How Does Health Insurance Work in Germany?

In Germany, health insurance is compulsory, and there are two main types offered by over 100 insurance providers (referred to as Krankenkassen). You must choose one of these options, though it is also possible (though uncommon) to combine both.

Public Health Insurance (Gesetzliche Krankenversicherung, GKV)

Public Health Insurance (GKV) is available to all residents of Germany, and if your annual income is below €69,300 (as of 2024), you are required to opt for public health insurance. GKV offers comprehensive coverage, including hospital care, doctor visits, and prescription medications. Additionally, GKV covers dependents (children and non-working spouses) at no extra cost. The contribution is 14.6% of your annual gross income, shared equally between you and your employer. Your employer also contributes half if you choose private health insurance.

Private Health Insurance (Private Krankenversicherung, PKV)

Private Health Insurance (PKV) is an option for those earning over €69,300 annually, or for self-employed individuals. PKV provides a higher quality of service compared to public health insurance, offering the following advantages:

• More extensive medication options
• Private rooms in hospitals with fewer patients
• Some doctors only accept PKV patients
• Premiums may be comparable to GKV in certain cases

However, there are some potential downsides to PKV:

• Premiums can increase with age and health conditions
• You need to file claims directly with the insurer, usually in German (though Provinzial offers English-speaking services)
• Dependents are not automatically covered
• Some doctors might over-prescribe medications, knowing your insurance will cover extra costs

Public Health Insurance is generally a better option for families, especially if you have a spouse or children who do not earn an income, as they are covered under your policy at no additional cost. Your employer will also contribute to both public and private insurance premiums.