As an expat settling in Germany, it's crucial to understand the local healthcare and protection systems. Expat Finances supports you in finding the optimal coverage for your situation.
Health and welfare in Germany
For whom?
In Germany, should I choose public or private health insurance ?
In Germany, having health insurance is mandatory. Choosing between private health insurance (PKV) and public health insurance (GKV) depends on your employment status, income level, and healthcare needs.
Public health insurance (GKV)
Public health insurance (GKV) is mandatory for employees whose annual gross income is below the threshold (approximately €69,300 in 2024). It operates on an income-based contribution system and covers essential medical care, hospital treatment, and prescription drugs, with moderate out-of-pocket costs. GKV is especially suitable for families, as unemployed spouses and children can be included at no additional cost.
Private health insurance (PKV)
Private health insurance (PKV) is available to self-employed individuals, civil servants, and employees whose income exceeds the GKV threshold. Unlike the public system, PKV premiums are not based on income but rather on age, health status, and the level of coverage selected. It offers faster access to care, higher reimbursements for specialist consultations, and broader hospital benefits — such as private rooms and treatment by senior physicians. However, it can become more expensive with age and does not allow free coverage for non-working family members.
The difference between public and private healthcare in Germany :
| Criteria | Public health insurance - Gesetzliche Krankenversicherung (GKV) | Private health insurance - Private Krankenversicherung (PKV) |
|---|---|---|
| For whom | All employees up to a certain income threshold (2025: €69,300 gross/year), Students, unemployed people | Employees above the income threshold, self-employed, civil servants, students (under certain conditions). |
| Attractive | Income-dependent. Contribution capped. | Depends on age and state of health at time of purchase, and on benefits selected. Individual premium, not linked to income. |
| Services | Uniform legal catalog (doctor, hospital, medication, preventive care). Limited to "necessary" care. | Customizable services (specialist doctors, single room, best turnaround times, alternative care depending on contract). Often more comprehensive. |
| Family | Free family insurance (married spouse with no income and children included at no extra cost). | No free coverage: each family member must pay his or her own contribution. |
| Advance payment | No advance payment: the insurance card (Gesundheitskarte) suffices, and costs are settled directly between the insurance company and the doctor/hospital. | The insured pays the bill first, then gets reimbursed by his or her insurance (except for hospitalization). |
What we offer :
Maintaining social security coverage in France :
This service is available exclusively to French nationals. No equivalent solution is offered for English-speaking expatriates wishing to maintain health coverage in their home country.
Registration with a private health insurance (PKV) :
If you're eligible for private health insurance in Germany (PKV), we help you choose the policy best suited to your profile. Private insurance offers higher reimbursements, better access to specialists, and enhanced benefits such as private hospital rooms, improved dental and vision care, and alternative medicine coverage. We assist you in comparing providers and subscribing to the PKV plan that fits your medical needs and budget.
Registration in the public health insurance system (GKV) :
If your status requires you to remain in Germany’s public health insurance system (GKV), we guide you through choosing the right insurance fund, completing administrative steps, and understanding reimbursement levels. We explain how GKV contributions work, what is covered under the system, and what options are available to enhance your protection with supplemental health insurance.
Applying for complementary health insurance in Germany :
To supplement the reimbursements provided by your public (GKV) or private (PKV) health insurance, we can help you take out a health insurance policy for expatriates in Germany. We'll guide you towards the most suitable contracts, covering under-reimbursed treatments such as dentures, glasses, alternative therapies and extra fees.
Guidance and support during sick leave :
If you are on sick leave, the coverage differs depending on whether you are insured under the public (GKV) or private (PKV) health system. We help you understand your entitlement to daily sickness benefits, the steps to follow to receive compensation, and the available options to secure your income in the event of long-term incapacity.
Signing up for disability insurance (Berufsunfähigkeitsversicherung) :
Disability insurance is essential to protect your financial security in the event of a permanent loss of earning capacity. We help you choose the right policy tailored to your profession and personal situation, ensuring a stable income if you are no longer able to work.
Signing up for income protection insurance (Krankentagegeldversicherung)
Whether you are an employee or self-employed, income protection insurance helps secure your earnings in the event of an extended medical leave. We assist you in subscribing to a policy that complements your GKV or PKV coverage and advise you on the best solutions to maintain your standard of living during a temporary inability to work.