Germany · Healthcare
How the Germany healthcare system works — public vs private care, eligibility, and costs for residents and visitors.
AI-drafted, editorially reviewed. Confirm specifics with the official authority.
Health insurance is compulsory for everyone living in Germany, and you need valid cover to obtain a residence permit — that link is what catches newcomers out. There are two pillars: statutory insurance (GKV), covering around 88% of residents with income-based contributions split with the employer, and private insurance (PKV), generally for higher earners above the threshold, the self-employed and civil servants. Students and lower-income employees are usually in the GKV.
Health insurance is mandatory for everyone living in Germany. There are two pillars: statutory health insurance (gesetzliche Krankenversicherung, GKV), which covers around 88% of residents with income-based contributions, and private health insurance (private Krankenversicherung, PKV), generally for higher earners, the self-employed and civil servants. You must have valid cover to get a residence permit.
- Health insurance is compulsory for all residents; you need valid cover to obtain a residence permit.
- Statutory health insurance (GKV) covers ~88% of residents, with income-based contributions split with the employer.
- Private health insurance (PKV) is generally for higher earners above the threshold, the self-employed and civil servants.
- Students and lower-income employees are usually in the GKV; check eligibility before choosing.
- 1
Treat cover as a residence-permit prerequisite
You need valid health cover to obtain a residence permit. Sort insurance before or alongside the permit application, not after.
- 2
Work out whether GKV or PKV applies
GKV covers around 88% of residents; PKV is generally for higher earners above the income threshold, the self-employed and civil servants. Check which pillar you fall into before choosing.
- 3
Understand how contributions work
Statutory contributions are income-based and split with the employer. That makes GKV predictable relative to salary rather than a flat premium.
- 4
Check the student and low-income position
Students and lower-income employees are usually in the GKV. Confirm eligibility before signing up for private cover, since switching back is not always straightforward.
- 5
Keep proof of cover to hand
Because cover underpins your residence permit, keep the insurance confirmation available for permit applications and renewals.
- Health cover arranged before or with the permit application
- GKV or PKV pillar identified
- Income threshold checked if considering PKV
- Contribution basis understood (income-based, employer-split)
- Student or low-income eligibility confirmed if relevant
- Switching implications considered before choosing PKV
- Proof of cover kept for permit renewals
- Make it in Germany — Health insurance
Official government guide for foreign residents.
- Federal Ministry of Health (BMG)
National health authority.
Frequently asked questions
Do I need health insurance to get a German residence permit?
Yes. Health insurance is compulsory for everyone living in Germany and you need valid cover to obtain a residence permit. Sort the insurance before or alongside the permit application rather than treating it as a later task.
What is the difference between GKV and PKV?
GKV is statutory insurance covering around 88% of residents, with income-based contributions split with the employer. PKV is private cover, generally for higher earners above the income threshold, the self-employed and civil servants. Which applies depends on your status and income.
Are students in the statutory system?
Usually yes — students and lower-income employees are typically in the GKV. Confirm your eligibility before signing up for private cover, because switching back from PKV is not always straightforward.
Government portals
- Federal Government of Germany — Germany's Federal Cabinet official website — policy, legislation, news, and government programs
- Federal Office for Migration (BAMF) — German visas, EU Blue Card, asylum, integration courses, and permanent residency
- Federal Central Tax Office (BZSt) — Tax ID (IdNr) registration, tax identification lookup, withholding tax refunds — the key authority for foreign taxpayers in Germany