Health insurance in Germany: how it works for newcomers
In German: Krankenversicherung (Krankenkasse)
Everyone who lives in Germany needs health insurance from the day they arrive.
On this page
Who needs it
Everyone who lives in Germany must have health insurance. This is the law (§ 193 VVG and the social code, SGB V). It applies to employees, freelancers, students, job seekers and family members.
Germany has two systems:
- Gesetzliche Krankenversicherung (GKV), public (statutory) health insurance. You join one of about 90 non-profit insurers called a Krankenkasse.
- Private Krankenversicherung (PKV), private health insurance. Only some people may choose it, for example high earners, the self-employed and civil servants.
Employees are usually in the GKV automatically. If your gross salary is below €77,400 per year (€6,450 per month), public insurance is mandatory for you. Above that threshold you may choose. See public vs private health insurance for how that choice works.
Students have their own rules. See student health insurance.
When
- Before you arrive (non-EU citizens): your visa application usually needs proof of health insurance. See the visa section below.
- When you start a job: tell your employer which Krankenkasse you chose. If you don't tell your employer within two weeks after your job starts, your employer registers you with a fund.
- If you are self-employed: you arrange cover yourself before you start working.
What you need
- Passport or ID card
- Your address in Germany (the Anmeldung certificate helps)
- Your employer's name and start date, if employed
- A photo for the health insurance card (Gesundheitskarte)
- Your social security number, if you already have one. If not, the Krankenkasse can apply for it for you.
How to do it
1. Choose a Krankenkasse (employees)
You can freely choose any Krankenkasse that is open in your state. Core medical benefits are set by law and are almost the same everywhere. The differences are:
- the Zusatzbeitrag (additional contribution) each fund sets on top of the general rate,
- extra services (for example some dental cleaning, travel vaccinations, sports courses),
- service in English and the quality of the app or website.
The GKV-Spitzenverband (the funds' umbrella body) publishes a list of all Krankenkassen and their current Zusatzbeitrag.
2. Apply
Most funds let you apply online. Send your membership confirmation (Mitgliedsbescheinigung) to your employer, or the fund sends it electronically.
3. Get your card
Your Gesundheitskarte arrives by post. Show it at every doctor's visit. Until it arrives, the fund can give you a temporary confirmation.
What you pay
| Rate in 2026 | Who pays | |
|---|---|---|
| General rate | 14.6% of gross pay | Half you, half your employer |
| Zusatzbeitrag | Set by each fund; average 2.9% | Half you, half your employer |
| Average total | 17.5% |
Contributions are only charged up to a ceiling of €5,812.50 per month (€69,750 per year). Long-term care insurance (Pflegeversicherung) is charged on top and is handled by the same fund. Freelancers in the GKV pay both halves themselves.
Family insurance
In the GKV, your spouse or registered partner and your children can often be insured for free. This is called Familienversicherung. The conditions:
- they live in Germany,
- they have no own insurance obligation and a low income (up to €565 per month (€603 if the income is from a minijob) in 2026),
- children are covered up to 18, up to 23 if not working, and up to 25 while in education.
Private insurance has no free family cover. Each family member pays their own premium.
Insurance for your visa
Non-EU citizens must show adequate health insurance for a residence permit (§ 2 AufenthG). What the embassy usually asks for depends on your situation:
- You start a job soon after arriving: you are usually in the GKV from your first working day. The embassy often asks for travel or incoming health insurance that covers you from entry until your employment starts.
- Job seekers, language students and others without a job: you usually need private incoming or travel health insurance for the whole period.
- University students: see student health insurance.
Each German embassy publishes its own checklist. Check it before you buy anything, because the required cover and period vary.
EU citizens and the EHIC
- Visiting or staying temporarily: your European Health Insurance Card (EHIC) from home covers necessary treatment. It is not meant for moving here.
- Moving and working in Germany: you join the German system like everyone else.
- Studying without working in Germany: EU students can often use their EHIC and stay insured at home.
- Still insured in another EU country (for example a posted worker or a pensioner): ask your home insurer about the S1 form and register it with a German Krankenkasse.
Common problems
Can I switch my Krankenkasse?
Yes. After 12 months with a fund, you can switch. If your fund raises its Zusatzbeitrag, you may switch earlier. The new fund handles the cancellation for you.
My employer asked which Krankenkasse I have, but I don't have one yet. What now?
Choose one and tell your employer within two weeks of starting. If you don't, your employer registers you with a fund. You can switch later.
Does public insurance cover dental care?
Basic dental treatment, yes. Dentures and crowns are usually only partly covered, so expect to pay part of the cost. Ask your fund what it pays.
Is my foreign insurance enough?
Usually not for living here long-term. The cover must meet German standards. Ask the Krankenkasse or your immigration office before relying on it.
Official sources
Rules can change. These are the pages we checked — they have the final word. How we check facts
- § 193 VVG — Versicherte Person; Versicherungspflicht (duty to have health insurance)
- § 5 SGB V — Versicherungspflicht (who is compulsorily insured, incl. students)
- § 10 SGB V — Familienversicherung (free family cover)
- § 175 SGB V — Ausübung des Wahlrechts (choosing and switching Krankenkasse)
- Krankenkassen erhöhen die Beiträge (average additional contribution 2026)
This guide explains how the insurance system works. It is not medical or insurance advice for your individual situation.
Related guides
- Public vs private · GKV (gesetzlich) vs PKV (privat)Who may choose private health insurance in Germany, how it differs from public insurance, and why switching back later can be hard. Neutral 2026 overview.
- Student health insurance · Krankenversicherung der Studenten (KVdS)You need health insurance to enrol at a German university. How student public insurance works, what it costs in 2026, the age-30 limit and opting out.
- Sick leave · Krankmeldung / Arbeitsunfähigkeitsbescheinigung (AU)Off sick in Germany? Tell your employer at once, get a doctor's note by day 4, and receive full pay for 6 weeks, then Krankengeld. The 2026 rules explained.
- Social security number · Sozialversicherungsnummer / Rentenversicherungsnummer (Versicherungsnummer)How you get a German social security number: it is issued when you start your first job. What the number looks like, the Versicherungsnummernachweis and replacing it.
- Residence permit · Aufenthaltstitel (Aufenthaltserlaubnis, eAT)Who needs a German residence permit, the main permit types for work, study, family and job search, how the Ausländerbehörde works, and what to do while you wait.