Health Cover Is a Visa Condition
For expats moving to Germany, valid health insurance is not optional — it is a legal condition of obtaining and keeping a residence permit, including the popular EU Blue Card for skilled workers. Whether you end up in statutory insurance (GKV) or private health insurance (private Krankenversicherung, PKV) depends on your employment and income, but proof of adequate cover is required either way.
The essentials: Blue Card holders are typically employees, so whether you can choose PKV depends on whether your salary exceeds the threshold. Many Blue Card salaries do — which opens the door to private cover.
Blue Card Holders and the Salary Threshold
The EU Blue Card targets higher-earning skilled workers, and many Blue Card salaries comfortably exceed the PKV salary threshold (Jahresarbeitsentgeltgrenze). If yours does, you may opt for PKV instead of GKV. If your salary is below the threshold — possible in some shortage occupations with lower minimums — you would normally be in GKV. Either way, your employer handles the registration, and you provide proof of cover for your permit.
| Situation | Health cover route |
|---|---|
| Blue Card salary above threshold | Choice of PKV or GKV |
| Blue Card salary below threshold | Usually GKV |
| Self-employed visa | PKV available regardless of income |
| Job-seeker / pre-employment | Often incoming/expat PKV cover |
Why Many Expats Choose PKV
Skilled-worker expats often favour PKV for practical reasons: faster specialist appointments, English-speaking service from expat-friendly insurers, comprehensive benefits, and premiums based on age and health rather than income. For a young, healthy professional on a good salary, PKV can offer superior cover at a competitive cost — and several insurers specialise in serving international clients.
What to Check Before You Arrive
- Visa-acceptable cover — confirm the policy meets the standards required for your residence permit
- Start date alignment — cover must be in place from your registration/employment start
- English-language support — valuable while you settle in
- The long-term view — remember that switching from PKV back to GKV is restricted, so choose deliberately
A Decision Worth Getting Right
Because health cover is tied to your right to live and work in Germany, and because the PKV-versus-GKV choice has long-term consequences, it is worth taking advice tailored to your visa type, salary and plans. Done well, your insurance not only satisfies the immigration requirement but gives you fast, high-quality healthcare from day one in your new country.
Frequently Asked Questions
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