Health Insurance in Germany: GKV and PKV

Start with your insurance status

Before comparing prices, establish which type of German health insurance is available in your situation. Employment, previous insurance and family circumstances can all matter.

• Employees: The general annual earnings threshold is €77,400 in 2026. Exceeding it does not automatically complete a switch; timing and the applicable rules need checking.
• Self-employed people: Self-employment does not always create a free choice. Some groups remain subject to statutory insurance.
• Civil servants and students: Separate rules can apply. Do not transfer an employee’s eligibility assessment to another status.

Legal eligibility and an insurer’s acceptance are separate questions. For ordinary private tariffs, the health assessment can affect the offer. Check your route into cover before cancelling an existing policy.

Source: Federal Ministry of Health: statutory insurance and eligibility.

Understand GKV and PKV before choosing a policy

I am Sven Chalupa, an insurance broker offering advice in English, in person in Berlin and online throughout Germany. Many of my English-speaking clients are unfamiliar with Germany's statutory and private health insurance systems. You do not need to arrive with a preferred option.

I start by explaining how GKV and PKV work, then look at your income, how predictable your work and earnings are, your health history and your plans for the next few years. My aim is to help you understand the decision before we compare individual policies.

For more background, read the GKV vs PKV guide for expats.

Costs: compare the same things

For GKV, relevant income, contribution rules and the fund’s supplementary rate determine the cost. Private premiums depend on factors including age at entry, health assessment and benefits. A price without those details is not a reliable personal quotation.

Include deductibles, long-term care cover, family costs and any applicable employer subsidy in your comparison. Distinguish the total premium from the amount you personally pay.

Family members

Contribution-free GKV family insurance has conditions; it is not automatic for every spouse or child. In PKV, each insured person normally needs separately priced cover. Check the position of every family member.

For families with two or more children, I pay particular attention to whether the household income can comfortably support private cover. In my advice, remaining in GKV may be the more suitable option. We still need to check the insurance position of each family member; the number of children alone does not decide the answer.

If you expect to stay in Germany for only two to five years, that needs a separate discussion. A shorter planned stay does not by itself establish eligibility for PKV or make it the better choice.

Self-employed people and tax

Your own health insurance is generally considered under personal special-expense rules (Sonderausgaben), rather than simply being a business expense. The deductible share depends on the cover and your tax circumstances. Confirm the treatment with a tax adviser. See § 10 EStG.

Health insurance questions in English

What to expect when we speak

1. First meeting: understand your situation. Our first conversation usually takes 60–90 minutes. We get to know each other, I explain how I work, and we discuss the questions that matter to you.
2. Second meeting: discuss your personal plan. I prepare a recommendation based on our first conversation and explain it at our next meeting. Where relevant, this can take account of your other insurance and investment arrangements.
3. Follow-up: work through remaining questions. There is usually a third meeting to clarify further questions. The number of meetings depends on what we need to discuss.

Before an application, I go through the relevant health questions with you. We then discuss whether a preliminary risk enquiry would be useful in your situation. Read how I prepare and handle a preliminary risk enquiry.

For your first enquiry, see the guidance on what to send in the questions above.

Discuss your health insurance questions with Sven