What is it?
Public health insurance (Gesetzliche Krankenversicherung, or GKV) is Germany's default healthcare system, covering 87% of the population. It's run by 94 non-profit insurance funds called Krankenkassen, not by the government directly.
The system operates on a solidarity principle - everyone pays based on their income to ensure all residents can access healthcare regardless of their wealth or health status. Unlike private insurance, your age, health conditions, or how often you get sick don't affect your costs.
There are many significant differences between Public and Private health insurance systems, which we will touch upon on this page but we go much more in depth in a dedicated blog post series here. For this guide, we'll focus specifically on how public health insurance works, what it costs, and what it covers.
Who needs public health Insurance?
For most people in Germany, public health insurance isn't optional - it's required by law.
You must have Public Insurance if:
You cannot get Public Insurance if:
To learn more about Private health insurance, you can find more information here.
Special cases to be eligible for Public health insurance:
Children and families in Public health insurance
The big advantage of a family membership is that those members can join their spouses / parents plan for free, but like most things in the German insurance world - this is also not as clear as it could be.
First we need to figure out if you spouse/children are eligible to be in Public health insurance with you or if they might require private insurance.
For spouses it is easier:
When determining whether a child can be covered by family insurance, it is relevant how the parents are insured, whether they are married and how much they earn. If one parent has private health insurance, it is necessary to check whether non-contributory insurance is possible for the child, regardless of the factors listed above.
How much does Public Health Insurance cost?
Public health insurance costs are income-based, not health-based. The standard rate is 14.6% of your gross income, plus additional contributions (Zusatzbeiträge) that vary by provider.
Each provider charges slightly different additional rates, creating price differences of €10-30 per month. You can compare providers using our cost calculator.
If you're employed:
If you're self-employed:
Students
What Public Insurance covers?
Listing all benefits would and does fill entire books. The task of the GKV is “to maintain the health of the insured, to restore or to improve their health” and this has direct consequences for the benefits and procedures.
By law, benefits must be “adequate, appropriate and economic and must not exceed what is necessary”. Thus, the procedures that are covered are derived. At regular intervals these procedures get reviewed or new ones get added. This process is strictly regulated by law. To generalise, the GKV pays for all medically necessary and common procedures including things such as rehabilitation.
The method used for reimbursement is the so-called “Sachleistungsprinzip”. It means that the insured person does not have to pay anything (except for certain mandated additional payments) to physicians, hospitals, pharmacies, etc. or other institutions that offer health care services
Did you know?
You can add supplemental insurance to cover gaps like dental care, vision, or private hospital rooms while keeping your public insurance base. To learn more about supplemental insurance, you can got this overview.
Choosing between Public Insurance providers
Here's the thing: all public providers offer nearly identical coverage and costs. Price differences are typically under €30/month, and basic coverage is standardized by law.So why choose one over another? It comes down to customer service and extra benefits.
Generally speaking, we normally recommend our international clients to go with the Techniker Krankenkasse (TK)
TK is Germany's largest public health insurance provider with over 11.3 million members nationwide. It's a statutory health insurance fund that operates independently while being publicly regulated.
Why TK is popular?
TK consistently ranks well in independent studies and has built a strong reputation, particularly among young professionals and expats.
Here's what sets it apart:
Extra benefits beyond standard coverage:
TK combines the reliability of Germany's largest health insurer with strong digital services and good English support, making it a solid choice for both Germans and international residents.
The Bottom Line:
Public health insurance provides solid, comprehensive healthcare coverage for the vast majority of Germans. While it may not offer the premium perks of private insurance, it's reliable, affordable, and covers all your essential health needs.
The choice between providers is less critical than understanding what's covered and ensuring you have the support you need in your preferred language.
Ready to get covered? Contact one of our experts to find the best fit for your situation!
Daniel Weiss
Email: daniel.weiss@versicherungsbuero-weiss.com
Telefon: +49 30 - 40 36 31 95 1
Mobil / WhatsApp : +49 178 - 140 584 0
Book a free consultation: https://calendly.com/vb-weiss_daniel/meeting
