Health Insurance in Germany: What Newcomers Need to Know

Health insurance is mandatory in Germany from day one of your employment – and your employer cannot even run payroll properly without it. The system has two worlds; most newcomers belong in the first.

Public insurance (GKV): the default

Roughly 90 % of residents are publicly insured. Contributions are a fixed percentage of your gross salary, split with your employer, and – the big advantage – non-working spouses and children are covered free of charge (Familienversicherung). All public funds offer the same core benefits; differences lie in extras and English-language service. As an employee you simply pick a fund, and it confirms your membership electronically to your employer.

Private insurance (PKV): only for some

Private insurance is an option above the income threshold (Versicherungspflichtgrenze) or for the self-employed. Premiums depend on age and health, each family member costs extra, and returning to the public system later is difficult. For most relocating employees with families, public insurance is the sensible default – treat private offers with care, especially aggressive expat packages.

The enrolment timeline

Ideally you choose a fund before your first working day; the employer reports you, and cover starts with the employment. Gaps are a problem: Germany requires seamless insurance, and uncovered periods can trigger back-payments. Incoming EU citizens can bridge with the EHIC card; most non-EU visas already required travel cover for the entry period.

What it means for your visa and daily life

Proof of health insurance is required for residence permits. Once enrolled, you get an electronic health card (eGK) – doctor visits are cashless, and you can pick any GP or specialist. We help newcomers choose a fund, complete enrolment and connect the paperwork to payroll, registration and the residence permit in the right order.