Does my German health insurance cover me immediately when I start working?

Yes. GKV coverage begins on your first day of employment. However, your physical Gesundheitskarte (insurance card) takes 2–3 weeks to arrive by post. In the meantime, ask your Krankenkasse for a paper Mitgliedsbescheinigung (membership certificate) — pharmacies and doctors accept this as proof of insurance while you wait for the card.

What is the best Krankenkasse for expats in Germany?

Techniker Krankenkasse (TK) is almost universally recommended for expats. TK offers an excellent English-language app for submitting claims, downloading documents, and contacting support, a comprehensive English website, and English-speaking phone agents. Barmer and DAK also have improving English-language services. AOK is regionally managed and quality varies — it can be excellent in Bavaria but inconsistent elsewhere.

Can I bring my spouse and children to Germany and have them covered by my health insurance?

Yes, under GKV family insurance (Familienversicherung). A spouse or civil partner who earns less than €505/month (2025) and children under 23 are covered for free under your GKV policy — no additional premium. However, if your spouse earns over €505/month, they must take out their own GKV policy. Under PKV, each family member requires a separate policy, which significantly increases costs for families.

What happens to my health insurance if I lose my job?

If you become unemployed and register with the Arbeitsagentur (employment agency), you automatically receive continued GKV coverage funded by the unemployment insurance (Arbeitslosenversicherung). If you are self-employed or not registered as unemployed, you must either continue voluntary GKV membership (minimum contribution ~€226/month in 2025) or arrange private coverage. You cannot be uninsured — the Krankenkasse will retroactively charge premiums for any gap period.

Is dental treatment really covered by German statutory insurance?

Basic dental care is covered by GKV: check-ups twice a year, basic fillings, simple extractions, and dentures at 60% (rising to 80–90% if you have maintained your Bonusheft for 5+ consecutive years). However, high-quality restorations (ceramic inlays, implants, premium dentures) require significant out-of-pocket payments. Many expats add supplementary dental insurance (Zahnzusatzversicherung) for €8–€20/month to cover these extras.

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🇩🇪 Germany

Healthcare

Germany operates one of the world's most comprehensive healthcare systems, combining mandatory statutory health insurance (GKV) for most residents with a parallel private insurance system (PKV) for higher earners — providing full coverage from day one of employment..

14.6%

GKV Contribution Rate

Split equally: 7.3% employee + 7.3% employer

~1.7% avg.

Additional GKV Surcharge

Varies by Krankenkasse (insurer)

1–3 days

GP Appointment Wait

For registered patients with a Krankenkasse

€69,300/yr

PKV Threshold (2025)

Annual salary to opt into private insurance

80% statutory

Dental Coverage

GKV covers basic dental; PKV covers more

Last updated: March 2026

Overview🎨Berlin 🍺Munich ⚓Hamburg

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Overview

Key Takeaways

Total GKV contribution: approximately 16% of gross salary (7.3% employee + 7.3% employer + ~1.5% additional)
Eligibility: employees earning over €69,300/yr gross (the Versicherungspflichtgrenze) for at least one year
Step 1: Register your address at the local Bürgeramt (Anmeldung) — you need this before almost anything else
Dentist visits: twice-yearly check-ups fully covered; maintain your Bonusheft (dental record booklet) to improve subsidy rates on dentures

Statutory Health Insurance (GKV) — How It Works

The Gesetzliche Krankenversicherung (GKV) is Germany's statutory health insurance system and is mandatory for all employees earning under €69,300/year. Contributions are deducted automatically from your salary — you pay 7.3% plus an insurer-specific additional contribution (averaging 1.7% in 2025), and your employer matches 7.3%. Coverage begins on your first day of employment and covers your spouse and children at no additional cost.

Total GKV contribution: approximately 16% of gross salary (7.3% employee + 7.3% employer + ~1.5% additional)
Covers: GP visits, specialist referrals, hospital treatment, surgery, most medications, mental health therapy, physiotherapy, maternity care, and preventive check-ups
Dependents: spouse and children under 23 who are not working are covered for free under family insurance (Familienversicherung)
No deductibles (Eigenanteil) for most treatments; €10 per quarter per specialist visit was abolished
Prescription co-pay: €5–€10 per prescription, with annual maximum of 2% of gross income
Major insurers: Techniker Krankenkasse (TK), AOK, Barmer, DAK — TK and Barmer are most popular with expats for English-language support
Register immediately upon receiving your employment contract — bring your Anmeldebestätigung (residence registration) and salary contract to your chosen Krankenkasse

Private Health Insurance (PKV) — For High Earners

Employees earning over €69,300 gross per year can opt out of the GKV system and take out private health insurance (PKV). PKV typically offers faster specialist access, single rooms in hospital, professor-level doctors, and broader dental coverage. However, premiums are age and health-dependent and can increase significantly as you age — it is a long-term decision requiring careful consideration.

Eligibility: employees earning over €69,300/yr gross (the Versicherungspflichtgrenze) for at least one year
Premiums: typically €200–€600/month for a healthy 30-year-old; increases significantly with age
Benefits over GKV: no waiting lists for specialists, senior consultant treatment, private rooms, broader dental coverage, faster appointments
Critical drawback: family members are NOT covered automatically — each dependent requires a separate policy, significantly increasing family costs
Switching back to GKV: difficult after age 55 — once you choose PKV and age, returning to GKV is legally restricted
Self-employed and freelancers must arrange their own health insurance — PKV or voluntary GKV are both options
Recommended providers: AXA, Debeka, DKV, HUK-Coburg — compare via independent broker (Versicherungsmakler) not tied to one provider

How to Register for Health Insurance

Health insurance registration in Germany follows a clear sequence. Before you can register with any Krankenkasse, you need your Anmeldung (residence registration). Before you can complete your Anmeldung properly, you need an address. Start this process before you arrive by selecting a Krankenkasse online — TK (Techniker Krankenkasse) is strongly recommended for English-speaking expats.

Step 1: Register your address at the local Bürgeramt (Anmeldung) — you need this before almost anything else
Step 2: Contact your chosen Krankenkasse online or by phone with your employment contract and Anmeldung certificate
Step 3: Krankenkasse issues a health insurance certificate (Mitgliedsbescheinigung) — present this to your employer
Step 4: Employer processes payroll deductions; your GKV card (Gesundheitskarte) arrives by post within 2–3 weeks
TK (Techniker Krankenkasse): best English-language app and phone support — highly recommended for new expats
AOK: large regional insurer, good for families; coverage and service vary significantly by region
If you arrive without a job, you must arrange voluntary GKV or PKV coverage — being uninsured is illegal in Germany

Dental Care, Specialists, and What GKV Covers

GKV covers comprehensive dental treatment including basic fillings, extractions, dentures, and preventive check-ups twice per year. Specialist access requires a GP referral (Überweisung) in most cases. Mental health therapy is covered but waiting lists for Kassenzulassung (approved) psychotherapists can be 3–6 months — many expats use English-speaking private therapists in the interim.

Dentist visits: twice-yearly check-ups fully covered; maintain your Bonusheft (dental record booklet) to improve subsidy rates on dentures
Dental fillings: basic amalgam/composite covered at 80%; upgrades to ceramic or higher-spec materials require a top-up payment
Orthodontics for adults: not covered by GKV; PKV plans vary — expect €3,000–€8,000 out of pocket
GP (Hausarzt): register with one GP as your primary doctor — they manage specialist referrals and coordinate care
Specialists: most require a referral from your GP; direct booking is possible but may require private co-payment under GKV
Mental health: up to 80 sessions of psychotherapy per year covered by GKV — but finding a Kassenzulassung therapist quickly is difficult
Emergency: call 112 (Notruf) for life-threatening emergencies; 116 117 for out-of-hours non-emergency medical advice (Ärztlicher Bereitschaftsdienst)

FAQs