Health Insurance in the germany: How It Works & Best Plans (2025)

Germany Health Insurance: Public vs Private – Which is Better? (2025 Full Guide)

Germany is known for its world-class healthcare system, which is ranked among the best in Europe. But unlike some countries, health insurance here is mandatory for everyone — whether you are a German citizen, an international student, or an expat worker.

One of the most important decisions you will face after moving to Germany is choosing between Public Health Insurance (GKV) and Private Health Insurance (PKV). Both systems have unique advantages and disadvantages, and the right choice depends on your age, income, and personal situation.

Why Health Insurance is Mandatory in Germany

• Since 2009, health insurance has been a legal requirement for all residents.

• Without it, you cannot get a visa, work contract, or long-term residence permit.

• Medical costs without insurance are extremely high, making it risky to stay uncovered.

💡 This rule ensures universal coverage and protects residents from financial disaster.

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🏥 Germany’s Dual Health Insurance System

1. Public Health Insurance (GKV – Gesetzliche Krankenversicherung)

• Covers about 90% of residents.

• Premium is based on income (14.6% + ~1.6% additional contribution).

• Employer pays half, employee pays half.

• Dependents (spouse & children) are covered for free.

2. Private Health Insurance (PKV – Private Krankenversicherung)

• Covers around 10% of residents.

• Premiums depend on age, health status, and coverage (not income).

• Popular among high earners, self-employed, and young professionals.

• Each family member needs a separate policy.

✅ What’s Covered Under Public Health Insurance (GKV)

Public insurance in Germany provides comprehensive coverage, including:

• General practitioner and specialist visits

• Hospital treatment (shared rooms)

• Emergency care and ambulance services

• Prescription medicines

• Maternity and pediatric care

• Preventive checkups and screenings

• Basic dental care

💡 Dependents (spouse & children) are automatically included at no extra cost.

❌ Limitations:

• Waiting times for specialists can be long.

• Some top doctors only accept private patients.

• Limited dental & vision coverage.

What’s Covered Under Private Health Insurance (PKV)

Private insurance is more flexible and premium-oriented.

✅ Benefits include:

• Faster appointments with specialists

• Private or semi-private hospital rooms

• Wider choice of doctors (including top specialists)

• Extended dental and optical coverage

• Customizable plans for individual needs

💰 Costs: Premiums can range from €200–€700/month, depending on age and health.

• Young, healthy professionals often pay less than public insurance.

• But premiums increase with age.

❌ Downsides:

• No free coverage for family members.

• Once you switch to private, it’s difficult to return to public insurance.

• Older people may pay very high premiums

Health Insurance Costs in Germany (2025)

Public Health Insurance (GKV)

• ~14.6% of gross salary + 1.6% extra contribution.

• Shared equally between employer & employee.

• Example: If you earn €3,000/month → about €240–260/month contribution.

Private Health Insurance (PKV)

• Starting from €200/month (young, healthy individuals).

• Can exceed €700/month for older people or comprehensive coverage.

• No sharing with employer if self-employed.

Health Insurance for Expats, Students & Foreigners

• Expats/Workers: Must show proof of insurance for residence permit. Most employees are automatically enrolled in public insurance unless they earn above €69,300/year (2025 threshold).

• International Students: Can choose cheap student public plans (~€120/month) or private student insurance.

• Freelancers/Self-employed: Free to choose between public or private insurance.

• Tourists: Not eligible for GKV/PKV. Must buy travel insurance.

💡 Tip: If you’re planning to stay long-term with a family, public insurance is usually better. If you’re young, single, and earning well, private insurance can save money

Pros & Cons

Public Health Insurance (GKV)

✅ Fair – contributions based on income
✅ Dependents included for free
✅ Stable and reliable system
❌ Long waiting times for specialists
❌ Limited dental/vision coverage

Private Health Insurance (PKV)

✅ Faster, premium-level service               

✅ Choice of doctors and hospitals
✅ Better dental and optical coverage
❌ Expensive as you age
❌ No free family coverage
❌ Hard to switch back to public

Quick FAQs

Q1: Is health insurance mandatory in Germany?
👉 Yes, everyone must be insured by law.

Q2: Can expats use public health insurance?
👉 Yes, if they are employed under the salary threshold or students.

Q3: Which is better for families?
👉 Public insurance (GKV) because dependents are free.

Q4: Which is better for young professionals?
👉 Private insurance (PKV) can be cheaper with better coverage.

Q5: Can I switch back from private to public insurance?
👉 Very difficult, especially after age 55. Choose carefully