Guide to Public Insurance in Germany

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Germany’s healthcare system is rated one of the best in the world. Once you understand it, it is remarkably easy to get started! Once you’ve read our guide to public health insurance in Germany you’ll be well-informed and well-prepared! 

It is mandatory to be insured with a German health insurance from the day you are registered in Germany. There are two types of insurance in Germany: public and private. About 85% of people are publicly insured, and the rest hold a private insurance. Let’s take a look at public insurance, or the Government Health Insurance System (GKV)). 

Sign up for health insurance in germany

Eligibility & Sign-up

You must be publicly insured if you earn less than 60,750 Euros gross per year (2019). Even if you have a pre-existing condition, the insurance company is obliged to offer you coverage.

In most cases, you will need to have an employment contract in order to sign up for public insurance as a newcomer to Germany. If you are coming to Germany as a freelancer you will likely need to have private health insurance, or even an industry-specific one.

You’ll need to fill out a simple registration form and confirm your earnings and start date to sign up for health insurance. These forms are available on each health insurance company’s website.

Choosing an insurer

There are about 300 public insurance providers in Germany, the main ones being AOK, TK (Techniker Krankenkasse), and Barmer GEK. These are all great options, but TK offers the best service in English. Although not every customer service representative there will speak English, they will usually be able to transfer you to someone who does. The others may not be so flexible. You should investigate each one, as they offer some bonus programs which might be interesting!

The service each offers will be very similar; they are all competing to give you the best value for your money!

health insurance cards, germany

How much does insurance cost me?

Your contributions to the insurance are based on your income. The total costs for your health insurance are about 14.6% of your gross income. Some insurances may add up to 0.9% further costs. Your employer will contribute about half of this cost.  All these costs are automatically deducted from your gross salary by your employer, and paid on your behalf to the insurance company. It’s important to note that if you earn more than EUR 60,750 annually, your costs will not rise from the set percentage of that amount.

Example: if you earn 50,000 EUR annually the total costs will be 14.6% of that amount. If you earn more than 60,750 EUR annually, the total costs will be capped at 14.6% of the 60,750 EUR.

Medically necessary costs are covered, but non-necessary costs usually are not. An example is that you can go to the eye doctor for free, but choosing to get cosmetic surgery is not free.

Pro's and Con's of Public Health Insurance

Below are a few points to consider about public health insurance:


  • Your family (spouse and dependents at the same address) can be covered by your public insurance at no extra cost. If your spouse or family moves to Germany and is not yet employed, they will be covered by your policy. Your total family costs will not go up. Once your spouse gets a job, they will be covered under their own policy with the insurer of their choice.
  • Your costs are predictable and will not go much over the amount you pay through your salary. In case of a hospital stay, you will probably pay about 10 Euros per night for the overnight stay.
  • If you are covered by statutory health insurance, you are expected to pay a small nominal fee of 10% of the prescription cost for medication (a minimum of 5 euros and a maximum of 10 euros per medication).


  • Since a doctor would receive more money from private insurance than from public insurance you may face some delays in seeing a specialist. In case of emergency, however, you will get the same treatment. You should not worry that you will suffer poorer quality care. For example, if two women are giving birth in the same hospital and there are not private rooms for all women, a woman with private insurance would get the single room and a woman with public insurance would get a double room. The same doctor is probably taking care of them both.
  • Some health care providers, such as therapists, exclusively work with privately insured customers, and there may be a delay in finding an available therapist in the mental health field.
  • Your costs in the short term will likely be higher than if you are privately insured. However in the long term and in case you develop a serious illness, your costs will be stable under public insurance, while a private insurer will raise your costs.

Important: You will get your Social Security Number (Sozialversicherungsnummer) from your health insurance company when you register. This is done automatically and will be sent to you with your registration. 

Talk to your HR team about how to sign up for health insurance in Germany. You must be registered with a health insurance to receive a visa to work in Germany, and to be paid by your company. Make sure you can tell your HR team who you are insured with, and get a confirmation letter from the insurance company that will include your registration number and date the coverage starts.


If you have questions about this guide to public health insurance in Germany, let us know! Check out out guide to private insurance to completely cover this topic. We are happy to advise or point you in the right direction!


Pragmatic. Informative. Uses a machete to cut through red tape.

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