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 73,800.
• 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, 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'll receive confirmation of your coverage within a few days. Here's how long it takes to get public health insurance in Germany.

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

• You earn more than EUR 73,800 annually as an employee (as of 2025).
• 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. If you want coverage for more than 5 years, consider long-term expat insurance.

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.

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 €5,512.50 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 2025:

Calculate your public insurance cost

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:

Calculate your private insurance cost

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.

1. 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.

1. 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.

Complete application form

1. 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. 

1. 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



Dental Coverage



Treatment and Therapies Coverage



Vision Coverage



Pregnancy and Childbirth Coverage



Hospital Coverage



Outside of Germany Coverage

Health Insurance FAQ

Are pre-existing conditions covered by health insurance?

Public healthcare plans include, by law, coverage for all pre-existing conditions. 

On the other hand, private insurers are not required to cover you for pre-existing conditions. Here’s what they could do:

• Refuse coverage for individuals with existing health conditions
• Impose higher costs depending on the person’s medical background
• Deny to cover specific ongoing or planned treatments
• Provide full coverage; not all conditions will result in changes!

The only way to know for sure is to apply for private health insurance.

Does My Health Insurance Plan Cover My Family as well?

If your family lives in Germany, they must be registered with a health insurance provider. 

If you have public health insurance, your policy covers your family members. There’s one condition: your dependents must not earn more than €538 per month.

Here’s who your public policy can cover:

• Your spouse or civil partner under the Civil Partnership Act
• Your biological and adopted children, typically until they turn 18. If they are not employed, coverage may extend until age 23. If they are in school, vocational training without pay, studying, or doing volunteer work abroad without pay, coverage may extend until age 25.
• Children of your family-insured children
• Stepchildren and grandchildren living with you
• Foster children, as long as they are not under professional care

If you have private health insurance, you can cover your family members for an extra cost. However, they cannot earn more than €470 per month; if they do, they will need their own policy.

Here’s who your private policy can cover:

• Your biological or adopted children
• Your spouse or registered life partner

Please note that private health insurance may not cover certain health conditions and treatments, such as asthma, arthritis, cancer, diabetes, ADHD, mental health conditions, and recent or longer-term psychotherapy.

How do I find an english-speaking doctor for expats in Germany?

Finding a doctor in Germany is hard if you don’t speak the language. Luckily, there are resources online to help you find an English-speaking doctor (or your native language).

For example, Doctolib is an all-in-one doctor search and booking tool. After choosing the type of doctor you’re looking for and the area code you’re searching in, you can filter doctors by:

• Languages spoken
• Whether they take private or public insurance
• Dates of availability

After you find a doctor who fits your needs, you can make an appointment through their platform.

What are the health insurance requirements for expats in Germany?

In Germany, the health insurance requirements for expats state the policy must cover a range of medical treatments and services. 

Specifically, your insurance must provide “adequate” medical care in these areas:

• Medical Coverage:
  • Visits to doctors
  • Access to dentists
  • Access to psychotherapists
  • Hospital treatments
  • Medical rehabilitation
  • Home nursing
• Supplies and Medicines:
  • Necessary medicines, like prescriptions.
  • Medical dressings, like bandages.
  • Medical devices, like pacemakers
  • Medical aids, like crutches
• Additional benefits:
  • preventive and rehabilitation measures
  • midwifery services during pregnancy and maternity
  • artificial insemination
  • non-prescription pharmacy-only medicines
  • household help

On top of that, another requirement for your health insurance is cost-effectiveness. Treatments and services covered must be sufficient and appropriate without being overly expensive.