Ankommo
Health Insurance in Germany

German Health Insurance: Complete Guide for Foreigners

Mandatory for everyone in Germany: you cannot live or work there without it. Public vs private explained, major providers compared, and exact costs by situation.

Cost at a glance (2026)

Employed (€3,000/mo gross)

You pay this; your employer matches €263

~€263/mo

Student (under 30)

Subsidised student rate

~€130–160/mo

Self-employed

Full contribution (no employer share)

~€250–1,000/mo

Covered as family member

Spouse/children under €565/mo income

€0/mo

Top pick for expats: TK (Techniker Krankenkasse). Best English support, digital app, and expat resources.

Day 1

insurance is mandatory from your first day in Germany

14.6% + 2.9%

public rate + average Zusatzbeitrag (2026)

€77,400

income threshold to choose private (2026)

€0

family members co-insured free in public insurance

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Guide by

Abdullah

Creator of Ankommo · Based in Germany

I moved to Germany and built Ankommo to help others navigate the same process I went through. We offer 1-on-1 video consultations on visas, Ausbildung applications, citizenship requirements and settling in.

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Estimate your monthly cost

Pick your situation below to see your public insurance cost with 2026 rates, and how much your employer covers. Switch provider to compare Zusatzbeitrag rates.

Coming as a student? The rules differ by age and student type, so use the dedicated student guide.

Cost Estimator

2026 rates · public insurance (GKV)

You pay

€259/mo

Your situation

€3.000
€1,000€5,812.50 cap€8,000

Provider (Zusatzbeitrag)

You pay€259/month
Employer pays€259/month
Total contribution€518/month

Your employer pays exactly half; this is mandatory by law.

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Public vs private health insurance

Most people in Germany, including almost all foreigners, are in public health insurance (GKV). Private insurance (PKV) is only available if you are self-employed, a civil servant, or earn above €77,400/year (2026).

Public (GKV)

Most people

Who: Employees, students, unemployed, low earners

Cost: ~14.6% of gross salary (employer pays half) + Zusatzbeitrag (2.9% average in 2026)

Pros

  • Same price regardless of health condition
  • Dependants can be covered for free
  • Nationwide acceptance
  • Employer pays 50% of premium
  • Easy to switch providers

Cons

  • No choice for most employees (mandatory)
  • Higher cost for healthy high earners
  • Longer waits for some specialist appointments

Private (PKV)

High earners only

Who: Self-employed, civil servants, high earners (>€77,400/year in 2026)

Cost: Risk-based: age, health, chosen coverage level. Typically €300–€700/month

Pros

  • Faster specialist access
  • Better hospital room options
  • More comprehensive coverage
  • Cheaper when young and healthy

Cons

  • Premiums rise significantly with age
  • Pre-existing conditions may be excluded
  • Dependants are NOT covered for free
  • Hard to switch back to public later

Major public insurance providers compared

All public providers cover the same legally required benefits. Differences are in their Zusatzbeitrag (supplemental rate), digital services, and optional extras.

ProviderZusatzbeitragEnglishApp

TK (Techniker Krankenkasse)

Best digital experience, strong English support, popular with expats, and below the 2.9% average in 2026.

2.69%YesExcellent

Barmer

Large nationwide network, strong customer service, good supplemental benefits, but an above-average rate in 2026.

3.29%PartialGood

AOK

Largest provider: each regional AOK sets its own rate (around the 2.9% national average).

varies by regionLimitedVaries

DAK-Gesundheit

Solid service and digital tools; rate slightly above the 2026 national average.

3.2%LimitedGood

KKH

Raised sharply for 2026, now one of the highest rates among the major providers.

3.78%LimitedBasic

Rates as of January 2026 (national average: 2.9%). Zusatzbeitrag changes annually, so check current rates at krankenkasseninfo.de.

How much does it cost, by situation

Employed (earning €3,000/month gross)

Your half of the 17.5% total (14.6% + 2.9% average Zusatzbeitrag, 2026); your employer pays the same again.

~€263/month

Student (under 30, at German university)

Subsidised student rate incl. long-term care. Available until age 30 or end of 14th semester.

~€130–€160/month

Self-employed

You pay the full contribution (no employer share). A minimum income base (~€1,318/month in 2026) applies even if you earn less.

~€250–€1,000/month

Unemployed (receiving Bürgergeld)

The Jobcenter pays your health insurance contributions while you receive Bürgergeld (citizen income).

€0

Family member of insured employee

Spouse and children can be covered for free under family insurance (Familienversicherung) if they earn below €565/month (2026; €603 for minijobs).

€0

How to register for health insurance

01

Choose a public provider

Compare Zusatzbeitrag rates and services. TK and Barmer are popular choices for expats due to English support and strong digital tools.

02

Complete the registration form

Fill in your name, address, date of birth, and start date. Most providers now offer online registration in minutes.

03

Provide your documents

Upload or send: your passport, Meldebescheinigung, and (for employed people) your employment contract or start date confirmation.

04

Receive your insurance certificate

The provider sends a Versicherungsbescheinigung. Give this to your employer immediately: they need it to register payroll deductions.

05

Receive your health card (Krankenversicherungskarte)

Your health card arrives by post within 2–4 weeks. Until then, your certificate confirms coverage.

Frequently asked questions

Is health insurance mandatory in Germany?
Yes. Health insurance (Krankenversicherung) is legally mandatory in Germany for everyone living or working there. You cannot legally live in Germany without health insurance. Uninsured people can face large backdated premium bills covering the uninsured period.
What is the difference between public and private health insurance in Germany?
Public health insurance (gesetzliche Krankenversicherung / GKV) is income-based and covers almost everyone. Private health insurance (private Krankenversicherung / PKV) is risk-based, often cheaper for young healthy high earners but can become expensive with age. Only the self-employed, civil servants, and high earners above the Versicherungspflichtgrenze (€77,400/year in 2026) can choose PKV.
How much does health insurance cost in Germany?
Public health insurance costs 14.6% of gross salary (split equally between employer and employee) plus a provider-specific Zusatzbeitrag; the national average is 2.9% in 2026. Students pay a subsidised rate of around €130–€160/month including long-term care insurance. The self-employed pay the full contribution themselves.
Which public health insurance provider is best in Germany?
TK (Techniker Krankenkasse) and Barmer are consistently rated highest for customer service, digital services, and English-language support. AOK is the largest provider and varies by region. All public providers cover the same legally required benefits; differences are in supplemental services, digital tools, and additional benefits.
Can I keep my foreign health insurance in Germany?
Generally no. Foreign health insurance is not accepted as a substitute for German statutory or private health insurance. EU citizens with an EHIC (European Health Insurance Card) are covered for emergencies but need to get German insurance for long-term residence. Travel insurance also does not count.

Sort your German before you register

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