How Does Health Insurance Work in Germany?

In Germany, health insurance is compulsory, and there are two main options provided by over 100 companies (known as Krankenkassen). As health insurance is mandatory, you must choose one of these two options:

Public Health Insurance (Gesetzliche Krankenversicherung, GKV)

Public Health Insurance (GKV) is available to all residents of Germany, but it is generally mandatory if you earn less than €69,300 annually (as of 2024). Public health insurance offers comprehensive medical coverage, including hospital stays, doctor visits, and prescribed medication. Additionally, dependents such as children and non-working spouses are covered under your plan, often at no extra cost. The premium for GKV is calculated at 14.6% of your gross income, and this amount is split between you and your employer.

Private Health Insurance (Private Krankenversicherung, PKV)

Private Health Insurance (PKV) is available to individuals with an income above €69,300 per year or for self-employed people. Private insurance offers more extensive options and better service quality compared to public health insurance, including:

• More extensive medication options
• Fewer patients sharing a hospital room
• Access to some doctors who only accept PKV patients
• Private insurance may have costs similar to or only slightly higher than public health insurance

However, PKV also has some potential drawbacks:

• Premiums may increase with age or health conditions
• You must file claims directly with the insurer, often in German (but English-speaking options are available through PAX Familienfürsorge)
• Dependents are not automatically covered, unlike with GKV
• Some doctors may prescribe more medication than necessary, knowing that your insurance will cover the costs

Public Health Insurance is typically a better option if you have dependents (children or a non-working spouse), as they will be covered at no extra charge under your plan. Additionally, your employer contributes half of your premium, whether you choose public or private health insurance.