Health Insurance and Healthcare in Germany Explained

Jump right in:

• How health insurance works in Germany
• Public health insurance
• Private health insurance
• Choosing between private and public health insurance
• The pros & cons of public and private health insurance
• German health insurance FAQs
• Seeing a doctor in Germany
• What to do in a medical emergency in Germany
• Getting dental treatment in Germany

How does health insurance work in Germany?

There are two types of health insurance in Germany: gesetzliche Krankenversicherung (public or statutory health insurance) and private Krankenversicherung (private health insurance). It’s a legal requirement to have some form of health coverage, whether public or private.

If you need a visa to come to Germany or a residence permit to stay in the country, you usually have to show proof of healthcare coverage. It must be valid for the entire duration of your planned stay and needs to meet the stan¬dards of German statutory health insurance.

If you are a foreign student enrolled at a German school or university, you’re covered by public health insurance and benefit from a reduced contribution rate. However, you can opt out and choose private health insurance instead.

As a foreign national taking up employment subject to social security contributions in Germany, you’re required to join the statutory health insurance system. You can switch to private health insurance if your income exceeds 73,800 EUR p.a. (as of 2025).

For EEA citizens working as freelancers, statutory health insurance is required if you were previously insured in a public health system in your home country. If you were privately insured, you need to take out private health insurance in Germany as well.

There can be exceptions to signing up for health insurance in Germany if you have special status (e.g., you’ve been transferred to Germany for a limited period).

How to get health insurance in Germany

Within the public and private sectors, you can choose your health insurance provider freely. Every public health insurance provider has to accept you, no matter your employment or health situation. Meanwhile, private health insurance providers require a health assessment, which will determine your contributions and the plan they’ll offer you.

Public health insurance in Germany

Roughly 90% of the population in Germany have statutory health insurance. There are almost 100 public health insurance providers (gesetzliche Krankenkassen), on both regional and national levels.

You can find a list and further information on the website of the association of public health insurance providers GKV.

While statutory coverage is the same among all of them, additional benefits may vary among providers. They can include free health apps, bonus point programs for regular health check-ups, reimbursement of certified sports programs, a doctor’s appointment service, etc.

Your employer in Germany will typically take care of registering you with the public health insurance provider of your choice, and your contributions will be automatically deducted from your salary. If you don’t have an employer, it’s your responsibility to register with and pay your chosen health insurance provider. You can do so once you’re officially registered at a German address.

How much does public health insurance in Germany cost?

The amount you pay each month is based on your income. Contributions are calculated at 14.6% on all earnings up to the contribution assessment ceiling of 5,512.50 EUR per month (as of 2025). Public health insurance providers also require a small additional contribution, which is on average 2.5% of your salary.

If you’re employed, your employer covers half of the total contribution. If you’re self-employed, you’re responsible for the full amount. In this case, your minimum contribution assessment base is 1,248.33 EUR per month (as of 2025), meaning you pay contributions on at least this amount if you’re enrolled in statutory health insurance.

The German Federal Ministry of Health has all the necessary information on statutory health insurance tarifs on their website.

Private health insurance in Germany

As an employee, you can only switch to the private health insurance system if you earn at least 73,800 EUR (as of 2025) gross per year. There’s no such limitation if you’re self-employed.

Once you’re in the private health insurance system, switching back to public insurance is only possible under specific conditions, e.g., you’re an employee below 55 years of age and earning less than the above-specified 73,800 EUR; you’re receiving unemployment benefits; or you’re not working and joining your partner’s insurance.

If you choose to go the private route, you’ll have to go through the selection and application process without your employer’s help.

How much does private health insurance in Germany cost?

While you can choose freely from the more than 30 private providers in Germany, whether they accept you and which plan they’ll offer you at which rate depends on several factors, such as your age and any pre-existing health conditions.

Many insurance providers attract with cheap plans, but they may not provide the same level of coverage as statutory health insurance. On the other hand, a “premium plan” may not always be worth its high price tag.

All in all, the market is crowded and hard to navigate. Stiftung Warentest, Germany’s best-known consumer organization, offers independent and unbiased advice on choosing the right private health insurance plan for your individual needs. They also offer a downloadable PDF with detailed comparisons of 41 insurance plans in 2025 for a small fee.

Choosing between private and public health insurance in Germany

What's the difference?

Whether public or private health insurance is the better option depends on your individual circumstances. The main factors to take into consideration are your planned length of stay in Germany, income, age, health, and family situation.

The quality of medical treatment you’ll receive is the same, no matter if you’re privately or publicly insured. However, there’s a difference in how quickly you’ll receive non-emergency treatment, especially if you need to see a specialist.

This is because with public health insurance, there are fixed fees for most treatments and doctors can’t charge more than that. Private health insurances don’t have this cap, so doctors can charge two or three times as much for the same treatment. This leads to preferred treatment of privately insured patients when it comes to giving out appointments. But whether your private health insurance will reimburse you for a specific treatment depends on your coverage plan.

It’s important to note that in emergency situations, there’s no preferential treatment according to insurance type.

Another difference is the type and number of treatments you’ll receive. Public health insurance is regulated by law to ensure good quality and sufficient care for everyone. If you want treatment that’s beyond statutory coverage (e.g., alternative medicines, additional health screenings, some dental treatments), you either have to pay for it yourself or take out additional insurance (Zusatzversicherung).

Private health insurers pay for whatever is covered by your policy, which may be more or less than statutory health insurance. The downside is that doctors may offer you treatments that aren’t necessary because they can charge more.

In short, private health insurance offers advantages such as faster access to care, bespoke coverage, and potential cost savings for young, healthy, high-earning individuals. Expats planning to leave Germany before high premiums kick in in old age may especially benefit from it.

Keep in mind that there’s no one-size-fits-all solution. The non-exhaustive overview of some key differences between the two systems below can help you decide what’s right for you.

The pros and cons of public and private health insurance in Germany

Eligibility Public system: Open to everyone Private system: Eligibility criteria apply (e.g., pre-existing health conditions)

Costs Public system: Contributions depend on income (minimum and maximum rates apply); Family members (children and spouses without income) are insured for free Private system: Individual rates based on coverage level as well as age and health upon entry, but it may increase over time; Family members need separate policies

Billing Public system: Medical treatments and prescriptions are billed to the health insurance provider directly Private system: Patients pay for treatments and medication, then submit claims for reimbursement

Coverage Public system: Benefits are uniform across all providers but can be changed by law; prescription drugs are covered (a contribution of 5–10 EUR applies) Private system: Benefits vary between insurers and policy types, but contractually agreed benefits are guaranteed for life

Treatment Public system: Often long waiting times for non-emergency treatments Private system: Usually fast access to appointments and all doctors (some only accept private patients)

For a more detailed overview, check out the health insurance comparison by Stiftung Warentest.

German health insurance FAQs

What if I don’t have health insurance in Germany? To reside in Germany legally, you need to have health insurance that satisfies the standards of German statutory health insurance. It’s also not possible to take up employment without health insurance. In case of emergency, you’ll be treated, but you’ll have debts to repay. For all other non-emergency treatment, you’ll need to prove first that you can pay for it out of pocket. If you get health insurance after having resided in Germany for a while, you’ll be expected to pay for the months you missed.

Is health insurance free in Germany? How much does health insurance cost in Germany? You pay monthly contributions for health insurance coverage in Germany. If you’re employed and insured with a public provider, these contributions amount to at least 14.6% of your salary — contributions are split equally with your employer and automatically deducted from your monthly salary. If you’re privately insured, the amount you pay each month depends on your coverage plan and certain factors such as age and health.

Do I need private health insurance in Germany? It’s not necessary to have private health insurance in Germany. If you need a visa to enter the country, you’ll need proof of health insurance that covers you during your stay in Germany. Once you’re a legal resident of Germany, you can sign up for the public health insurance system or choose to stay with private healthcare. The quality of medical care you’ll receive is the same, but privately insured patients usually get faster doctor appointments and more comfortable rooms in hospitals if available.

When you need to see a doctor in Germany

Unless it’s an emergency, your first point of contact is usually your Hausarzt (general practitioner). It’s highly recommended to find a trusted Hausarzt before you desperately need one, as some practices may not accept new patients when they’ve reached capacity, and waiting times may be long.

Your Hausarzt will take your medical history, arrange further tests, prescribe treatment and/or medication, or refer you to a specialist or hospital if necessary.

For most specialists, you need a referral from your Hausarzt before you can make an appointment. However, patients with private health insurance (Privatpatienten) or who pay for treatment out of pocket (Selbstzahler) can usually get an appointment with any doctor without referral.

How to find a doctor in Germany

General practitioners aren’t in short supply if you live in a decent-sized city in Germany. Every town center and residential area has several practices that can be reached by foot or public transportation. If you live in the countryside, you may need to travel to the next bigger town or find a Hausarzt that offers home visits.

An internet search will show you the nearest practices in your area. You can also use dedicated directories, such as doctolib.de or jameda.de, that allow you to search by area and type of doctor. Gelbeseiten.de is a general business directory that includes doctors, and the official website of the city you live in often features a section listing doctors. And if you need a doctor who speaks your native language, you can contact your local embassy or consulate for advice.

A step-by-step guide to your doctor’s appointment in Germany

• Always bring proof of health insurance when you visit a doctor in Germany. In most cases, this will be your health insurance ID card issued by your health insurance provider.
• Plan ahead, especially if you’re a new patient. You may not get an appointment for several weeks.
• If your case is urgent but not an emergency, you can go to your Hausarzt (GP) without an appointment, but be prepared to spend some time in the waiting room.
• If you have a regular appointment with your Hausarzt, simply show up a few minutes in advance.
• Check in at the reception and hand over your health insurance ID card. If you’re seeing a doctor for the first time, you may have to fill out a medical history questionnaire.
• Your doctor in Germany may be rather assertive.
• During the appointment, you may be asked to undress.
• If you’d like to get more information on your condition, just ask.
• After the examination, the receptionist will issue any required sick leave certificates, prescription slips, and schedule a follow-up appointment if necessary.
• Prescriptions are handed out as a paper slip or digitally stored on your health insurance ID card. To get the required medication, you’ll need to present the slip or your card at a pharmacy.
• If your insurance doesn’t cover the appointment and other needs, or if you’re privately insured, you’ll be sent a bill.

What to do in a medical emergency in Germany

• In a potentially life-threatening emergency, call 112 for an ambulance.

• In a non-life-threatening emergency where you need urgent medical assistance outside your doctor’s opening hours, call 116117 for the doctor’s emergency service (ärztlicher Notdienst). They’ll be able to advice you on the nearest doctor on duty (Bereitschaftspraxis) or in severe cases may send a doctor to see you.

• Depending on the emergency, you can also take a taxi to the nearest hospital with an Accidents & Emergencies Unit (Notaufnahme).

• If you need over-the-counter medicine outside normal pharmacy hours, you can use the search function provided by aponet.de or apotheken-umschau.de to find the nearest pharmacy on duty.

Hospitals in Germany

Every major city in Germany has at least one hospital. There are hospitals affiliated with universities, hospitals run by local authorities, hospitals run by orders of the church, and private clinics. Except for the latter, all hospitals have a contract with public health insurance providers, meaning you can be treated in any of them.

If you need to be admitted to hospital in Germany for non-emergency treatment, you’ll need a referral from your doctor, either your Hausarzt (GP) or a specialist who has treated you. If you’re privately insured, you don’t need this referral; however, you may be asked for proof that your insurance will cover your treatment before being admitted.

Getting dental treatment in Germany

Dental work in Germany can be expensive, and you often need to present a cost estimate to your insurance provider prior to getting treatment. It’s not always guaranteed that your insurance company agrees the work necessary, as they differentiate between cosmetic work and medical treatment. So they may not reimburse you or cover the full amount.

The percentage your insurance will pay depends on the type of coverage you’ve selected. Many Germans with public health insurance take out additional private health insurance coverage for dental treatment. This kind of top-up insurance option is called Zahnzusatzversicherung or Zahnschutz-Zusatzversicherung.

If you’re in the public system, your insurance recommends two dental check-ups per year. These are free of charge and allow you to collect “bonus points” with your health insurance provider.