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Germany Expat: Healthcare Registration

Choose between public (GKV) and private (PKV) health insurance and register with a Krankenkasse.

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Quick Overview

Health insurance is mandatory in Germany. Employed workers earning under €69,300/year must join gesetzliche Krankenversicherung (public health insurance) at ~14.6% of gross salary (split with employer, ~€300-450/month employee share). Those earning above can choose private insurance. Public insurance covers family members for free (Familienversicherung). Major public insurers: TK (Techniker Krankenkasse), AOK, Barmer, DAK. Register within 14 days of employment start. Self-employed can choose public (~€200-800/month based on income) or private insurance. Medical care is excellent with free doctor visits and hospital stays.

Key Facts

Public insurance cost

~14.6% of gross salary (employer pays half)

Employee contribution

~€300-450/month for €50,000 salary

Registration deadline

14 days from employment start

Family coverage

Free for spouse/children under public insurance

Income threshold

€69,300/year (above this = can choose private)

Best public insurers

TK, AOK, Barmer (similar coverage, slight fee differences)

How It Works

Germany Expat: Healthcare Registration in Germany

Germany has mandatory universal health insurance (Krankenversicherung) with two systems: gesetzliche Krankenversicherung (GKV, public) and private Krankenversicherung (PKV, private). Employees earning under €69,300/year must join public insurance, automatically deducted from salary at ~14.6% (employer pays half, you pay ~7.3%). Public insurance includes free coverage for non-working spouse and children (Familienversicherung). Choose your Krankenkasse (public insurer) - all offer identical basic coverage, slight differences in additional benefits and fees. Top choices: TK (Techniker Krankenkasse), AOK, Barmer, DAK. Process: (1) Choose Krankenkasse and apply online or in person with passport, Anmeldung, employment contract; (2) Receive insurance card (elektronische Gesundheitskarte) within 1-2 weeks; (3) Employer deducts contributions automatically. Doctor visits, hospital stays, prescriptions (€5-10 per prescription), and most treatments are free/covered. Self-employed pay full contributions (~€200-800/month based on income) to public insurance or can choose private insurance. Those earning over €69,300/year can switch to private insurance (initially cheaper when young, but cannot easily switch back). Students pay subsidized rate ~€110/month. Germany's healthcare quality is excellent with no waiting for specialists.

Mandatory health insurance enrollment

Understand German health insurance system

Learn the difference between public and private insurance.

Choose public health insurance (Krankenkasse)

Select your public health insurer.

Register with chosen Krankenkasse

Complete health insurance enrollment.

Receive health insurance card (eGK)

Wait for elektronische Gesundheitskarte.

Add family members (if applicable)

Register spouse/children for Familienversicherung.

Health insurance for self-employed

Register as Freiberufler or Selbstständiger.

Germany Expat: Healthcare Registration Costs in Germany (2025)

Public insurance (employed)~€300-450/month

Employee share (~7.3% gross salary), employer pays other half

Total contribution (employed)~€600-900/month

~14.6% of gross salary (split with employer)

Public insurance (self-employed)€200-800/month

Pay full contribution, based on income

Student insurance~€110/month

Subsidized rate until age 30

FamilienversicherungFree

Spouse/children covered at no extra cost

Doctor visitsFree

Covered by insurance

Hospital staysFree (€10/day for food)

Fully covered

Prescriptions€5-10 per item

Small copay

Dental50-90% covered

Basic care covered, bonus for checkups

Total
€110-800/month depending on employment and income

*Employed workers pay ~7.3% of gross salary with employer covering the other half. Self-employed pay full amount. Family members covered free. Healthcare quality is excellent. Prices current as of January 2025.

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