🏥 Health insurance in Germany

1. 🔀 The two systems

Germany has two main systems:

Public health insurance (Gesetzliche Krankenversicherung, GKV)

• Used by most people
• Contributions depend on your income
• Family members can be insured for free (if they don't earn much)
• Coverage is standardized by law

Good for employees and families.

Private health insurance (Private Krankenversicherung, PKV)

• Available to certain groups
• Premium depends on age, health and coverage level
• No free family insurance
• Can be cheaper for young, healthy, high earners

Often chosen by freelancers and high-income employees.

2. 👥 Who must join public insurance?

You usually must join public insurance if:

• You are an employee earning below the income threshold
• You are a student under 30
• You were already in public insurance

If your salary is above the annual threshold, you can choose between public and private.

3. 👤 Health insurance for different situations

Employees

• Employer pays about half
• You pay the other half
• Contributions are automatically deducted from salary

Freelancers

• You pay the full contribution yourself
• Public insurance can be expensive
• Private insurance can be cheaper, but switching back is difficult

Choosing carefully is important.

Students

• Discounted public student rate until age 30
• After 30, costs increase significantly

EU citizens

You can use your European Health Insurance Card (EHIC) temporarily. Once you start working in Germany, you must join the German system.

Non-EU citizens

You need valid health insurance to:

• Apply for a visa
• Apply for a residence permit

Travel insurance is usually not enough for long-term stays.

4. ✅ What does health insurance cover?

Basic coverage includes:

• Doctor visits
• Hospital treatment
• Prescription medication
• Emergency care
• Sick leave certificates

Public insurance has standardized benefits. Private insurance depends on your contract.

5. 💰 How much does it cost?

Public insurance

• Around 14 to 15 percent of your gross income
• Plus small additional contributions
• Split between employer and employee (if employed)

Freelancers pay the full amount themselves.

Private insurance

• Based on age and health
• Can start cheaper than public
• Can increase over time

Premium does not depend on income.

6. 🤔 How to choose

Public insurance is usually safer if:

• You have children
• Your income fluctuates
• You want predictable rules

Private insurance can make sense if:

• You are young and healthy
• You earn well
• You plan long-term carefully

Switching from private back to public is very difficult after a certain age.

7. ✍️ How to sign up

Employees

Choose a public insurer and inform your employer.

Freelancers

Register directly with the insurer.

Private insurance

Apply directly. You must answer health questions honestly.

You receive:

• Insurance number
• Insurance certificate

Your employer or immigration office may need proof.

8. 📌 Important notes

• You cannot cancel insurance without switching to another valid provider.
• Gaps in coverage create debt.
• Health insurance contributions are tax-deductible.

✅ Summary

Health insurance in Germany:

• Is mandatory
• Has two systems: public and private
• Costs depend on income or health profile
• Is required for work and residence permits

Choose carefully, especially if you are self-employed or planning long-term residence.