Health
Krankenversicherung: German health insurance, explained
Public vs private, which provider to choose, what it actually costs, and the rules that catch Indians off guard.
Public health insurance (GKV) is mandatory if you earn below €77,400/year. You pay ~14.6% + ~2.5% Zusatzbeitrag, split 50/50 with your employer. TK, AOK, Barmer, DAK are the main providers with minimal differences. Private (PKV) is cheaper when young but gets expensive with age.
Health insurance in Germany is mandatory. You cannot legally live here without it. You cannot get a residence permit without it. You cannot change jobs or enrol at a university without it. Your Anmeldung triggers the requirement; your insurance start date usually matches your move in date.
The system splits into two halves: gesetzliche Krankenversicherung (GKV, public) and private Krankenversicherung (PKV, private). Most Indians arriving on a work visa go public. Here is why, and what to actually pick.
Public (GKV) vs private (PKV)
Public (GKV) is a fixed percentage of your gross salary (currently about 14.6% base rate plus 2 to 3% provider-specific surcharge), capped at a monthly income ceiling (Beitragsbemessungsgrenze, around €5,812.50/month in 2026). Half is paid by you, half by your employer. Your spouse and children under 25 are covered for free on your plan (Familienversicherung). Covered services are identical across all GKV providers because the scope is federally defined.
Private (PKV) charges based on your age, health, and chosen coverage. It can be cheaper than GKV when you are young and healthy, and notably more expensive as you age. It covers your family only if you pay separately for each person. You cannot easily switch back to GKV once you leave it.
You can only choose PKV if:
- You are a salaried employee earning above the Versicherungspflichtgrenze (approximately €77,400 gross per year in 2026), OR
- You are self-employed or a freelancer, OR
- You are a civil servant (Beamter)
Below that salary threshold, GKV is mandatory.
Which GKV provider to pick
All GKV providers cover the same things. They compete on customer service, app quality, extra perks, and the Zusatzbeitrag (the 2 to 3% top-up).
The major ones you will encounter:
- TK (Techniker Krankenkasse): most popular among internationals. English-language customer service, decent app, widely accepted. Zusatzbeitrag around 2.5%. Safe default choice.
- AOK: state-based (AOK Bayern, AOK Nordost, etc.). Solid, traditional. English support varies by region.
- Barmer: large, English online portal, good app. Similar cost to TK.
- DAK-Gesundheit: long history, decent customer service.
- IKK Classic: smaller, slightly cheaper in some regions.
For most Indians arriving in Germany, TK is a safe pick. You can switch provider after 12 months if you dislike them.
If you want to compare Zusatzbeitrag rates and extra benefits across all providers, Verivox* shows a side-by-side comparison filtered by your situation (employed, student, self-employed).
How to sign up
Your employer's HR team will ask you which provider you chose before your first payroll run. Call or email the provider, give them your passport, Anmeldung, and employment contract. They send you a membership certificate (Mitgliedsbescheinigung) which you forward to your employer.
Your Gesundheitskarte (health card) arrives by post in 1 to 3 weeks. Carry it to every doctor visit.
What it actually covers
- Unlimited GP (Hausarzt) visits, no co-pay
- Specialist visits (Facharzt), need a referral (Überweisung) in some cases
- Hospitalisation (€10/day co-pay, max €280/year)
- Prescription medication (€5 to €10 co-pay per item)
- Mental health (therapy with long waiting lists)
- Dental basics (cleanings cost extra; implants not covered)
- Vision basics (glasses mostly not covered, only frames in some cases)
For anything cosmetic or elective, you pay out of pocket.
Specific scenarios for Indians
Student visa: you must enrol in GKV. Student rate is around €120 per month across all providers. This is heavily subsidised.
Blue Card holders: your employer handles it. Go with TK or Barmer unless HR recommends otherwise.
Freelancers and self-employed: you can choose either GKV (voluntary membership, you pay both halves so around €400 to €900/month depending on income) or PKV. Most freelancers eventually regret PKV because premiums rise sharply with age.
Family members in India visiting: they need travel insurance, not your German policy. Your policy does not cover them while they are abroad.
Spouse joining you on a family reunion visa: immediately register them on your Familienversicherung (free). They are covered from day one.
Children born in Germany: automatically covered under your plan.
Finding a Hausarzt
Call around. Many GPs are not accepting new patients, especially in Berlin. Try doctolib.de for availability filtered by language (Hindi, Urdu, Punjabi, and Tamil speaking doctors exist in most major cities).
Once you find a Hausarzt, stick with them. They become the gatekeeper for referrals to specialists.
Switching providers
You can switch after 12 months of continuous membership, with 2 months notice. The process is paperwork-light: the new provider handles most of it.
Things nobody warns you about
- Waiting times for specialists can be 6 to 12 weeks. Therapy waiting lists are often 3 to 6 months.
- Your GP will test less than an Indian GP would. Routine bloodwork is not automatic. If you want a specific test, ask for it by name.
- Prescriptions expire fast. The pink slip (Kassenrezept) is valid for 28 days only.
- Your Gesundheitskarte must be physically presented or the clinic may bill you privately.
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Frequently asked
Public or private health insurance in Germany: which should I choose?
Public (GKV) is safer for most people: no age-related price hikes, family members covered free, regulated. Private (PKV) is cheaper when young and single but locks you in and gets expensive with age. If you earn below the annual income threshold (~€77,400 in 2026), you must go public anyway.
How much does public health insurance cost in Germany?
About 14.6% of gross salary plus 2 to 3% additional contribution, split roughly 50/50 between you and your employer. For a €60k salary, expect around €300 to €350 per month deducted from your net pay.
Can I keep my Indian health insurance in Germany?
No. German law requires everyone legally resident in Germany to have German-recognised health insurance. Indian policies are not accepted. You must enrol with a German GKV or a German-licensed PKV provider.
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