FOR EXPATS IN GERMANY
Insured properly in Germany – explained in English.
Health insurance is mandatory here, the system is unlike almost anywhere else, and the first decision is often the hardest to undo. I help expats choose between public and private health insurance and protect their income – in plain English.
In short
Anyone living in Germany must have health insurance[1], and you need adequate cover for your residence permit[2]. Employees earning up to the annual income threshold (€77,400 in 2026) are automatically in public health insurance (GKV); above it, and as a freelancer, you can choose private health insurance (PKV)[3]. Gregor Vollmer-Fuchs, a financial advisor based in Magdeburg, advises expats across Germany by video call in English on health insurance and disability income protection.
- Advice in English and German
- EN + DE
- insurers compared
- 36
- contracts arranged
- 2,500+
THE BASICS
Health insurance is mandatory
Everyone with residence in Germany must hold health insurance that covers at least outpatient and inpatient treatment. By law, a deductible of up to €5,000 per year is allowed[1]. If you sign up more than a month late, private insurers charge a late surcharge[1].
For a residence permit, immigration offices accept public insurance automatically. Private policies are checked to see whether they match public cover – large exclusions, benefit caps or policies that end automatically can lead to problems, and some offices expect a low deductible[2][4].
TIP
Before you sign anything, ask us or your immigration office whether the policy will be accepted for your permit and its renewal.
GKV OR PKV
Public or private? It depends on how you work
Employee below the threshold
GKV is mandatory. The contribution is 14.6 % of your gross salary plus your insurer's additional rate (average 2.9 % in 2027[5]), shared roughly half and half with your employer, up to a ceiling. Spouses without their own income and children can often be co-insured for free.
Employee above the threshold
Threshold: €77,400 in 2026; 2027: €84,150 (expected). You can choose. If this is your first job in Germany, you can join the GKV voluntarily – but you must apply within three months of starting work[6]. Or you choose PKV; your employer then contributes up to half.
Freelancers and self-employed
You are not automatically in the GKV. Voluntary membership usually requires previous public insurance periods (e.g. 12 months in a row or 24 months within five years[6]), which many newcomers don't have – so PKV is often the realistic route.
FIRST WEEKS
Expat and incoming policies
Short-term expat or incoming policies can bridge your first weeks. But many are time-limited, can't be extended or don't build up old-age provisions, and immigration offices may not accept them for a residence permit or its renewal[4]. If you plan to stay longer, switch to a permanent solution early – a later health issue can make it harder or more expensive.
PKV
Private health insurance: what expats need to know
- Every family member needs their own policy – there is no free family co-insurance like in the GKV.
- Premiums depend on age and health at entry, not on income. Part of your premium builds old-age provisions to keep premiums stable later in life.
- Moving within the EU/EEA: your German policy can continue, but the insurer only pays what it would pay in Germany[7]. Moving elsewhere: an “Anwartschaft” (dormant policy) can keep your entry age and health status for a possible return.
- Going back to the GKV later is limited – and from age 55 often no longer possible[3]. That's why this decision should be made carefully.
- Honest answers to the health questions are essential. We send anonymous pre-checks to several insurers before you apply.
INCOME PROTECTION
Protect your income: disability insurance (BU)
In Germany, the state disability pension is low – new disability pensions averaged around €1,067 per month in 2025[8] – and you usually need five years of contributions, three of them compulsory contributions in the last five years, before you qualify[9]. As a newcomer you are often not covered at all.
Private occupational disability insurance (Berufsunfähigkeitsversicherung, BU) pays a monthly pension if you can no longer work in your job. Many tariffs cover you worldwide, so your protection stays if you move – we check the conditions for you. Rule of thumb for the pension: 80 % of your net income.
HOW IT WORKS
Four steps. No sales funnel.
Free first call
By video, in English or German – usually within the same week. You tell us what's on your mind. We listen.
Your situation and options
We look at your job, residence status, family and plans, and show you which options are really open to you.
Comparison and pre-checks
We compare 36 insurers and send anonymous pre-checks to several of them before you apply.
Long-term support
Life changes – your cover should keep up. We stay with you, also when you move or your life changes.
FAQ
Questions expats ask us
Do I need German health insurance as an expat?
Yes, if you live in Germany. The law requires cover for at least outpatient and inpatient treatment, and you need adequate cover for your residence permit.[1][2]
Can I choose private health insurance as an employee?
Only if your salary is above the annual threshold (€77,400 in 2026). Below it, public insurance is mandatory.[3]
I'm a freelancer – can I join public health insurance?
Often not right away. Voluntary membership usually requires previous public insurance periods. Many freelancers who move to Germany therefore start with private insurance.[6]
Is my expat or travel health insurance enough for my residence permit?
Not always. Immigration offices check whether private cover matches public insurance; time-limited policies or policies with large exclusions may not be accepted. Ask before you rely on it.[4]
What happens to my private health insurance if I leave Germany?
Within the EU/EEA, your policy can continue, but benefits are limited to what you'd get in Germany. Outside the EU, a dormant policy (Anwartschaft) can keep your status for a later return. We plan this with you before you move.[7]
Can I switch back from private to public insurance?
Only under certain conditions, for example if you become an employee earning below the threshold – and from age 55 it is usually no longer possible.[3]
Do I need disability insurance in Germany?
If you depend on your income, yes. The state disability pension is low and newcomers often don't qualify yet. A private BU pays a monthly pension if you can no longer work in your job.[8][9]
Do you really advise in English?
Yes. Gregor advises in English and German, by video call across Germany or in person in Magdeburg. The first call is free.
NEXT STEP
Let's find out what fits you.
30 minutes, free, in English. You'll leave knowing your options and your next step.
Sources
- [1]Bundesministerium der Justiz (gesetze-im-internet.de) — § 193 VVG – mandatory health insurance. https://www.gesetze-im-internet.de/vvg_2008/__193.html
- [2]Bundesministerium der Justiz — § 2 AufenthG – adequate health insurance for residence. https://www.gesetze-im-internet.de/aufenthg_2004/__2.html
- [3]Bundesministerium der Justiz — § 6 SGB V – income threshold, 55+ rule. https://www.gesetze-im-internet.de/sgb_5/__6.html
- [4]Kreis Rendsburg-Eckernförde, Ausländerbehörde — Merkblatt zum erforderlichen Krankenversicherungsschutz für Aufenthaltserlaubnisse. https://www.kreis-rendsburg-eckernfoerde.de/fileadmin/bilder/Familie_und_Soziales/Zuwanderung_und_Integration/Aufenthalt/Merkblatt_zum_erforderlichen_Krankenversicherungsschutz_fuer_die_Erteilung_bzw._die_Verlaengerung_von_Aufenthaltserlaubnissen.pdf
- [5]Bundesministerium für Gesundheit — „Zusatzbeitragssatz bleibt auch 2027 stabil“ (30.10.2026). https://www.bundesgesundheitsministerium.de/presse/pressemitteilungen/zusatzbeitragssatz-gkv-2027-festgelegt
- [6]Bundesministerium der Justiz — § 9 SGB V – voluntary GKV membership. https://www.gesetze-im-internet.de/sgb_5/__9.html
- [7]Bundesministerium der Justiz — § 207 VVG – moving within the EU/EEA. https://www.gesetze-im-internet.de/vvg_2008/__207.html
- [8]Deutsche Rentenversicherung — Rentenstatistik 2025. https://jahresbericht.deutsche-rentenversicherung.de/artikel/in-zahlen-2025/
- [9]Bundesministerium der Justiz — § 43 SGB VI. https://www.gesetze-im-internet.de/sgb_6/__43.html
General information, not legal or tax advice. Rules can change; your individual situation decides.
Gregor Vollmer-Fuchs
Financial advisor (§§ 34d / 34f GewO)
Magdeburg · advising across Germany
Last reviewed: November 2026