Health Insurance Is Mandatory — and a Real Choice
For expats arriving in Germany, health insurance is both a legal requirement and an important decision. You must hold valid cover to register, work and obtain a residence permit. Many expats — particularly higher earners, freelancers and skilled workers — find that private health insurance (private Krankenversicherung, PKV) offers faster access, broader benefits and English-language service. This guide walks you through the essentials.
The big picture: Germany has statutory insurance (GKV) and private insurance (PKV). Whether you can choose PKV depends on your employment and income — but for many expats, PKV is both available and attractive.
Can You Choose PKV?
You can opt for private cover if you are:
- An employee earning above the salary threshold (€77,400/year in 2026)
- Self-employed or a freelancer — eligible regardless of income
- On certain visas where private cover is accepted, including many EU Blue Card holders
If your salary is below the threshold as an employee, you will normally be in GKV. Students and short-stay arrivals have their own routes, often via specialist incoming-student or expat policies.
Why Expats Often Prefer PKV
| Benefit | What it means for you |
|---|---|
| Faster appointments | Quicker access to specialists |
| English-language service | Easier to navigate as a newcomer |
| Tailored benefits | Single rooms, strong dental, more choice |
| Premiums by age/health | Competitive for young, healthy professionals |
Several insurers specialise in serving international clients, with English documentation and support — a meaningful advantage when you are settling into a new country and system.
What Does It Cost?
PKV premiums depend on your age, health and chosen benefits — not your income. A young, healthy professional can often secure comprehensive cover at a competitive premium, and employees receive an employer subsidy (Arbeitgeberzuschuss) covering roughly half the premium up to a cap. Freelancers pay the full premium themselves but should add a daily sickness benefit (Krankentagegeld) to protect income, since there is no employer sick pay.
Visa and Residence Requirements
Your residence permit requires proof of adequate health cover, and PKV from an established German insurer satisfies this. Make sure your policy starts from your registration/employment date and meets the standards your permit requires. Keep your insurance confirmation handy for your appointments at the immigration office (Ausländerbehörde).
Choosing the Right Cover
- Compare across insurers — tariffs and underwriting vary widely
- Check English-language support if German is not yet comfortable
- Match benefits to your needs — inpatient comfort, dental, outpatient
- Add income protection if self-employed
- Understand the long term — returning to GKV is restricted after 55, and an Anwartschaft can preserve your rights if you later leave Germany
Getting Started
The practical path is straightforward: confirm your eligibility, compare expat-friendly insurers, complete the health questionnaire honestly, choose your benefits and deductible, and set the start date to align with your move. Because the decision is long-term and the health declaration matters, many expats use an independent adviser who can explain options in English and match cover to their situation.
Done well, your health insurance not only meets the legal requirement but gives you fast, high-quality, English-supported healthcare from your very first weeks in Germany.
Frequently Asked Questions
Compare PKV Tariffs for Your Situation
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