Insurance in Germany (GKV)
Public health insurance is the backbone of the German healthcare system — around 90% of the population is enrolled in GKV.
If you’re employed and earn less than €77,400 per year (2026 threshold), you’re required to sign up for public insurance from your first day of work. Costs are handled through statutory health funds — Krankenkassen — which pay your doctors and hospitals directly.
Popular public insurers include:
- TK (Techniker Krankenkasse)
- Barmer
- DAK
- AOK
If you’d like help signing up with TK or Barmer, get in touch — we’re happy to walk you through it. Just mention in the comments that you need help with health insurance.
How much does public health insurance cost?
GKV contributions are income-based: 14.6% of your gross salary, plus a small surcharge set by your chosen fund. Importantly, the cost is split 50/50 between you and your employer — so in practice, you pay around 7–8% of your salary.
Advantages of public health insurance
Key benefits of GKV:
- Free family coverage for non-working spouses and children
- Broad coverage of most medical services
- No health checks required to enroll
- Stable, well-established system
Disadvantages of public health insurance
Despite its accessibility, GKV comes with some notable limitations:
- Waiting times for specialists (orthopedists, dermatologists, neurologists, etc.) can stretch to several weeks or months
- GKV only covers basic dental care — implants, orthodontics, and professional cleanings cost extra
- Contributions are tied to income: the more you earn, the more you pay, regardless of how often you use healthcare
- Limited scope of services — doctors prescribe only what’s medically necessary; additional tests or procedures are often not covered
- No priority access to specialists — GKV patients typically wait longer than those with private insurance
- Self-employed individuals pay the full contribution themselves
- Switching back from PKV to GKV is notoriously difficult without dropping below the income threshold (below €77,400 per year gross in 2026)
Private Health Insurance in Germany (PKV)
Private health insurance (PKV) is the alternative system — available to:
- Employees earning over €77,400 per year (2026 threshold)
- Freelancers and self-employed individuals
- Civil servants (Beamte)
About 10% of Germany’s population holds private insurance.
PKV premiums are calculated individually based on:
- Age
- Gender
- Health status
- Chosen coverage package
Rough price ranges:
- €250–400/month for young professionals
- €600+/month for comprehensive packages
Your employer also contributes — but only up to the amount they would have paid into GKV. If your PKV premium is higher, you cover the difference yourself.
Advantages of private health insurance
PKV typically offers:
- Faster appointments with specialists
- A wider range of covered treatments
- Private rooms in hospital
- Access to senior specialists and consultants
Disadvantages of private health insurance
- No free family coverage — spouses and children must be insured separately
- Premiums tend to rise with age
- Harder to switch back to GKV if circumstances change
Popular private insurers: Allianz, AXA, Ottonova.
Add-On Insurance Policies in Germany
Beyond mandatory health coverage, a number of supplementary policies (Zusatzversicherungen) are widely used in Germany — some are practically considered essential.
Dental insurance (Zahnzusatzversicherung)
Public insurance only covers basic dental work. A supplemental dental plan helps cover professional cleanings, implants, high-quality fillings, and orthodontic treatment.
Get Dental Insurance via Feather
Personal liability insurance (Haftpflichtversicherung)
This policy covers damage you accidentally cause to other people or their property — whether it’s damaging something in a rented apartment, injuring someone, or breaking a neighbor’s belongings. It’s often required by landlords when renting.
Get Liability Insurance via Feather
Dog owner liability insurance
This covers damage or injury your dog causes to third parties or their property. In several German states, it’s legally required for dog owners.
Get Dog Insurance via Feather
Legal expenses insurance (Rechtsschutzversicherung)
Legal insurance covers attorney fees, court costs, and legal consultations. It’s particularly useful in disputes with employers, landlords, or insurance companies.
Get Legal Insurance via Feather
Pet insurance
Pet health insurance helps cover veterinary costs if your animal needs treatment.
Get Pet Insurance via Feather
Summary
Health insurance in Germany is a complex but well-structured system — and there’s a right fit for every situation. Your best option depends on your employment status, income level, and personal circumstances.
- If you’re just arriving — you’ll need incoming insurance to get your visa.
- Once employed — you’ll automatically be enrolled in GKV.
- With a higher income or specific circumstances — private PKV may be worth considering.
- Add-on policies (dental, liability, legal) fill in the gaps and make day-to-day life in Germany much smoother.
Need help sorting out insurance or planning your relocation to Germany?
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FAQ
Is health insurance mandatory in Germany?
Yes. Everyone living and working in Germany on a permanent basis is legally required to have health insurance — either public (GKV) or private (PKV).
Can I choose private insurance instead of public?
Yes, but only under certain conditions. Employees can switch to PKV if their income exceeds €77,400 per year (2026 threshold). Freelancers and civil servants can opt for PKV from day one.
Does GKV cover my family members?
Yes. GKV includes free family coverage for non-working spouses and children up to age 18 (or up to 23–25 for students under certain conditions). This is one of the biggest advantages of the public system.
What if I’m only coming to Germany for a short period?
Take out incoming insurance (Einreiseversicherung) before you travel. It covers emergency medical treatment and is a mandatory requirement for both Schengen and national visas.
Do I need additional insurance if I already have GKV?
GKV covers most medical needs, but not everything. Many residents in Germany also take out supplemental dental insurance (Zahnzusatzversicherung), personal liability insurance (Haftpflichtversicherung), and legal expenses insurance (Rechtsschutzversicherung).
