Definitive Guide to Health Insurance for Expats in Germany

Today, we’ll show you precisely what you need to know about health insurance for expats in Germany.

Here’s what we’ll cover today:

• Learn if you need German health insurance and how it works.
• Discover the different types of health insurance and their benefits.
• Get some actionable tips on choosing your health insurance as an expat.

Without further ado, let’s get started.

Do I need health insurance as an expat in Germany?

All expats living in Germany need health insurance for the entirety of their stay, including their family and dependents.

It has been legally required for every German citizen since the 2009 Fifth Book of the Social Code amendment. The law requires citizens to obtain insurance through either the statutory or public system, or private health insurance.

The goal is to ensure expats can access Germany’s healthcare system without worrying about the financial repercussions of expensive treatments. 

What health insurance do I need?

Expats can choose between two types of health insurance in Germany: statutory (public) and private. 

The type of insurance you need depends on your job, visa, income, and how long you plan to stay in Germany.

We’ll break each of your options for you in more detail later in this post, but here’s a quick rundown so you can skip ahead to the section that’s important to you:

Public health insurance:

• is mandatory for employees earning less than 69,300.
• is cheaper for those with multiple dependents.

Private health insurance:

• allows you to access the best treatments available in Germany.
• is cheaper for young, healthy individuals.
• is easy to access for freelancers.

Expat health insurance:

• is the best insurance for visa and chancenkarte applicants.
• is the cheapest of all insurance options.
• can only be taken out if it’s your first health insurance AND you’re not an employee of a German company.

Public Health insurance (Gesetzliche Krankenversicherung or GKV)

Most expats in Germany enroll in public health insurance. This system covers about 90% of citizens. 

When you start a new job, this is what you can expect:

• Your employer will ask you to choose between providers like TK, Barmer, AOK, or DAK.
• You will complete an online public health insurance registration form. 
• Your employer will then automatically enroll you into the Social Security system, which includes your health insurance. 
• You and your employer then share the cost of insurance until the end of your employment.

You can opt out of public insurance only if you meet at least one of these conditions:

• You earn more than EUR 69,300 annually as an employee (as of 2024).
• You are self-employed or a freelancer.
• You are a civil servant.
• You are a student over 30 years old.

If you decide to opt-out, you will need private health insurance.

Private Health Insurance (Krankenversicherung or PKV)

You can choose private insurance if you are eligible based on income or job status (criteria are listed above). It covers around 10% of people living in Germany.

In most cases, private insurance provides better coverage and is cheaper.

Unlike public insurance, privately insured individuals must first obtain an employer certificate (Arbeitgebersbescheinigung) to get their employer to share the cost of insurance.

Expat Health Insurance (International Health Insurance or Incoming Insurance)

If you’ve moved to Germany as an expat and still need to secure insurance through public or private providers, this insurance covers you in case of accidents, emergencies, and new illnesses.

The most common use case for this type of insurance is for visa applications, for freelancers and American expats. 

This insurance provides coverage for up to 5 years from the date you enter Germany.

Generally, it’s the most affordable health insurance available to expats. However, you must fulfill at least one of the eligibility requirements:

• You’re looking for your first health insurance plan.
• You’re seeking a health insurance plan for your visa or Chancenkarte application.
• You have German citizenship but have never lived in Germany.

Also, you won’t be able to obtain this type of insurance if you:

• Are employed by a German company and earn over €520 per month.
• Have lived in Germany for over 5 years.
• Are older than 75.
• Are applying for a secondary visa or visa renewal.
• Have pre-existing conditions with treatment costs exceeding €416.66 per month.
• Need permanent or high levels of care.
• Are a professional athlete.

What is the difference between private and expat health insurance?

How much is health insurance for expats in Germany?

The cost of health insurance for expats in Germany can drastically vary based on:

• If you opt for public, private, or expat health insurance
• Your employment status and income
• Your provider
• Your level of coverage
• Your age

How much is public health insurance for expats?

Public health insurance for expats costs between €400 and €1,000 per month. You’re only expected to pay half, as your employer will cover the rest. 

The actual cost of public insurance is proportional to your income:

• If you earn over €5,175.00 per month, your contribution will be based on that amount.
• If you earn less than €1,178.33 per month, your contribution will be based on that amount.
• If you earn anywhere in between, your contribution will be based on your income.

Here is what your contribution is made up of in 2024:

Cost Factor	Price	Additional note
Health insurance	14.6% of your income	This is the same across all public health insurers in Germany
Provider-specific additional contribution	1.2% – 2.7% of your earnings	Your public health insurance provider sets it.
Long-term care insurance	3.40% of your income	It decreases by 0.25% per child (max 1%); if you’re over 23 and have no children, you pay an additional 0.6%.

How much is private health insurance for expats?

Your monthly premium for private insurance is dependent on a few factors:

• Your age
• Your health status
• The level of coverage you choose

So, for example, if you join at a young age with no preexisting conditions, your premium will be lower than if you enter when you’re older or have chronic health problems. 

At Feather, the price of private health insurance averages between €371 and €556, but you’ll only pay half. 

Like public health insurance, you and your employer split the cost of your private health insurance, each paying 50%. 

However, the split changes if your private insurance costs more than your employer would pay for statutory insurance. Here’s a quick breakdown:

Insurance Plan Cost	Employer Contribution	Employee Contribution
Less than €1,020	50% of the plan cost	50% of the plan cost
More than €1,020	€510	Plan cost minus €510

How much does expat health insurance cost?

Expat health insurance at Feather starts at €72 per month and goes up to €134 monthly for plans with more extensive coverage.

Unlike private or public health insurance, the price of expat health insurance is the same for everyone.

Public vs private: Which is better for expats?

It depends on your situation and needs.

This should help you understand the general factors to consider when deciding whether public or private insurance is better for you.

Generally speaking, if you’re eligible, private health insurance is the better option. Here’s why:

• It’s usually cheaper than public insurance.
• Far better coverage. You get the best available treatment, whereas you get “economically sensible” treatment with statutory insurance.
• You get cash backs if you’re not using the insurance.
• You get access to more doctors, as some only treat private health patients.

But, don’t sign up for private health insurance just yet, because there’s some nuance. If you’re not single, young, and healthy, considering public health insurance might be a good idea. Here’s why:

• With private health insurance, you have to add each family member to your policy, which can get a little expensive.
• With private insurance, your risk profile determines your cost. Hence, it can become expensive if you’re older or less healthy.

5 steps to get German health insurance

1. Choose Between Private, Public, or Expat health insurance

Determine if you qualify for private or expat health insurance or must get statutory health insurance. 

Since this is such a complicated question, we’ve created a recommendation tool for you to identify which is better for you.

2. Choose a Health Insurance Provider

You should explore various health insurance providers that tailor services to expatriates. 

Compare their benefits, coverage options, and costs. Opt for a provider with excellent reviews (Feather’s rating is 4.9/5) and those offering English-speaking customer service.

3. Complete the Application Form

You can complete your application form online on our website. Make sure all your information is accurate, up to date, and complete to avoid any administrative hassles down the road.

4. Get Insured

If you’ve completed your application form, you should wait a few days until your provider confirms if you’re eligible for your preferred policy. 

Once you complete that, you should receive important documents:

If you are privately insured (PKV)

Once your application is approved, you will receive:

Your Confirmation of Coverage (Versicherungsbescheinigung), which you’ll need for visa applications. 

You’ll also get a Letter for Employer, which you’ll need to get your employer to pay you their part of the contribution. You’ll also need it to enroll at a university, change employers, or join an employment agency or a job center. 

Once your policy is active, our team will directly upload these to your account.

You won’t receive an insurance card because you’ll pay for medical expenses upfront, and your provider will reimburse you after reviewing your claim.

If you are publicly insured (GKV)

For public health insurance, you’ll receive a health insurance card (Versichertenkarte). Unlike private insurance, you won’t need to pay bills by yourself. Instead, you must present your insurance card to access healthcare services. 

5. Pay Your Premiums

The method and frequency of premium payments will vary depending on whether you are under a public or private plan. 

Paying premiums with Public Health Insurance

You won’t need to worry about paying for your insurance. The premiums are automatically deducted from your salary if you’re employed.

Paying premiums with Private Health Insurance

At Feather, your payment is debited automatically on the 1st of the month.

The 1st payment is debited once your coverage is confirmed and active. If the start date for your coverage is in the past, the first payment will be made as soon as the coverage is confirmed.

You should note that your bank account is debited the total monthly payment. Your employer pays his share of the insurance to your bank account simultaneously with your salary. 

What is covered by health insurance in Germany?

In Germany, the type of health insurance you choose—public or private—and the provider you select determine what medical services and benefits expats receive. 

Here’s a breakdown of the general services covered by both public and private health insurance:

• In-patient hospital services: includes care when you stay in the hospital overnight.
• Out-patient hospital services: covers treatment where you do not need to stay overnight.
• Dental care: covers basic procedures and check-ups.
• Medications: covers all prescribed generic drugs.
• Ambulance services: Transportation in case of emergencies.

Below, we compare the differences in coverage between public and private insurance at Feather:

General Coverage

Benefit	Public	Feather Private Insurance
General doctors’ visits	100%	100%
Specialists	100%	75-100%
Medication	90%	80-100%
Vaccinations	100%	100%
Transportation	100%	100%
Income protection	Limited to €3,491 per month	Up to 100% of net income per month
Digital health apps	Certified apps	80-100%



Dental Coverage

Benefit	Public	Feather Private Insurance
Annual coverage limit	Limited	Up to unlimited
Dental checkups	100%	100%
Dental cleanings	Not included	1-2x per year
Dentist procedures	100%	100%
Inlays	30%	70-90%
Tooth replacement	50%	70-90%
Orthodontics for children	80-100%	70-90%



Treatment and Therapies Coverage

Benefit	Public	Feather Private Insurance
Preventive care treatments	Partially covered	100%
Therapeutic measures	90%	80-100%
Mental health therapy	100%	70-100%
Radiation therapy	100%	100%
Natural health treatments	100%	80%
Medical aids	75-90%	80-100%



Vision Coverage

Benefit	Public	Feather Private Insurance
Vision aids	Not included	€150-€450 every 2 years
Refractive eye surgery	Not included	€3,000-€5,000



Pregnancy and Childbirth Coverage

Benefit	Public	Feather Private Insurance
Pregnancy coverage	100%	100%
Fertility treatment	Rarely	80-100%
Midwife support	100%	100%



Hospital Coverage

Benefit	Public	Feather Private Insurance
Board and room	Shared room	Shared room to private room (1-2 beds)
Private hospitals	Not included	Included
Treatment by a head physician	Not included	100%



Outside of Germany Coverage

Benefit	Public	Feather Private Insurance
Worldwide coverage	Included	Included
EU-wide coverage	Partially covered	Included
Repatriation costs	Not included	Included

Conclusion

Navigating health insurance for expats in Germany can seem challenging, but understanding your options and requirements is the first step to ensuring you and your family are adequately protected. 

Now, we’d like to hear from you! 

What type of health insurance are you considering for your move to Germany? Do you have any specific questions about health insurance for expats in Germany? 

Comment below or book a call to learn more and get the best coverage for your needs.