Health Insurance in Germany 2026
Germany runs two health insurance systems side by side: public (GKV) and private (PKV). Which one you end up in depends on your job, your income, and your personal situation. This guide covers both so you can make a decision that actually fits your life.
Public vs Private Health Insurance: What's Actually Different?
Public health insurance (GKV) covers about 90% of people in Germany. Your premium is a percentage of your salary. Private insurance (PKV) works differently: your premium depends on your age at sign-up, your health, and the benefits you pick.
| Feature | Public (GKV) | Private (PKV) |
|---|---|---|
| Premium basis | % of salary (14.6% + avg. 2.9% supplement) | Age, health status, chosen benefits |
| Employer contribution | 50% of your premium | Up to EUR508.59/month (2026) |
| Family coverage | Spouse + children free (if no/low income) | Each family member needs own policy |
| Specialist access | Referral usually needed, longer waits | Direct access, shorter waits |
| Hospital | Shared rooms, staff doctors | Private rooms, chief physician treatment |
| Dental | Basic coverage (~60%) | Typically 80-100% depending on tariff |
| Worldwide coverage | Limited, mostly EU | Usually included |
| Switching back | N/A | Very restricted (see below) |
Important: Switching from PKV back to GKV is extremely hard. If you're over 55, haven't been in GKV during the last 5 years and were exempt, opted out or self-employed for at least half of that time, you're basically locked into PKV for good (§ 6 (3a) SGB V). (Source: BMG, Wechsel zwischen GKV und PKV)
Who Can Get Private Health Insurance?
Employees
Annual income above EUR77,400 (2026 JAEG). That's EUR6,450/month before taxes. Below that, you stay in GKV. In 2025 it was EUR73,800. (Source: Bundesregierung.de)
Self-Employed & Freelancers
If self-employment is your main occupation, you can choose PKV regardless of income. This includes software developers, consultants, and restaurant owners if this work is their main occupation. Exception: self-employed artists and publicists are usually compulsorily insured through the Künstlersozialkasse (KSK) and can opt out only in specific cases.
Civil Servants (Beamte)
Beihilfe from the employer covers 50-80% of medical costs. They only need PKV for the remaining portion, making it significantly cheaper. See our civil servant PKV comparison for details.
Students
Can apply for exemption from compulsory student insurance within three months of the start of that insurance (§ 8 (1) no. 5, (2) SGB V). The exemption cannot be revoked.
What Does Health Insurance Actually Cost?
GKV Costs (2026)
Example: EUR4,000/month gross salary
- General rate (14.6%)EUR584
- Avg. supplement (2.9%)EUR116
- TotalEUR700/month
- Your share (50%)EUR350/month
Capped at BBG of EUR5,812.50/month. Earning more? Your GKV contribution stays the same.
PKV Costs (2026)
Premiums depend on your individual profile
- Max employer contributionEUR508.59/mo
Source: § 257 (2) SGB V
Major Insurance Providers in Germany
Public Funds (GKV)
Germany has several public funds. All cover the same core benefits set by law. Differences are in the Zusatzbeitrag and extras.
- TK (Techniker Krankenkasse)~12 million members, often rated top GKV
- Barmer~8.3 million members
- DAK-Gesundheit~5.4 million members
- AOK11 regional orgs, 20.9 million members total
Source: GKV-Spitzenverband, Krankenkassen.de
Private Insurers (PKV)
About 30 companies in the PKV market. Some of the largest:
- DebekaMarket leader, 2M+ members, popular with Beamte
- Allianz & AXAStrong financial backing, international experience
- DKV4M+ members (many in supplementary plans)
- OttonovaDigital-first, English website and support, 33% growth
Source: PKV Verband, VersicherungsJournal
How to Compare and Switch
Check eligibility
Employee above EUR77,400/year, self-employed as main occupation (not via KSK), or Beamte with Beihilfe? You can go private.
Gather documents
ID, employment contract, income proof, health history.
Use comparison tool
Enter details, age, desired coverage level below.
Review quotes
Review the offers you receive.
Read the fine print
Check deductibles (Selbstbehalt), exclusions, premium guarantees.
Apply
Most insurers accept digital applications, results in 24-48h.
Already in GKV and want PKV? The switch happens at the end of the calendar year in which your pay goes above the JAEG, provided the pay also exceeds the threshold that applies for the following year (§ 6 (4) SGB V).
Want a deeper look at PKV options with detailed tariff breakdowns? Compare private health insurance plans to see comprehensive PKV tariffs from leading German insurers in one place.
Need help with the application itself? Our guide to applying for private health insurance covers eligibility checks, required documents, and how to get approved quickly.
Special Situations
Expats and Foreigners
Need proof of insurance for your visa? Depending on your salary, you'll go into GKV automatically or choose PKV. Ottonova offers English-speaking support, and TK and Barmer publish English information pages.
Expat health insurance guideStudents
International students can apply for exemption from compulsory student GKV within three months of the start of that insurance and choose private student insurance instead (§ 8 (1) no. 5, (2) SGB V). The exemption cannot be revoked.
Student health insuranceCivil Servants (Beamte)
Beihilfe covers 50-80% of medical costs, so you only insure the remaining 20-50% privately. PKV can be surprisingly affordable for Beamte.
Supplementary Insurance
Happy with GKV but want better dental or a private hospital room? Supplementary insurance adds these extras without leaving the public system. Dental add-ons from ~EUR15-30/month.
Supplementary insuranceTurkish Speakers (Türkçe)
Looking for this comparison in Turkish? Our dedicated Turkish-language page covers PKV options with Turkish-speaking advisors, Turkish doctor networks in Germany, and coverage for trips to Turkey.
Özel sağlık sigortası karşılaştırma (TR)Things People Get Wrong
"Private is always better."
Not true. If you have a family with kids and a non-working spouse, GKV is often cheaper. Dependents are covered free in GKV. In PKV, every family member needs their own policy.
"I can switch back anytime."
Wrong. Returning from PKV to GKV is heavily restricted, especially after age 55. Think of PKV as a one-way door for most people.
"My premium will stay the same forever."
PKV premiums do increase over time, though insurers build age reserves (Alterungsruckstellungen) to smooth this out. Expect annual adjustments of 3-5%.
Compare Health Insurance Plans
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Frequently Asked Questions
Common questions about health insurance in Germany
Need life insurance too? Compare life insurance plans from German providers to protect your family financially.