Moving To Germany Series : 3/15 Health Insurance (2025)

EuroXpat
Apr 26
3 min read

Understanding Germany’s healthcare system is crucial for anyone planning to live, work, or study in the country. Health insurance is mandatory for all residents, ensuring access to high-quality medical services. This guide provides an in-depth look at the two primary health insurance systems in Germany—Statutory Health Insurance (GKV) and Private

🔍 Overview of Germany’s Health Insurance Systems

Germany operates a dual health insurance system:

Statutory Health Insurance (GKV): Covers approximately 90% of residents. Contributions are income-based.
Private Health Insurance (PKV): Covers about 10% of residents. Premiums are based on individual risk factors such as age, health status, and chosen coverage.

🏛️ Statutory Health Insurance (GKV)

Eligibility

GKV is generally mandatory for:

Employees earning below €73,800 annually (2025 threshold) .
Students under 30 years old.
Unemployed individuals receiving benefits.
Pensioners.

Self-employed individuals and freelancers can opt into GKV voluntarily.

Contributions

Rate: 14.6% of gross income, split equally between employer and employee.
Additional Contribution: An average of 1.6%, also shared equally.
Self-Employed: Responsible for the full contribution.

Coverage

General practitioner and specialist visits.
Hospital care.
Prescription medications (with co-payments).
Maternity and preventive care.
Mental health services.
Rehabilitation services.

Family Coverage

GKV offers free coverage for non-working spouses and children, making it a cost-effective option for families .

🏥 Private Health Insurance (PKV)

Eligibility

PKV is available to:

Employees earning above €73,800 annually (2025 threshold) .
Self-employed individuals and freelancers, regardless of income.
Civil servants.
Students over 30 years old or those not eligible for GKV.

Premiums

Premiums are calculated based on:

Age at enrollment.
Health status.
Chosen coverage level.
Deductibles and co-payments.

Younger, healthier individuals often benefit from lower premiums.

Coverage

PKV plans can offer:

Faster access to specialists.
Private hospital rooms.
Comprehensive dental and vision care.
Alternative treatments.
International coverage options.

Considerations

Family Coverage: Each family member requires a separate policy, potentially increasing costs.
Long-Term Costs: Premiums can rise with age and health changes.
Switching Back to GKV: Returning to GKV from PKV can be challenging, especially after age 55.

🎓 Health Insurance for Students

Under 30 Years Old

GKV Student Tariff: Approximately €110–€120 per month, including long-term care insurance.
Eligibility: Available to full-time students enrolled at recognized institutions.

Over 30 Years Old

PKV Options: Often more affordable than voluntary GKV contributions.
Considerations: Evaluate long-term costs and coverage needs.

💼 Health Insurance for Freelancers and Self-Employed

GKV: Voluntary enrollment is possible, with full contributions paid by the individual.
PKV: Often chosen for customizable coverage and potentially lower premiums for younger individuals.
Artists’ Social Insurance Fund (KSK): Eligible freelance artists and publicists can receive subsidies covering 50% of GKV or PKV contributions .

🆕 2025 Updates in German Healthcare

Digital Health Records (ePA)

Starting January 15, 2025, electronic patient records (ePA) will be implemented as an opt-out system, simplifying access to medical histories and prescriptions .

Telemedicine Expansion

The Digital Act (DigiG) has integrated telemedicine into standard care, allowing for:

Remote consultations.
E-prescriptions.
Digital health applications (DiGAs).

These services are now reimbursable under GKV and supported by many PKV providers .

Contribution Adjustments

High Earners: Slight increases in GKV contributions for those earning above €73,800, with a cap to prevent excessive payments .
Long-Term Care Insurance: Contribution rates have increased by 0.2 percentage points, affecting both GKV and PKV members.

📝 Enrollment Process

Determine Eligibility: Assess whether GKV or PKV is appropriate based on income, employment status, and personal circumstances.
Choose a Provider:
- GKV: Options include TK, AOK, Barmer, among others.
- PKV: Providers such as Ottonova, Feather, and Allianz offer various plans.
Gather Required Documents:
- Proof of identity (passport or ID card).
- Proof of residence (Anmeldung certificate).
- Employment contract or proof of self-employment.
- Bank account details.
Submit Application: Complete the application process with your chosen provider, either online or in person.