Health Insurance in Germany

How to cover your medical expenses in Germany

Your first priority when coming to Germany should be health insurance. Medication, doctors, and hospitals are extremely expensive, so you must make sure that you are covered for sickness and emergencies.

In addition, you will typically not get a residency permit without proof of adequate insurance. Health insurance is also mandatory for all employees and students in Germany, so you will not be able to start working or studying without it.

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In 2007, there were some 200 000 persons living in Germany without health insurance coverage. With the health insurance reform of 2007, the German government implemented an insurance law which makes insurance mandatory for everybody living in Germany. When living in Germany, this law will also apply to you.

There is an EU agreement which guarantees free medical treatment for EU citizens in Germany. Since the 1st June 2004, European citizens who are traveling within the European Economic Area (EEA) are given a European Health Insurance Card (EHIC) which simplifies the procedure when receiving medical assistance during their stay in a Member State. The European Health Insurance Card replaces forms E111 and E111B, E110, E128, and E119. However, if you wish to take up long-term residence in Germany, you must exchange the card for a local health insurance scheme.

Health insurance contributions are split 50-50 between employers and employees, regardless of whether you opt for a statutory or private insurance scheme. Students are offered special student insurance schemes with favourable rates. Note that health insurance in Germany is part of the social security system.

Statutory and private health insurance in Germany

In Germany, there are two parallel health insurance systems:

  • State health insurance is run by the German government. Most foreigners (and Germans as well) are obliged to take out state health insurance.
  • Private health insurance can be chosen in some specific cases. It generally offers more extensive coverage but is not automatically an advantage for all cases.

Almost everyone can join the state insurance scheme, but only a few people are allowed to leave this system for private insurance. To work out which insurance scheme fits is best for you, follow these steps:

  • Find out whether you can choose between private and public insurance. If you’re obliged to join the state system, it is irrelevant to compare it with private insurance. To find out whether the state system is mandatory for you, have a look at our information below.
  • If you are allowed to take private health insurance, you should compare the advantages and disadvantages of both systems before making a final decision.

Although this is complicated, take the time to analyse your situation in order to make the right decision. Our health insurance guide will lead you to step by step through this decision process.

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When is state health insurance mandatory?

As of 2007, state health insurance was compulsory for the following groups:

  • In 2019, the general annual income limit for mandatory state insurance is 60,750 Euros per year, or 5,063 Euros per month.
  • Students at state and state-approved universities.
  • People on work experience (internships) or in secondary education.
  • Old-age pensioners who have been in a statutory health insurance scheme or insured as a family member for most of the latter half of their working life.
  • Unemployed people receiving benefits from Federal Employment Services (with some exceptions).

You can within a period of three months join a state health insurance scheme voluntarily if you:

  • Have been a compulsory member, your membership is terminated and you have certain qualifying insurance periods.
  • Are an employee and your income in your first job exceeds the limit, as long as you apply for membership within three months of starting work.
  • Are severely disabled (subject to certain other requirements).
  • Have been insured through a family member for a specific minimum period and this insurance has expired.

Students from countries with which Germany has concluded a social security agreement that includes an insurance clause can continue to be covered by their home insurance company while they are in Germany. For further information, inquire at your institution’s International Office. In such cases, you will be required to present proof of insurance coverage to the health insurance company in Germany.

The Federal Ministry for Health and Social Security offers detailed information on statutory insurance in different languages at

Who can opt for private health insurance?

In theory, everybody not in the categories above can choose a private insurance scheme. However, once you’ve opted out of the state insurance scheme, it can be very difficult to go back. Before you make this decision, you should therefore carefully compare the advantages and disadvantages of the two systems.

If you opt-out of statutory health insurance and cannot go back, the private insurance companies will be forced to offer you a basic tariff with the same fees as the statutory insurance from 2009.

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