How Does Health Insurance Work in Germany?

In Germany, health insurance is mandatory. You must choose between two types of insurance offered by over 100 companies (referred to as Krankenkassen). While you can combine the two types in some cases, these are the primary options:

Public Health Insurance (Gesetzliche Krankenversicherung, GKV)

Public Health Insurance (GKV) is available to all residents. If you earn under €73,800 annually (as of 2025), you are required to take out public insurance. GKV provides comprehensive coverage for hospital stays, doctor visits, and medication. Furthermore, if you are married or have children, they are automatically covered under your insurance at no additional cost. The cost of GKV is 14.6% of your annual gross income, split equally between you and your employer. Employers also pay half if you opt for private health insurance.

Private Health Insurance (Private Krankenversicherung, PKV)

Private Health Insurance (PKV) is available to individuals earning over €73,800 annually. PKV generally offers better service, including:

• More extensive medication options
• Fewer patients per hospital room for greater privacy during a hospital stay
• Access to doctors who only accept private patients
• In some cases, costs may be similar to public insurance

However, there are some potential drawbacks to PKV:

• Premiums can increase with age and health problems
• You need to file claims directly with the insurer, which generally requires filling out forms in German (though Sono Krankenversicherung offers English-language support)
• Dependents are not automatically covered
• Some doctors may prescribe more medication than necessary, knowing your insurance will cover it

Public Health Insurance is often the better choice if you are married, have children, or have a non-working partner, as they are covered under your policy at no extra cost. The premiums are based on 14.6% of your gross salary, shared equally between you and your employer.