One of the first administrative hurdles you’ll be faced with as a newly arrived expat is figuring out whether to take public or private health insurance.

For those of you who are self-employed, the situation is different than it is for employees. You automatically have a choice of public or private insurance. We cover options for insurance for freelancers separately.

However, depending on how you view it, the good news is that as an employee, you may not even need to make a choice.


Public or Private Health Insurance in Germany: What’s best? Do I even have a choice?


If you’re an employee, and earn less than €62,550 (in 2020), then you are automatically obliged to take out public insurance. In fact, over 90% of residents in Germany are in the public system.

There are many different public health insurers (or Gesetzliche Krankenkassen in German) to choose from.

While they are all broadly similar regarding what they’re mandated to cover by law, there are some subtle differences in non-essential cover that may be subject to extra charges. We cover this later in the article.

Whether or not you can sign up and deal with them in English is much likely to be of higher importance if you’ve just moved and aren’t yet confident dealing with correspondence in German.

What if I earn more than €62,550?


So, you earn above the €62,550 per annum gross threshold, and you’re not self-employed?


Now let’s drill down into the detail of who may be better served through the public health insurance system and who may be better advised to go private.

Should I go Private?


This is not a question an expat services website can or should answer!

Healthcare is a deeply personal, tailored product and each individual has different needs and expectations. 

If you’re an employee who earns over €62,550 and would like to better understand your options, I would suggest in the first instance you speak to a friendly, English-speaking insurance broker such as Mirja Link-Lundehn at KL for Expats.

However, we can guide you based on a couple of examples.

Let’s take a look at where it may make sense to go for one option over the other, before we go on to evaluate some other nuances and considerations which may be important to you.

Example 1:

– 30-year-old male

– No history of serious medical conditions

– No dependent children

– Non-smoker

– Annual gross salary of €75,000

– Intends to spend a few years in Germany before returning home

In this instance, it would in most cases make sense to seriously consider private health insurance. 

As a higher earner, the contributions into the public system would mean that it is relatively expensive (because, as we mentioned in our article on how the German healthcare system works, public health insurance contributions are a percentage of gross salary). 

Whereas with private insurance the premium is based on risk and this person is young, in good health and with no dependent family members.

At this point in life for this individual, it would almost certainly be cheaper to go private.

Example 2:

– 45-year-old male

– Married with 2 children

– Planning to stay permanently

– Non-working spouse

Here a whole new set of factors come in to play. 

First of all he is 15 years older. In almost all cases a private health insurance company would consider him to be a higher risk. 

Secondly, he has two dependent kids whom he will also have to insure. Let’s assume, for the sake of this example, that his spouse is not working full time and therefore cannot insure them on her policy. 

Finally, his move is likely to be permanent. Let’s not forget that as this person gets older, his insurance will become a higher risk to the insurer and his premium as such will almost certainly rise over time. Irrelevant for a temporary stay but a vitally important consideration for those making the move a permanent one.

These criteria would swing more towards a public health insurance option being the best bet.