Health Insurance in Germany
Contents
The German healthcare system has long been considered one of the best in Europe and is certainly the oldest of its kind. Medical insurance in Germany is funded by the government, employers, and private individuals. Most residents, including foreigners, are enrolled in Public Health Insurance, but more and more people are realising the advantages of Private Health Insurance, especially international students over 30.
This article will give you an overview of the German Health Insurance system and will cover more specific topics such as the costs of Health Insurance, how sick days work, and what is the difference between statutory and private insurances.
It is mandatory by law for all residents and visitors in Germany to have some sort of healthcare coverage, whether that’s statutory public healthcare, private healthcare, or some other valid form for short-term visitors. You must have Health Insurance in Germany, whether you are unemployed or employed.
How does German Health Insurance work?
There are two health insurance systems: Public and Private Health Insurance.
A large portion of residents in Germany are part of the statutory Public Healthcare Insurance system (Gesetzliche Krankenversicherung, GKV). International students will pay their insurance premium directly to the insurance company on a monthly basis, such as TK (Techniker Krankenkasse). Employees pay via the social security system whereby their employer pays half of the contribution for them, and this is deducted from their monthly paycheck.
In this system, the insured person will usually not pay anything for necessary medical treatment. Instead, hospitals and doctors make claims to the Health Insurance company whenever their services are used. If you are going for medical treatment as a publicly insured person, always make sure you confirm with the medical service that they accept public insurance.
Some people have the choice between Public and Private Health Insurance. If you’re eligible for Private Healthcare Insurance (Private Krankenversicherung, PKV), such as with our partner ottonova, you can access the same services and doctors, as well as private-only doctors and hospitals. Many international students are eligible for PKV, and for students over 30, PKV is mandatory.
Healthcare in Germany is excellent, and those who use the public system ultimately receive a similar level of care as those who use the private system; however, those on a private insurance package may also be able to access additional healthcare add-ons such as advanced dental treatment or private doctor’s offices and hospitals, and often have a quicker time finding appointments.
What is the difference between Private and Public Health Insurance in Germany?
The main differences between Public and Private Healthcare is the health coverage it offers, how it is paid for, and who’s eligible for it.
Here are some of the differences between Public and Private health insurance:
Public Health Insurance:
• Almost everyone can take out public insurance.
• Employees: Your contribution depends on your salary: the more you earn, the more you must pay (up to a maximum rate).
• Students: Your contribution depends on your age and if you have children.
• If you earn over €66,150, premiums can reach up to €590 for employees, and €1,170 a month for self-employed.
• Medical providers bill the public insurance directly
Private Health Insurance:
• Students and self-employed people are eligible.
• Civil servants, and employees who have a salary above the annual income threshold of €73,800 are eligible for private insurance (as of 2025).
• Your monthly premium does not depend on your salary.
• Premiums depend on your health status, the desired scope of benefits, and your age of entry.
• Medical providers bill the insured person, and they submit the invoice afterward and get reimbursed by the Private Health Insurance. Many PKV, like ottnova have an app to make the reimbursement process simple and fast.
• Coverage can be more extensive (e.g., visual aids, single or double room in the hospital, dental care)
• Benefits are guaranteed for the entire duration of your contract.
Find out more about Private Insurance on our Private Healthcare in Germany page.
What is statutory Health Insurance in Germany?
Around 90% of the German population uses public healthcare. Any employee earning under €73,800 a year is automatically enrolled in this type of Health Insurance. Statutory Health Insurance is another term for Public Health Insurance in Germany.
If you are a student with Statutory Health Insurance, you pay your own contribution in full.
If you are an employee of a company, you are entitled to employer contributions. However, if you are self-employed, you pay the whole amount by yourself. The coverage you receive is the same for you regardless of whether you are a self-payer or not.
Individuals can choose from different Health Insurance providers within the public system (called Krankenkassen). For example, TK (Techniker Krankenkasse) who have been awarded Best Health Insurance Fund by Focus Money.
Find out more about statutory Health Insurance on our Public Healthcare in Germany page.
How does Private Health Insurance in Germany work?
Students, employees earning above € 73,800 (as of 2025), freelance workers, self-employed people, and civil servants have the option to choose private healthcare insurance instead.
Private healthcare may also be paid for by a combination of employer and employee contributions (in the case of employees and civil servants).
If you are self-employed, or a student, you pay the whole premium yourself. The premium is not calculated based on your income, but on your age, your health status, your chosen tariff, and the coverage that you get.
With Private Health Insurance, you can choose the level of your health coverage, which is often more extensive in many cases, like dental care, visual aids, or free choice of doctors and hospitals.
Find out more about private insurance on our Private Healthcare in Germany page.
Do I need Health Insurance in Germany?
Yes, Health Insurance is compulsory for every resident of Germany. In addition to Public and Private Insurance, Health Insurance coverage for EU citizens living in Germany for the short term can come in the form of an EHIC (European Healthcare Insurance Card) issued from an applicable EU country.
Health Insurance for non-EU citizens can sometimes take the form of Private Healthcare cover from your home country, but you will need to check that your plan covers you for living in Germany and for accessing German healthcare services.
How to get your Health Insurance number and card in Germany?
If you choose the public healthcare system, you will receive a healthcare insurance number and card (Krankenversichertenkarte). You will need to take this card along to all appointments because the doctor's office bills the insurance company directly.
If you’ve signed up for Private Health Insurance, you will receive an individual insurance number as well, but you may not always get an insurance card. Since the doctor's office bills you as a private patient, you will submit the invoice to your private health insurer yourself, for example, with ottonova via their app.
What is the cost of Health Insurance in Germany?
The premiums for Private Health Insurance are not based on your income but on your age, health, and your chosen coverage. So, the cost of healthcare in Germany for those who choose private coverage can differ.
Public healthcare contributions, on the other hand, start for employees at 7.3% of your gross salary, which is matched by your employer to make up a total of almost 15%. Those in employment also automatically pay an individual surcharge depending on the chosen Public Health Insurance, as well as a compulsory nursing care contribution (Pflegepflichtversicherung) of around 2.5-4%, which is intended to cover the cost of care in later life.
For students aged over 23 and under 30, Public Health Insurance with long-term care costs €144 a month, regardless of your level of income (2025 figures). EU students may be covered by their EHIC card, but they have to exempt themselves by providing a letter from a Public Health Insurance fund. Students between 23 and 30 years old with a child, and students under 23 pay €139.11 for Public Health Insurance and long-term care.
The costs for Private Health Insurance plans vary from provider to provider. With our partner ottonova, you can take out Private Health Insurance for students incl. long-term care starting at €119 (depending on your age and health status).
Health Insurance for international students
You can organize your student public or private healthcare plan quickly and conveniently with Expatrio as part of our Value Package and Health Insurance Plus package. Find out more about your options for student Health Insurance with our partner TK or ottonova on our Health Insurance for Students page.
What does Health Insurance cover in Germany?
German Public Health Insurance generally covers visits to doctors as well as basic dental care, surgery, outpatient appointments, and essential or non-cosmetic in-hospital treatments.
Private Health Insurance covers the same services as well as additional health care (e.g. visual aids and resources, private doctors, and hospitals, single or double room in the hospital, worldwide coverage).
How to cancel Health Insurance in Germany?
Any social security contributions will naturally stop being made when you stop working or studying in Germany. However, to cancel your Public or Private Insurance plan, you will need to contact the provider directly.
Dental care
The state public healthcare or your private healthcare insurer generally covers routine procedures such as check-ups and fillings. This means that you do not necessarily need to take out any additional dental insurance, although the high cost of major dental work means that additional dental insurance could save you money in the long run. Major dental work includes procedures such as fitting crowns or dentures. If you are a Private Health Insurance customer, you do not have the option of opting in for additional add-ons like extra dental insurance.
Always ask your dentist for a full cost breakdown (Heil-und Kostenplan) and show this to your healthcare insurer before proceeding with any work. If you are publicly insured, sometimes the insurer will only pay out 60-80% of the work, and you will need to cover the rest yourself. Private health insurers can cover up to 100% of the costs.
The quality of dentistry in Germany is considered especially high, and a good thing to know is that you should never experience a shortage of trained dental staff in Germany – not even outside of the major cities and in smaller towns.
Language barriers for non-German speaking residents can be an issue, but many dentists, especially in bigger cities, will generally have a good level of English. It is worth searching for English-speaking dentists if you require one, but just know that if you have public insurance, this may limit the number of professionals available to you.
Health Insurance providers with good customer service, like ottonova or TK may even have an appointment service to help you find an English-speaking doctor.
Sick leave in Germany
Thanks to excellent employment laws in Germany, falling ill should not be too much of a worry when it comes to your job. Employers are required by law to pay for up to six weeks (for physical or mental ailments that mean you cannot fulfill your role) at full pay, but this can be extended should the circumstances require it to. After six weeks, employees can apply for Sickness Allowance (paid for by your public health insurance) which is 70% of your pay and payable for up to 78 weeks.
If you have Private Health Insurance, make sure to take out a daily sickness allowance, too. It is worth it for employees, especially self-employed people, to ensure they’re also covered for sickness payment if they get sick and can’t work for longer than 6 weeks.
Students who are unwell should inform their tutors that they cannot attend lectures. You may be able to get an extension on an assignment. Many universities in Germany place huge importance on well-being and even offer free counseling to help deal with stress and anxiety. Take advantage of these free services wherever possible. You can always find out more about the sickness policy and well-being services at a given university by contacting the Student Services Centre.
Sickness in Germany, Dos and Don’t
- DO Always inform your employer of your sickness before working hours begin and ideally before going to the doctor – basically, as early as possible.
- DO always try to get an official sick note (Krankschreibung) from the very first day of being ill. This usually means you must go to the doctor on your first sick day, as the doctor will not always backdate sick notes. Some employers will say you do not need a sick note for the first three days of being ill, but always check this.
- DO get your flu shot once yearly before winter; many doctor’s surgeries will issue this for free.
- DON’T try to go to work or university if you have a cold or any other infectious illness; even if you feel you can struggle through, and you have plenty of work to do, coming to work with an infectious illness will not be appreciated by your colleagues.
- DON’T fake sickness. Remember, you can’t always just call in sick to your employer; often, you will need to go to the doctor immediately to get a sick note and have the sick day authorized, so faking an illness will be particularly difficult and deceptive.
Pharmacies in Germany
It’s important to familiarize yourself with the location of your nearest pharmacy (Apotheke). Pharmacies in Germany are easily identified thanks to a red ‘A’ logo which is displayed outside. Unlike in the US or UK, pharmacists are only allowed to own up to three premises, which means there are no chains of branded pharmacies. Don’t confuse a drugstore (Drogerie) with a pharmacy; the former is a place to buy toiletries and wellness products, while the second stocks prescription and over-the-counter medicine.
Pharmacists in Germany require a high level of training and can often be helpful in finding the right non-prescription medicine for your needs. You will need a doctor’s prescription (Rezept) to obtain medicine that has been prescribed, and you will need to pay a small charge (Zuzahlungspflicht) if you have Public Health Insurance. Private Health Insurance covers the costs for prescribed medicine mostly in full.
The laws on dispensing medicine are relatively strict in Germany in comparison to other countries, which means medicines you can normally buy over-the-counter at home may require a doctor’s prescription in Germany.
List of common words for Health Insurance in Germany
It’s a good idea to familiarize yourself with words and phrases associated with healthcare and healthcare insurance before you move to Germany.
Useful German healthcare words:
- Apotheke = Pharmacy
- Gesetzliche Krankenversicherung (GKV) = Statutory Public Health Insurance (such as TK)
- Krank = Sick
- Krankenkassen = Non-profit associations that administer public healthcare insurance, like Techniker Krankenkasse (TK)
- Krankenschwester = Nurse
- Krankenversichertenkarte = Health insurance card
- Krankenwagen = Ambulance
- Öffentliche Krankenhäuser = Public hospital
- Pflegepflichtversicherung = Nursing care insurance
- Private Krankenversicherung (PKV) = Private Health Insurance (like ottonova)
- Private Krankenhäuser = Private hospital
- Rezept = Prescription
- Versicherung = Insurance
Useful German healthcare phrases
- Ich bin krank = I am sick/ill
- Ich fühle mich unwohl = I feel unwell
- Ich fühle mich echt mies = I am feeling really unwell
- Ich brauche einen Krankenwagen = I need an ambulance
- Mir ist schwindelig = I feel dizzy
- Ich habe Fieber = I have a fever
What to do in an emergency
In case of an emergency, call 112 for an ambulance. This number can be used in all EU countries. If you cannot explain what you need in German, ask for an operator that can speak English, there is no guarantee that someone will be available, however.
You can also phone 116-117 for non-urgent medical queries; this line is managed by the German National Association of Statutory Health Insurance Physicians.
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