In Germany, everyone who lives here must have health insurance. This is required by law. Health insurance pays, for example, for doctor visits, medicine and hospital treatment. Without insurance, these costs can be very high. There are two types: public health insurance (gesetzliche Krankenversicherung) and private health insurance (private Krankenversicherung). The providers of public insurance are called health insurance funds (Krankenkassen). Most people in Germany have public insurance. It is best to take care of your insurance right after you arrive. Your employer, your university or the immigration office (Ausländerbehörde, the authority for foreigners' residence) often asks for proof. Read more on the page Sorting out your residence permit.
What you need
First, you should know which insurance applies to you. This depends on your situation.
- Employees: If you are employed by an employer, you are usually subject to compulsory insurance (pflichtversichert). This means you must join public health insurance. Only people who earn more than a certain limit may have private insurance. This limit is called the compulsory insurance income threshold (Versicherungspflichtgrenze). It changes every year.
- Self-employed people: If you are self-employed, you can usually choose. You can take out voluntary public insurance or private insurance.
- Students: Students usually have public insurance. The university asks for proof of insurance before you can enrol.
- Family: In public insurance, spouses and children with no income or a low income can be covered for free. This is called family insurance (Familienversicherung).
For the application, you usually need these documents:
- passport or ID card
- an address in Germany where mail can be sent
- your employment contract, a certificate from your university or details about your self-employed work
- a passport photo for the health insurance card
- your bank details (IBAN) if you pay the contributions yourself. See Opening a bank account.
- proof of previous health insurance abroad, if you have any
- your social security number (Sozialversicherungsnummer), if you already have one. If not, the health insurance fund can apply for it for you.
Step by step
- Clarify your situation. Are you employed, self-employed or a student? This decides whether you must have public insurance or whether you may choose.
- Choose a health insurance fund. The funds mostly pay for the same services, because the law sets them. There are differences in the additional contribution (Zusatzbeitrag), extra services and customer service, for example advice in other languages.
- Apply for membership. You can usually do this online, by post or at a branch office (Geschäftsstelle) of the health insurance fund.
- Pass on the confirmation. The health insurance fund sends you a membership certificate (Mitgliedsbescheinigung). This is proof that you are insured. Give it to your employer or your university.
- Send a photo. After that, you will receive your electronic health insurance card (elektronische Gesundheitskarte) by post. You show this card every time you visit a doctor.
- Register your family. If your spouse or children should be covered too, apply for family insurance at your health insurance fund.
- For private insurance: Get several offers. Answer the questions about your health honestly. Read the contract carefully before you sign.
- Report changes. Tell your insurance about a new address, a new employer or a new income.
Costs and deadlines
In public insurance, the contribution depends on your income. It is a fixed percentage of your gross pay (Bruttolohn). Gross pay means your pay before any deductions. On top of this comes an additional contribution, which each health insurance fund sets itself. If you are employed, your employer pays about half. Your employer deducts your share directly from your pay. Self-employed people pay the full contribution themselves. With public health insurance, you automatically also have long-term care insurance (Pflegeversicherung). It helps when someone needs care over a long period.
In private insurance, the contribution does not depend on your income. It is based, for example, on your age, your health and the plan you choose. Every person needs their own contract, including children. You must take out private long-term care insurance in addition.
About deadlines:
- As an employee, you are insured from your first day of work.
- Choose your health insurance fund within two weeks after you start work. Otherwise, your employer will register you with a health insurance fund.
- As a rule, you can only switch to another health insurance fund after 12 months of membership.
Common problems for newcomers
No Schufa: Schufa collects data on whether people pay their bills. This does not matter for public health insurance. If you are subject to compulsory insurance, the health insurance fund must accept you. Read more on the page Understanding and building your Schufa.
No registered address yet: The health insurance fund sends your card and letters by post. Ask the fund which address it accepts at the beginning. Make sure your name is on the mailbox. After registering your address (Anmeldung), tell the health insurance fund your permanent address.
Little German: Many health insurance funds offer information or advice in other languages too. Ask about this before you decide. You can also bring someone who speaks good German. If you are employed, your employer's HR department (Personalabteilung) can often help as well.
Insurance from your home country: If you live and work in Germany, you usually need German health insurance. Travel health insurance is usually not enough for a long stay. The immigration office will tell you which insurance is enough for your visa or residence permit (Aufenthaltstitel).
Minijob: A minijob is a job with a small income. A minijob does not give you health insurance. You must arrange insurance yourself.
Think carefully about private insurance: Switching from private back to public insurance later is often difficult. So get good information before you take out private insurance.
Frequently asked questions
Can I see a doctor before I have my health insurance card?
Ask your health insurance fund for a temporary certificate. Show it at the doctor's practice. Agree with the practice how you will hand in the card later.
What happens if I was not insured for a while?
Register with a health insurance fund as soon as possible. You may have to pay contributions for the time without insurance. The sooner you act, the better.
Do I need health insurance for my residence permit?
In many cases, yes. For a visa or residence permit, you usually have to show that you have health insurance. The immigration office explains the exact rules for your case.
Does public insurance also pay for the dentist?
Yes, basic dental treatment is included. For some services, for example dentures and crowns (Zahnersatz), you often pay part of the cost yourself.
Do I have to take care of the tax ID myself?
The tax ID (Steuer-ID) is a different number from the social security number. Your employer needs both. Read how to get your tax ID on the page Getting your tax ID.