How German health insurance works
Public or private, how contributions are calculated, what your card covers and what to do before your first doctor's visit.
Short answer
Health insurance is compulsory for everyone living in Germany. Most employees join a public Krankenkasse, where contributions are a percentage of gross salary and are shared with the employer. You choose your provider yourself, receive an insurance card, and use it at every appointment.
Step by step
- 1
Work out which system applies to you
Employees below the income threshold are insured publicly. Higher earners, self-employed people and some students can choose private cover. Public insurance also covers non-working spouses and children in many cases.
- 2
Choose a provider
Core benefits are defined by law and nearly identical everywhere. Compare the additional contribution rate, the extra services, English-language support and how easy the app and offices are to use.
- 3
Apply and collect your confirmation
Applications are usually online. You receive a membership confirmation immediately, which your employer needs to register you, and the physical card follows by post.
- 4
Register with a general practitioner
Find a Hausarzt near you before you actually need one. Practices can be full, and having a doctor already is far easier than searching while ill.
- 5
Know the emergency routes
112 is the emergency number for ambulances. Outside surgery hours, 116 117 connects you to the medical on-call service for non-life-threatening problems.
Indicative costs
Public contributions are a percentage of gross income, split between employee and employer, plus a provider-specific additional rate. Private premiums depend on age and health rather than income.
Indicative timing
Membership confirmations are often issued within days. Switching from private back to public insurance is restricted, so treat the first decision as a long-term one.
Documents you need
- Passport or ID card
- Registration certificate (Meldebescheinigung)
- Tax ID once you have received it
- Employment contract or proof of your current status
- Previous insurance details if you were insured in another EU country
Common mistakes
- Assuming travel insurance or a European health card replaces German cover once you live here.
- Choosing private insurance for the lower initial premium without checking long-term costs.
- Starting a job without a membership confirmation, which delays payroll registration.
- Ignoring letters from the Krankenkasse asking for missing documents.
Practical tips
- Ask the provider directly whether they offer service in English before joining.
- Keep the membership number in your phone: employers, clinics and pharmacies ask for it.
- Note whether your provider reimburses preventive courses — many do.
Final checklist
- System identified: public or private
- Provider compared and chosen
- Application submitted
- Membership confirmation sent to your employer
- Insurance card received and stored safely
- General practitioner found near home