Health insurance in Germany: what newcomers must have

The duty, in one sentence

Every person with a residence in Germany must take out and keep a health insurance policy with an insurer licensed to do business in Germany (VVG section 193). The duty starts when you live here, not when you first see a doctor.

The law has two routes into cover: the statutory system, which employees join by law up to the earnings limit, and private insurance, which some people may choose. Which one you are in depends on your job and your pay.

Employees: statutory by default

Employees, and people in vocational training who are paid, are insured in the statutory system by law (SGB V section 5).

There is one big exception. Employees whose regular annual earnings are above the earnings limit are exempt from compulsory statutory insurance. That exemption is what lets them choose private cover (SGB V section 6). For 2026 the limit is set at EUR 77,400 a year, or EUR 6,450 a month (Rechengrößenverordnung 2026, section 2). A special limit of EUR 69,750 a year applies to some people under paragraph 7 of the same section.

The limit changes every year, so do not rely on last year’s number. If your salary is close to it, ask your employer’s payroll team which figure they use for you.

Students and people with no other cover

Students enrolled at state-recognised universities are insured in the statutory system up to age 30, as long as no other cover applies under international agreements. After 30 it depends on the course and your circumstances (SGB V section 5).

Section 5 also covers some people who have no other protection against illness. Self-employed people are generally not compulsorily insured under these categories, which means they have to choose and arrange their own cover. If you are self-employed or between jobs, get advice on your case before you decide.

What the statutory system costs

The general contribution rate is 14.6% of the income that counts for contributions (SGB V section 241). On top of that, each fund can charge an additional contribution, set as a percentage of the same income, if its funding does not cover its expected spending (SGB V section 242).

That means the price differs by fund. Before you join, look at the fund’s additional rate for the current year. We did not find an official, current list of the rates, so this guide does not print one.

What a private policy has to cover

A private policy that meets the duty has to cover outpatient and inpatient treatment, and its deductibles are capped at EUR 5,000 a year for each insured person (VVG section 193). The law sets this floor, and a policy can offer more. Read the schedule of benefits and the deductible before you sign, and check what happens to the price if your family grows.

What it costs to be late

If you take out a policy more than a month after the duty started, section 193 adds a surcharge. You pay one monthly premium for each further month you were uninsured. From the sixth month of being uninsured, the surcharge is one sixth of a monthly premium for each further month.

That is a reason to arrange a private policy before the move or in the first weeks, not after the first bill, and to ask the insurer on which day the cover starts.

If an insurer stops being paid

After two months of unpaid premiums, a private insurer has to send warnings. If you still do not pay, the contract is suspended from the first day of the following month and moves to emergency cover until the arrears are paid (VVG section 193). Emergency cover is not the cover you chose, so keep the premium paid.

What we could not source

We did not find a reliable figure for how many newcomers choose international or expat health insurance, and we did not research which funds or insurers suit which newcomers. Anyone who professionally mediates insurance contracts in Germany needs a licence under section 34d of the Trade Regulation Act (GewO section 34d), and ReloFinder gives no insurance advice. Ask a licensed adviser or the fund before you decide.