The German health insurance system seems rather straightforward comprising public and private sectors. It is, however, complicated enough that there are advisors who charge substantial fees to help you choose among German health insurance companies. There are many questions indeed! What services are included? Does German health insurance cover dental care? Is there English-language support? Read on to get an idea of how the German health insurance for foreigners operates and learn some useful tips.
German public health insurance
German private health insurance
Health insurance for international students
Temporary German health insurance for foreigners
Cost of German health insurance
Public or private: which is better?
German public health insurance
Gesetzliche Krankenversicherung – GKV
Who needs GKV
All residents of Germany must be covered by a German health insurance plan which includes hospital and out-patient medical treatments. Exceptions are nationals of the EEA and some other states, such as Brazil and India, that have special social security agreements with Germany; they can rely on their existing national coverage. Before taking up employment and paying for the German health insurance, it is a good idea to check if such an agreement exists for your country. This could save you money which you may instead send to your family or contribute towards your retirement fund back home.
Depending on the income level and some other factors, options available to those living in Germany include public and/or private health insurance.
About public insurance
Public providers’ fees and services are regulated by the state. As such, the German health insurance for foreigners assigned to a public company offers the same standard medical care as for locals.
Most employees are enrolled with the German public health insurance automatically, as soon as the employer registers them with the social security services. Upon registration in the system, one receives a German health insurance number and card, which must be presented during medical appointments.
Pros
- The size of the German statutory health insurance premium depends on the size of salary, which lowers the financial risk in case of lower income or unemployment
- Family coverage: spouse and children are covered free of charge
- Direct bill settlement: with the exception of small co-payments in some cases, the cost of services and medicines is paid directly by insurer
Cons
- Long waiting times for booking a doctor’s appointment
- No access to some clinics/specialists that work exclusively under the German private health insurance
- Premiums/coverage are universal and cannot be adjusted depending on one’s specific needs.
- Some special services/treatments are not available. For example, does German public health insurance cover dental care? Only the basic procedures, so if you need a wider range of dental services, you might acquire additional coverage from a private provider.
Once settled down in Germany, you may need to send money back home. Do it easily and beneficially with Profee. Check profee.com for more information.
German private health insurance
As of 2025, only if you meet one of the following criteria, you are eligible to opt for the German private health insurance:
- Annual gross salary over 73,800 EUR
- Student status (private insurance is mandatory for students over 30)
- Self-employment
Pros
- Much shorter waiting times and generally better service
- English-language support commonly available
- Tailor-made schemes for different needs
- Access to special treatments/services
- Cheaper for high-earners
Cons
- Application may be rejected due to poor health status
- Family members are not covered and must be insured separately
- Switching to the German statutory health insurance is very difficult in general and almost impossible for those over 55
- Switching to another private provider is expensive
- Cost of medical bills must be paid by the insured and only later will be reimbursed by the provider. This also involves much paperwork, often in German.
- The same premiums must be paid even in cases of lower income or unemployment
Learn more: German bank account types—Girokonto vs Tagesgeldkonto
German health insurance for international students
Those planning to study in Germany also must be insured. The choice of German public or private health insurance depends on several factors such as:
- Age of the student. Those under 30 are eligible to either type, but over-30s can only be insured privately (although they can voluntarily apply for the German public health insurance in addition to the private one, providing their stay is at least 12 months long).
- Type of institution. Only those studying at state-recognised educational institutions have the option of the German statutory health insurance.
- Type of programme. Students of language and/or preparatory courses must have coverage with a private provider.
The starting date of the German health insurance for international students coincides with the start of the semester, usually 1 April or 1 October, and is valid for the duration of their studies.
Keep in mind that you must get German health insurance for the enrollment to be possible. If you are eligible for German statutory health insurance but opt for private coverage, you must procure a certificate of exemption from the local public provider within the first three months of your stay. Also, this choice cannot be reversed: you will hold the German private health insurance card until the end of your studies.
In any case, you cannot opt out of German health insurance altogether. However, nationals of some countries are exempt and can use their respective national health insurance, specifically:
- EEA states
- Serbia
- Bosnia and Herzegovina
- Montenegro
- North Macedonia
- Israel
- Morocco
- Tunisia
- Turkey
Check the full list here.
Temporary German health insurance for foreigners
Any German health insurance is normally valid from the date of your employment or studies, as stated in the respective agreement. However, there might be a gap between the date of your arrival and the start of your activities. Keep in mind that even for this period the German health insurance for foreigners is mandatory. Usually, the coverage is provided under a so-called travel, or incoming insurance which is also a must for visa applications.
Some German health insurance companies offer this type of coverage in addition to their standard services, and opting for such a package can save you money. Your travel insurance is valid either until the starting date of your main insurance, or for 183 days after your entry to the country when you must either leave or obtain a long-term German health insurance number.
Cost of German health insurance
In the case of the German public health insurance, the size of premium depends on the size of salary, which is practical for those earning less but can get expensive for high-earners. The general contribution rate is 14.6% plus additional share imposed by the provider. For example, in 2025 Techniker Krankenkasse (TK), one of the largest German health insurance companies, charges 17.05% of gross income. This amount is equally shared between employer and employee whereas self-employed must pay the whole sum.
Those with German private health insurance will pay depending on their provider, services covered, age, health status, and so on. The price can be as low as 100 EUR for a young healthy individual and reach up to 1,500 EUR a month.
A German health insurance student card entitles its holder to discounted premiums, both with public and private providers, and the latter can be substantially cheaper. The German public health insurance for students is around 130-150 EUR per month, and you pay less if you are under 23 or have children. In turn, students can get German private health insurance for as little as 30-60 EUR per month and up to around 130 EUR for those over 40, with pre-existing conditions, or needing extra services.
Read more about the cost of living in Germany here.
Public or private: which is better?
Choosing the best type of German health insurance will depend on your specific situation and medical needs. The table below summarises the main differences between the two systems.
German public vs private health insurance
| Criteria | Public | Private |
|---|---|---|
| Eligibility | All with some exceptions | Some categories |
| Cost | Fixed share of salary with amounts capped; proportionate to income | Depends on age / health status / provider / package; does not reflect size of income |
| Dependent family members | Covered | Not covered |
| Payments | Paid directly by insurer except co-payments | Reimbursed above deductible |
| Quality of service | Standard | High |
| Access to services | Standard | Access to private-only doctors and additional services |
| Waiting time | Very long | Short |
| Flexibility | Not flexible | Adjusted for specific needs |
| English-language support | Not common | Common |
Overall, taking out the German private health insurance (if you are eligible) makes financial sense if you are under 40, healthy, single, and do not plan to settle in Germany. But if you have or plan to have a family and intend to make Germany your permanent home, then the German statutory health insurance might be a better option.
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