Welcome to our comprehensive guide on public health insurance in Germany for 2024.
In this guide, you will learn how to:
- Determine if public health insurance is for you.
- Select the best insurance company for you
- Calculate the exact cost of public health insurance
Let’s dive in.
What is public health insurance in Germany?
Public health insurance, also called GKV or statutory insurance, is Germany’s most popular healthcare solution. It covers about 90% of the population, is usually mandatory for employees, and is highly recommended for most students.
Here is what you need to know:
- Public health insurance provides solid benefits but lacks coverage in certain areas, so we recommend getting additional coverage (for example, with our dental insurance policy).
- The cost of statutory insurance is proportional to your income.
- You can change insurance companies yearly if you find one with better benefits, services, or lower premiums.
- Germany has over 100 statutory health insurance providers, but the best ones for English speakers are…
- An alternative is private health insurance, but it has stricter eligibility criteria.
Who is public health insurance for?
Employees
Employees under 55 years old earning less than €69,300 per year must join public health insurance. Those earning more can also sign up, but only if it’s their first job in Germany or they are currently insured by public health in the EU. Otherwise, they have to go for private health insurance.
Luckily, employees also have the easiest time signing up, which will automatically start with the first day of work. If you don’t sign up yourself within two weeks, your employer will do it for you.
Read our guide to private health insurance.
Students
Students must get health insurance coverage to be able to enroll in a German university. If you’re insured by your parents’ German family insurance, you can remain on it until you’re 25 years old. This also applies if you’re insured by your spouse’s policy. The only caveat is that you cannot work during that time.
If you’re over 25 or your parents live outside of Germany, you could also get discounted student health insurance.
For those over 30, it gets a little more complicated. You could sign up as a voluntary member, but it is much more expensive. The best alternative is expat health insurance.
Read our guide to health insurance for students.
Freelancers & Self-employed
Full-time self-employed individuals can choose between public or private health insurance. If you were insured for more than 24 four months in the last five years, you’d be accepted into the public system, no questions asked. The same thing applies to those insured for 12 or more months immediately before registering as self-employed.
Members of the KSK are required to have public health insurance.
Read our guide to health insurance for the self-employed.
Retirees & Pensioners
If you worked in Germany and were publicly insured, you can stay with your current health insurance.
If you worked in the EU and were publicly insured, you can choose to sign up with a German public health insurance company. You’ll need to complete an S1 form, and you’ll receive the same benefits as with your home country’s insurance.
How much does public health insurance cost?
The cost of public health insurance is proportional to your income. The more you earn, the more you pay (up to a certain limit). In 2024, the limit is 62,100, meaning that if you earn more, your contributions would be based on this amount.
In 2024, the contribution rate is 14.6%, plus a company-specific percentage (on average, it’s 1.7%). However, TK’s CEO, Jens Baas, says the cost of health insurance is expected to explode to 20% by 2030. You’ll also need to pay for long-term care insurance, which is around 3.6%.
On the bright side, whether it’s 14.6% or 20%, employees and trainees won’t need to worry about paying the whole thing themselves. By law, employers must pay half of your contribution.
Unfortunately, since the self-employed, by definition, do not have an employer, they must pay the contribution rate independently. There are some workarounds, like becoming a KSK member.
Retirees’ health insurance cost is a mix of subsidized and unsubsidized payments. Here’s what we mean:
- With a statutory pension, retirees pay 7.3%, with the Krankenversicherung der Rentner (pensioners’ health insurance) paying for the other 7.3%.
- With a private pension or other types of income, they’ll pay the full contribution of 14.6%.
As we mentioned earlier, student health insurance is much more affordable, at around €130 monthly.
What is covered by German public health insurance?
Generally, public health insurance covers all medically necessary interventions, with some preemptive measures also included, like cancer screenings. However, the exact coverage can vary from company to company.
Here’s a general overview of what services are covered:
| Specialists and general practitioners | You can freely choose your doctors. The only requirement is that they must participate in statutory health insurance. |
| Check-ups and vaccinations | Check-ups to detect and prevent diseases early are included. Vaccinations are limited to “standard” ones. |
| Long-term illnesses | Therapies and treatments for long-term or chronic illnesses are covered. |
| Accidents | Treatment and aftercare for accident-related injuries are covered, too. |
| Medicines | Most medications are covered but require a 10% out-of-pocket payment from your end. The minimum is €5, and the maximum is €10. For minors, the co-payment is 0%. |
| Remedies | Treatments like physiotherapy, occupational therapy and speech therapy are covered. Like medicines, you’ll pay for 10% and an additional €10 per prescription. Once again, minors do not have to participate in the co-pay. |
| Hospital stays | All hospital stays are covered, but you must pay for a €10 co-payment per day, for up to 28 days. Minors are exempt. |
| Medical aids | Things like wheelchairs, hearing aids, prostheses, or crutches are covered if prescribed by a doctor. There is a 10% co-payment (at least EUR 5). |
| Cancer screening tests | Adults (women over 20 and men over 35) are eligible for the full number of annual, medically recommended screenings. |
| Basic dental care | Basic checkups, pain relieving treatments, basic cleanings and fillings are covered 100%, aesthetic procedures aren’t covered |
| Dentures | 60% of denture costs are covered. Caveat: it only covers the most basic relevant procedure. If you want high-quality, visually pleasing materials, consider getting dental insurance. |
| Orthodontics | Usually, it only covers minors. |
| Medical repatriation | This is rarely covered, but if there is a strong reason to bring you back to Germany for treatment, your insurance will cover the travel costs. |
| Abroad treatments | Emergency treatments are covered in the EU, but only up to the cost that would be incurred for the same procedure in Germany.It’s highly recommended to obtain travel health insurance for trips outside the EU. |
| Psychotherapy | It will be covered if you have a diagnosis. |
| Alternative treatment | This varies from company to company. You should call the company’s helpline to determine if your desired treatment can be covered. |
What is the best public insurer in Germany?
Overall, TK (Techniker Krankenkasse) is the best public insurer in Germany. Strong alternatives include DAK, BARMER, or AOK.
If you want to evaluate other insurers, you should consider three factors:
- The individual contribution of the company. As we mentioned earlier, the average additional contribution is 1.7%, the lowest is BKK Firmus’s 0.9%, and the highest is BKK Textilgruppe Hof with 2.8%.
- Their ability to communicate in English (or in your preferred language). If you’re a fluent German speaker, this won’t be a problem, but if you’re not, this is crucial to ensure you can make the best use of your policy.
- Additional benefits they provide. 95% of benefits and coverage are mandated by law and identical from one company to the next. However, the 5% remaining caters to different type of people. For example, if you want to reduce your premiums, you should look for a company offering deductibles. Or maybe you value special benefits for pregnancy and young families, in which case public insurance with DAK is your best bet.
How to sign up for public health insurance
If you decide to sign up with one of our recommended insurance companies, the process is easy:
- Click on the button below to compare them.
- Click on the “Sign up” button of your preferred company.
- Complete the questionnaire.
- You will obtain a confirmation of coverage by email within 2 weeks.
- When your application is approved, you can request your health card, which you can use to see a doctor (usually within 2-3 weeks).
If you choose to sign up with another company, you can apply for membership by post, online, or personally at their office. The options that are available differ from one fund to another.
How to switch between public health insurance companies
People with public health insurance can change health insurance, but there are some rules regarding notice and commitment periods.
Here’s a step-by-step process for switching insurance:
- To do this, you must have been with your current insurer for at least 12 months before you can switch.
- There are two exceptions: if your employment changes (for example, with a new job or losing yours) or your insurer increases additional contributions, then you have a special termination right. This means you can switch immediately. You have a 14-day window to enable this right.
- If one of the cases above applies to you, then you can choose a new insurer.
- Once you’re happy with your choice, you can apply for membership in a new health insurance fund. There’s no need to inform your current insurance company or your employer, your new insurer will handle all the details.
- You’ll have a waiting period of two months before you actually switch insurers.
Public Health Insurance FAQ
Yes, you can opt out of public health insurance in Germany under certain circumstances. If your gross salary is more than €69,300 annually, or €5775 monthly, you can get private health insurance.
To pay for public health insurance as an employee, your employer handles the process by deducting the required amount directly from your gross wage before you receive your paycheck. This means the payment is automatically managed, and you don’t need to take any additional steps or make separate payments yourself.
Students and freelancers pay by bank transfer directly to the provider
Public health insurance covers emergy treatment abroad, but only in the EU/EEA and Switzerland. Coverage in these places is limited to the cost equivalent of treatment in Germany. Regular treatments must be postponed until returning to Germany.
Outside the EU/EEA, public health insurance does not cover treatments, which is why additional travel medical insurance is strongly recommended.
Yes, you can take out public health insurance even with pre-existing conditions and chronic illnesses. They will be covered.
Yes, you can include your family in your public health insurance policy, provided they earn less than €505 per month through alternative income (pension, rent, interests….) or less €538 through mini-job.
Dependants can be added for free, simply contact your current provider and let them know you’d like to insure a family member.
There are no claims in public health insurance. When you go to the doctor, dentist, or pharmacy, you simply show your health insurance card, pay the deductible if there is one, and your insurance will take care of the rest.
The only exceptions are special treatments that aren’t fully covered, like dental, which must be paid upfront. Afterward, you can claim the appropriate partial amount from the provider by sending invoices to the your insurance.
If you’re leaving permanently, it is usually enough to inform your provider. To do so, you can use our template. Most often, additional proof like an Abmeldung (de-registration from your city) or flight tickets might be required.
If you leave temporarily, you can actually pause your insurance. This is called Anwartschaft, and by doing this, you will make sure you have the right to join the same public insurer after returning. If this case relates to you, it is best to contact your public insurance provider directly.
Conclusion
With this comprehensive overview of public health insurance in Germany, you now have the essential information to make an informed decision about your healthcare coverage.
We’re interested in what you think:
- Does public health insurance suit you?
- Are you leaning towards the private health insurance system instead?
- Do you have any further questions or need clarifications?
Share your insights and questions in the comments below!
