Arenja & Raj FinanzWho is allowed to choose
Most employees are not. If you earn less than €77,400 a year you are compulsorily insured in the public system, and that settles it.
The choice opens up for three groups: employees earning above that threshold, the self-employed and freelancers, and civil servants. If you are in one of those groups, you have a genuine decision to make — and it deserves more than an afternoon.
What the public system costs
Public health insurance (gesetzliche Krankenversicherung, GKV) is a percentage of your income, not a price for a product.
| 2026 figures | Rate |
|---|---|
| Health insurance, total | 17.5 % of gross salary |
| Your half as an employee | 8.75 % |
| Long-term care, with children | 3.6 % total |
| Long-term care, without children | 4.2 % total |
| Income ceiling | €5,812.50 a month |
Above the ceiling the contribution stops rising, so the effective rate falls as your salary grows. Two features matter more than the price: children and a non-working spouse are covered at no extra cost, and the contribution follows your income — it falls when you earn less and stops being a problem in retirement.
What the private system costs
Private health insurance (private Krankenversicherung, PKV) prices your age, your health and the cover you choose. It has nothing to do with your salary.
For a healthy thirty-year-old the premium is often visibly lower than the public contribution, and the cover is usually better — shorter waits for specialists, treatment by senior doctors, single rooms in hospital. That comparison is what persuades most people.
What the comparison leaves out is the rest of your life. Premiums rise as medical costs rise, every family member costs their own premium, and returning to the public system after 55 is effectively impossible. None of that makes private cover wrong. It makes it a decision that has to be modelled over decades, not months.
The part that needs a conversation
Whether private cover works for you turns on questions a website cannot answer: how many children you expect, whether your partner will work, what your income is likely to do, and — for internationals especially — how long you intend to stay in Germany.
That last one changes the answer more than anything else. Someone planning fifteen years here is in a different position from someone whose contract runs for three, and both are different again from someone who genuinely does not know.
This is exactly the sort of case where an hour with someone who does the arithmetic every week is worth more than a week of reading. We do it in English, we compare across the market, and the conversation is free.
If you are self-employed
Freelancers and business owners can choose freely from day one, and the public system treats them differently from employees: there is no employer paying half, and contributions are assessed on income with a minimum basis of €1,318.33 a month, which can feel steep in a slow year.
That combination pushes many self-employed internationals towards private cover, sometimes rightly. It is also the group most likely to buy on price alone and regret the level of cover later. Worth thirty minutes before signing anything.
Health calculator
Run your own numbers
The calculator uses the official 2026 figures and shows what each system would cost you month by month. Four inputs is all it takes:
Want this checked against your own situation?
Fifteen minutes, free, and genuinely non-committal. We work with people building a life in Germany, and we speak English, German and Hindi.
Book a free callPick a time that suits youCommon questions
Is health insurance compulsory in Germany?
Yes, for everyone resident in Germany, under § 193 of the insurance contract act. You must hold cover from the day you take up residence, and you will be asked for proof when you register your address and when you start work. There is no version of living in Germany without it.
Can I choose private health insurance?
Only if you are an employee earning more than €77,400 a year, or self-employed, or a civil servant. Below that income threshold, employees are compulsorily insured in the public system. If you do have the choice, it is worth taking advice — the decision is difficult to reverse, particularly after age 55.
What does public health insurance cost in 2026?
17.5 % of gross salary in total, of which an employee pays half — 8.75 % — with the employer paying the rest. Long-term care insurance adds 3.6 % with children or 4.2 % without. Contributions are calculated only up to €5,812.50 a month, so higher earners pay a falling effective rate. Children and a non-earning spouse are covered at no additional cost.
Is private health insurance cheaper?
Often yes at the start, and often no later. Private premiums are based on your age and health when you join rather than your income, so they tend to look attractive to a healthy young professional — and each family member costs a separate premium, while premiums rise over the decades. Whether it works out depends on your income path, your family plans and how long you stay in Germany, which is why it is worth modelling rather than guessing.
Can I switch back from private to public?
It is difficult, and after age 55 it is effectively impossible in most cases. Before then it generally requires becoming compulsorily insured again — for example by taking employment below the income threshold. This is the single most important thing to understand before choosing private cover, and the main reason we prefer to look at your own numbers before you decide.
What happens to my health insurance if I leave Germany?
Cover normally ends with your residence, and what comes next depends entirely on where you go and whether Germany has a social security agreement with that country. If a move is on the horizon it belongs in the decision now rather than later — it is one of the questions we ask first when advising internationals.