Public health insurance, or gesetzliche Krankenversicherung, is state insurance that is provided by over 100 individual not-for-profit Krankenkassen, or public health funds. These include the funds we partner with: AOK, Barmer, DAK, and TK. Each of these funds is operated by contributions from both its members and the German government.
The Krankenkassen provide comprehensive coverage for all their members. This includes an extensive range of preventive services, as well as acute care and full or partial reimbursement for medications.
Signing up for public health insurance is easy if:
- You’re under 55 years old;
- You’re employed at a German company;
- You’re a student; and/or
- You’re moving to Germany from another EU country where you were insured in the public healthcare system.
If you’re employed by a German company, then you can sign up with one of our public insurance partners in a matter of minutes. If you’re a student or moving from another EU country (but not employed by a German company), then you’ll likely need to provide some supporting documents before your application can be approved. Even in these cases, though, you can usually complete signup within a few days.
The Krankenkassen operate on a salary-based system of contributions. This generally means that the more you earn, the more you’ll pay in monthly contributions. If you’re employed, then your employer will pay 50% of the fees.
In 2021, the official health insurance contribution is set at 14.6% of total income (though any Krankenkassen have additional contributions, averaging 1.1% of total income). Monthly payments top out at a salary of €58,050 annually (€4,837.50/month). This means that you won’t end up paying more than around €700/month in total in health insurance costs (€350/month with your employer paying half), even if you’re earning a six-figure salary.
If you get a new job and your salary changes, then your monthly contribution will be automatically adjusted. If your employment status changes (e.g. if you quit working full-time and start freelancing), then you may need to take some extra steps to ensure that you’re paying the correct amount. Freelancers generally pay estimated taxes and then the amount is adjusted to reflect their actual earnings when they file their yearly tax returns.
Pre-existing conditions will never exclude you from coverage in the public system. As long as you are eligible to join a Krankenkasse, any pre-existing conditions will be covered.
The public insurance system is generally the cheapest way to insure multiple dependents. If you have children, they will be covered at no additional cost by your Krankenkasse. As long as your children live in Germany and are not earning more than €455/month, they can be covered until the age of 23. If they are students, then they can be insured under your policy until the age of 25. Non-working spouses will also be covered by your Krankenkasse.
For additional information on insuring dependents, check our blog.
Can I switch to private?
If you’re employed by a German company, you may choose to switch to a private insurance plan as long as you’re earning more than €64,350 a year. If you are a freelancer, then you can choose to switch to private insurance even if you earn less than that amount. But you will likely need to earn at least €40,000 a year for private insurers to accept you. Read our section on private insurance to learn more about your options.