Health insurance in Germany: how it works for newcomers

2 min read · 6 steps · Updated 2 October 2026

Almost 90 percent of people in Germany are in the public system, called gesetzliche Krankenversicherung. It accepts everyone, and what you pay depends on what you earn, not on your age or health. Private insurance is open only to certain groups.

Rules, amounts and deadlines change. Check the official source linked at the end before you act, and ask the office in your city, because procedures differ from town to town.

Step by step

1. Know which system you belong to

   Employees below a yearly income threshold must be in the public system. The threshold was 73,800 euros gross in 2025 and rises most years. Above it, and if you are self-employed or a civil servant, you may choose private insurance.

   Done

2. Choose a public fund

   There are around 90 public funds (Krankenkassen), and you are free to choose. The benefits are almost identical by law. They differ in the extra contribution they charge, in service and in extras such as travel vaccinations.

   Done

3. Apply for membership

   Apply online or in a branch. You usually need a passport photo for the card, your registration confirmation and details of your employer. The fund sends a membership certificate.

   Done

4. Give the certificate to your employer

   The employer registers you and deducts your share from your salary. For jobs above the mini-job limit, employer and employee each pay about half of the contribution.

   Done

5. Add your family

   A spouse and children with little or no income of their own are covered free of charge through family insurance (Familienversicherung). Children are covered until 18, until 23 if they do not work, and until 25 if they study or train. Send the fund the form and their documents.

   Done

6. Use your card

   The fund sends an electronic health card (Gesundheitskarte). Show it at every doctor's visit. The doctor bills the fund directly, and you pay nothing at the practice.

   Done

Good to know

Some costs remain yours: usually 5 to 10 euros per prescription medicine and 10 euros per day in hospital. Medicines for children are free. Once your co-payments in a year pass 2 percent of your gross income, you can apply to be exempt for the rest of the year.

You can change to another public fund after 12 months, or at once if your fund raises its extra contribution. You do not need to cancel. You sign up with the new fund and it does the rest.

Going private is hard to undo. Returning to the public system is only possible under 55 and if your income falls below the threshold. Think twice before leaving the public system for a cheaper private offer.

Students, the self-employed and people with mini-jobs pay their contributions themselves, without an employer share.

In short: Compulsory for everyone. Employees: choose a public fund, employer pays about half, family insured free. Private only above the income threshold or for certain groups.