What is Public Health Insurance (GKV)?
German Public Health Insurance (known as Gesetzliche Krankenversicherung or GKV) is a state-regulated system. It operates on the principle of solidarity: contributions are calculated strictly as a percentage of your income, not your health risk or age. This means everyone gets the same high standard of medical care, regardless of how much they pay.
Who is Legally Required to Join?
In Germany, public health insurance is mandatory for several groups:
- Employees: Earning less than €69,300 per year (gross). If you earn above this threshold, you can voluntarily stay in public insurance or switch to private.
- University Students: Enrolled in a German university and under 30 years old. They receive a special heavily discounted rate.
- Job Seekers & Unemployed: Receiving state benefits (Bürgergeld).
How Much Does It Cost?
The cost is determined by your salary, up to a maximum cap (the Beitragsbemessungsgrenze):
- The base contribution rate is 14.6% of your gross salary.
- Each health fund charges a small supplementary contribution (typically 1.2% to 1.7%).
- The split: If you are an employee, your employer covers exactly 50% of these contributions. Your half is automatically deducted from your paycheck.
- Freelancers who voluntarily join must pay the full 14.6% + supplementary rate themselves (since they have no employer).
Key Benefits of Public Health Insurance
The benefits are extensive and include:
- Free Family Coverage: Your non-working spouse and children can be co-insured at no extra cost (Familienversicherung).
- Full Medical Cover: GP visits, specialist consultations, hospital stays, and emergency operations.
- Prescription Meds: Heavily subsidized. You usually only pay a small copayment of €5 to €10.
- Sick Leave Pay: If you cannot work due to illness, the health insurance covers your salary (usually 70% of gross) after 6 weeks of illness.
Recommended Provider: Techniker Krankenkasse (TK)
While there are dozens of public health funds (Krankenkassen) in Germany, they all offer very similar core medical benefits. However, we highly recommend Techniker Krankenkasse (TK). TK is Germany's largest public insurer and has been voted the best public health insurance fund multiple times.
Most importantly for expats, TK offers a fully English website, an English mobile app for submitting doctor bills, and a 24/7 English-speaking phone hotline.
Alternative: Expat Health Insurance (Short Term)
If you are a freelancer on a budget, or a job seeker waiting to get a job, public health insurance might be too expensive or unavailable. In this case, Expat Health Insurance (also called Incoming Insurance) is a great alternative. It is cheap, approved for visas, and provides basic medical care for up to 2-5 years.