Healthcare in Germany
Who is covered, from what date, and what insurance you need
Health insurance is compulsory for everyone resident in Germany, and the system is split between statutory insurance, which covers the large majority, and private insurance, which is open to high earners, the self-employed and civil servants. The choice between them is the single most consequential administrative decision a newcomer makes, because returning from private to statutory cover is difficult and in many cases effectively impossible.
| Coverage | Health insurance is mandatory for all residents source |
| Statutory system | Gesetzliche Krankenversicherung, contribution as a share of income |
| Private system | Private Krankenversicherung, premium based on age and risk |
| Family cover | Non-earning spouses and children are commonly covered at no extra contribution under statutory insurance |
| Long-term care | A separate compulsory long-term care contribution applies |
Statutory insurance
Statutory cover is provided by competing sickness funds under uniform legal rules. The contribution is a percentage of gross income up to an assessment ceiling, split between employee and employer, with an additional fund-specific supplement. Because it is income-based rather than risk-based, the benefit package is largely identical between funds and the differences are in service and supplementary offers.
The feature that matters most for families is that a non-earning spouse and dependent children are generally insured within the same contribution at no additional cost. No private policy replicates this.
Private insurance and why the choice sticks
Employees whose income exceeds the published compulsory insurance threshold, along with the self-employed and civil servants, may choose private cover. Premiums are calculated on age and health at entry rather than income, so a young, healthy, high-earning single person often pays less than they would under statutory cover, and gets faster specialist appointments.
The difficulty appears later. Premiums rise with age rather than falling; each family member is priced separately; and the legal routes back into statutory insurance are narrow, generally requiring income to fall below the threshold as an employee, or age and circumstances that many people never meet. Anyone weighing the decision should treat it as a long-term commitment rather than a comparison of this year's premium.
Practical points on arrival
- Proof of insurance is normally required before the residence permit is issued, and travel policies are commonly not accepted for this purpose.
- Registering with a sickness fund produces the insurance card that doctors' practices ask for at every visit.
- General practitioners act as the usual first point of contact, and specialist waiting times vary substantially between statutory and private patients.
- Dental treatment is only partly covered under statutory insurance, and supplementary dental policies are common.
- Prescription charges are modest but not zero, and a separate long-term care contribution is deducted alongside health insurance.
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Official sources
Checked against these pages in September 2026. Fees and processing times change without notice — confirm before you act.