How Does Health Insurance Work in Germany?

In Germany, health insurance is compulsory. You must choose between two main options, offered by over 100 different companies (known as Krankenkassen). It’s possible (though uncommon) to combine both types, but here are the two primary options:

Public Health Insurance (Gesetzliche Krankenversicherung, GKV)

Public Health Insurance (GKV) is open to all residents. If you earn under €69,300 annually (as of 2024), you are required to opt for public insurance. Public insurance provides comprehensive coverage for hospital stays, doctor visits, and medications. Additionally, if you are married or have children, they are automatically covered under your insurance at no extra cost. The cost of GKV is 14.6% of your annual gross income, split equally between you and your employer. Your employer will also pay half if you opt for private health insurance.

Private Health Insurance (Private Krankenversicherung, PKV)

Private Health Insurance (PKV) is available to those earning above €69,300 annually. PKV offers enhanced service options, such as:

• More extensive medication options
• Private or semi-private hospital rooms with fewer patients
• Access to doctors who may only accept private patients
• Premiums that may be similar to those of public insurance in some cases

However, PKV has some potential drawbacks:

• Premiums can increase with age and health problems
• Claims need to be filed directly with the insurer, usually in German (though Signal Iduna provides English-speaking support)
• Dependents are not automatically covered
• Some doctors may prescribe more medications than necessary, knowing your insurance covers it

Public Health Insurance is often the better option if you are married or have children, as they will be covered under your policy without extra costs. You and your employer will split the premiums, making it an affordable option.