It's mandatory
Everyone living in Germany must have health insurance. Employees earning under €77,400/year (2026) are automatically in statutory insurance (GKV). Above that limit, and for the self-employed and civil servants, private insurance (PKV) is an option.
GKV vs PKV
| Statutory (GKV) | Private (PKV) | |
|---|---|---|
| Cost | % of income: 14.6% + add-on (avg. 2.9%), half paid by employer, capped at €5,812.50 income/month | Based on age, health and tariff; doesn't depend on income |
| Family | Spouse and children with little or no income insured free (Familienversicherung) | Every family member pays separately |
| Pre-existing conditions | Irrelevant | Surcharges or exclusions |
| Getting back | — | Very hard to return to GKV, practically impossible after 55 |
| Billing | Card at the doctor, no bills | You pay, then claim reimbursement |
For most newcomers, especially families or those planning children, GKV is the safer choice. PKV can be cheaper when you're young and single, but costs rise with age.
Choosing a Krankenkasse
- All statutory insurers cover the same legal benefits. They differ in the add-on contribution (Zusatzbeitrag, roughly 2.2–4% in 2026), English service, apps and extras (professional teeth cleaning, osteopathy, travel vaccinations).
- You can switch after 12 months of membership, or at any time when your insurer raises its add-on (special termination right). The new insurer handles the switch.
Using it
- The eGK card with your photo is your proof at the doctor's — bring it every quarter.
- Prescriptions: €5–10 co-payment per item (Zuzahlung); children are exempt. E-prescriptions are loaded onto your card.
- Dental: basic care is covered; crowns and implants only partly. Consider dental supplementary insurance (Zahnzusatzversicherung).
- Sick pay: your employer pays 100% for 6 weeks, then the Krankenkasse pays Krankengeld (70% of gross, max. 90% of net).
- Electronic patient record (ePA): created automatically for every GKV member since 2025. You can object or restrict access through your insurer's app.