The Ultimate Guide: How to Get Health Insurance in Germany (2026 Edition)

What to consider when comparing private and public health insurance

• In Germany, health insurance is mandatory for all residents, and there are two main types: public and private health insurance.
• Public health insurance covers the same benefits across providers, while private coverage may offer additional services and faster access to specialists.
• The cost of public health insurance is typically a fixed percentage of your income, while private health insurance costs depend on your age, health condition, and the level of coverage you choose.
• Public health insurance is open to (almost) everyone. For private health insurance you have to qualify. It's only open to employees with an income over 77.400 Euros, self-emloyed, civil servants, and students.

The Dual System: Public vs. Private

In Germany, you must register with an insurance company and provide proof of valid health insurance in Germany, you may face penalties and have to pay all missed premiums if you want coverage again.

Germany is one of the few countries where you can choose between Statutory (Public) Health Insurance (GKV) and Private Health Insurance (PKV). Public or private insurance is compulsory for all residents, meaning everyone must have health insurance by law (compulsory insurance). The healthcare system in Germany is designed to ensure that all residents have equal access to healthcare services, regardless of income or health status.

If you're here on a work visa or as a freelancer, you'll need a "Certificate of Insurance" to finalize your residence permit.

Note: Employees split their premium 50/50 with their employer regardless of their type of health insurance.

Public Health Insurance 

• Public health insurance is funded through social security contributions and the cost is typically a fixed percentage of your income: 14.6% for emloyees or 14% for self-employed plus long-time nursing care (between 2.6% and 4.2% depending on the number of children you have) and an average additional contribution of 2.9%. So, contributions to public health insurance are based on your income.
• All public health insurance providers offer the same benefits, with only minor differences in additional benefits like vision aids or a private room in a hospital. It covers essential medical services, including doctor's appointments, hospital treatment (multi-bed room), prescribed medications (with possible co-payment), and basic dental care - but there's one scope of coverage for everyone. Any additional coverage must be paid for by yourself or insured via a top-up insurance.
• Public health insurance allows for kids and spouses without own inome to be included without additional costs.
• Pre-existing conditions aren't a factor to get coverage under public health insurance.

Private Health Insurance with ottonova

• Your premium is based on your age, health status, and chosen average, not your salary. This often results in lower costs for healthy professionals. Costs vary significantly from insurance to insurance.
• Private health insurance generally offers more comprehensive coverage and benefits compared to statutory insurance, like private rooms in hospitals and direct access to private specialists.
• The private health insurance system is available to specific groups such as self-employed individuals, civil servants and higher-income earners.
• Private insurance typically requires separate premiums for each family member.
• Pre-existing conditions are a factor for the possibility to get private coverage.

Eligibility: Can You Go Private?

The first step in how to get health insurance in Germany as a foreigner is checking your eligibility. The German government updates the income thresholds annually. Your residence status and employment contract are key factors in determining your eligibility for public or private health insurance.

Who can take out private health insurance?

• Employees: If your gross annual salary is above 77,400 Euros, you can opt out of the public system and join private health insurance.
• Self- Employed & Freelancers: You have the choice between voluntary public health insurance or private insurance regardless of your income level.
• Students: If you are a student, choosing private health insurance can offer better value and lower price than the public student insurance. International students over the age of 30 even have to take out private health insurance because the public insurance does not offer student rates past this age.
• Civil servants: Private health insurance is in most cases the best insurance option for civil servants as they benefit from individual Beihilfe when taking out private health insurance. You can take it out regardless of your income.

Full Private Insurance vs. Temporary Expat Insurance

Many foreigners are tempted by "Incoming" or "Expat" insurances because they are cheap. However, these are often just temporary travel policies with limited coverage. Travel insurance is designed for short-term stays or visits and does not meet the requirements for long-term residence or comprehensive healthcare in Germany. For those planning to live, work, or study in Germany, full health insurance is necessary to ensure proper coverage and to fulfill visa requirements.

Private providers in Germany offer both full private health insurance and top-up insurance (Zusatzversicherung) to cover gaps in public insurance, such as enhanced dental treatments or private hospital rooms. Insurance coverage must meet visa requirements for long-term stays, ensuring that essential healthcare services, including doctor visits, childbirth, dental treatments, and long-term nursing care (Pflegeversicherung), are included.

Health Insurance Providers: How to Choose the Right One

Navigating the world of health insurance in Germany can feel overwhelming, especially with so many health insurance providers and plans to choose from. Whether you're considering statutory health insurance or private health insurance, finding the right health insurance provider is crucial for your peace of mind and access to top-quality medical services.

In Germany, you'll encounter two main types of health insurance providers: statutory health insurance providers (like Techniker Krankenkasse or AOK) and private health insurance providers (such as ottonova).

Statutory health insurance companies offer comprehensive coverage for doctor's visits, hospital stays, and prescription medications, often with standardized benefits and regulated public health insurance costs. Private health insurance providers, on the other hand, give you the flexibility to tailor your insurance coverage, enjoy perks like private hospital rooms, and often benefit from faster access to specialists.

The traditional way involves paper forms, physical mail, and often a lot of German-only communication. We at ottonova think that's outdated. When we talk about how to get health insurance in Germany as a foreigner, we mean a process that happens entirely digitally. You shouldn't need a translator to understand your health benefits. That's why our entire onboarding process and our support is available in English.

Why Private Health Insurance is the Preferred Choice for Expats

You might wonder why so many foreigners specifically search for private health insurance in Germany. It's not just about the prestige; it's about access and ease. Many expats look for the best health insurance in Germany, comparing providers based on coverage, customer service, and affordability. In the public system, you might wait weeks for a specialist appointment.

But it goes deeper than just shorter wait times. Private patients can access similar or better healthcare services and may pay medical bills upfront and seek reimbursement, depending on their private health insurance plan. The private health insurance system in Germany is regulated and offers tailored plans for different needs.

Private health insurance generally offers more comprehensive coverage and benefits compared to public health insurance. Imagine waking up with a fever and not knowing which doctor to call. Instead of searching the web, you simply open the ottonova app and start a video consulation with a doctor. If you need a in-person appointment, our English-speaking concierge team will book it for you.

This seamless integration of technology and human support is why ottonova has become synonymous with modern private healthcare for the global community in Germany.