Health insurance is mandatory in Germany — for everyone living and working here, regardless of nationality. As a foreigner newly arriving in Germany, you'll need to understand how the system works, which type of insurance you need, and how to register. Here's a clear overview.
Two Systems: Statutory vs Private Insurance
Germany has two parallel systems. Statutory health insurance (GKV — gesetzliche Krankenversicherung): Mandatory for most employees earning below the insurance threshold (€73,800/year gross in 2025). Contributions are income-based: 14.6% of gross salary, split between you and your employer. Plus a fund-specific top-up premium (average ~1.7%). Private health insurance (PKV): Available to civil servants, self-employed individuals, and high earners (above the threshold). Premiums are based on age, health status, and chosen coverage level — not income.
As a regular employee, you'll generally be in the statutory system. As a freelancer or self-employed person, you choose — a decision with long-term consequences worth thinking through carefully.
How to Register as a Foreigner
Employees: Your employer handles registration with a statutory insurer (Krankenkasse) once you sign your employment contract. You choose the insurer — your employer accepts any statutory Krankenkasse. Request your health insurance card (Krankenversicherungskarte) directly from the insurer. Students (up to 30 years old): Reduced contribution of approx. €120–130/month. Self-employed: Register as a voluntary member of a statutory insurer (minimum contribution ~€200–230/month even without income) or choose private insurance.
Recommended Insurers for Expats
Among statutory insurers, expats often choose TK (Techniker Krankenkasse) — known for good service, English-language support, and a strong digital platform. DAK-Gesundheit and Barmer also have English-language customer services. Avoid choosing purely on price — service quality varies. For expats who prefer English communication, TK and DAK are frequently recommended.
New to Germany and unsure which health insurance to choose or how to register? Sylum helps you with your first steps in Germany. Contact us at sylum.de/contact.
