Private health insurance in Germany for expats

Health insurance is mandatory for everyone living in Germany, from day one. Whether you're starting a job in Berlin or freelancing in Munich, you need valid cover before your residence permit appointment. PKV, Germany's private health insurance system, is often the better fit for expats who qualify. We compare all major German private insurers and advise you in English, at no charge.

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GKV (public) vs PKV (private): 2 tracks
PKV premium, not income: Risk-based
advice in English: Free

By André Disselkamp, Co-Founder & Insurance Specialist · Insurancy · DVA-certifiedPublished November 3, 2026

Key takeaways

Cover is compulsory from day one. German law requires valid health insurance for every resident. You must show proof for your visa or residence permit.
PKV eligibility depends on how you work. Employees above the annual income threshold, freelancers, the self-employed, and civil servants can all access private health insurance.
Your premium follows your risk, not your salary. PKV calculates your premium based on your age at entry, your health, and the benefits you choose.
International plans often fall short. IPMI policies from global providers are often not accepted as long-term compliant cover for a German residence permit.
One broker, all major insurers, no fee. Insurancy compares all major German private insurers for free. André Disselkamp advises you personally, in English.

Germany's health system: two tracks, one decision

Germany runs two parallel health insurance systems. GKV (gesetzliche Krankenversicherung) is public health insurance and covers about nine in ten residents. PKV (private Krankenversicherung) is private health insurance, and it is where many expats end up once they understand how the two differ.

The sharpest difference is how premiums are calculated. GKV charges a percentage of your gross salary, currently 14.6 % plus an additional contribution set by each fund, split between you and your employer. PKV charges a risk-based premium: your age at entry, your health status, and the benefits you select determine what you pay, not what you earn.

PKV also gives you more control over what you get. You choose your benefits package, which typically includes faster specialist appointments without a GP referral, private or semi-private hospital rooms, and broader dental coverage. Billing works differently too: you usually pay the doctor directly and then submit the invoice to your insurer for reimbursement.

Many expats also arrive with an IPMI (international private medical insurance) plan from providers like Aetna or Cigna. These work well if you move countries every few years, but German authorities often do not accept them as permanent, compliant cover for a residence permit. Short-term incoming health insurance bridges your first weeks in Germany but is not a substitute for long-term cover. You can read more about the full trade-offs in our guide to private vs public health insurance in Germany.

What PKV actually gives you

Private health insurance in Germany is not just a legal requirement. For eligible expats, it offers concrete advantages over the public system.

Faster specialist appointments

Private patients usually get appointments with specialists sooner, and you choose your doctors yourself.

You design your benefits

Choose the level of hospital accommodation, dental coverage, and outpatient benefits that match your needs and budget.

Risk-based, not income-based pricing

Your premium is fixed by your age at entry and health, not by a percentage of your salary. Employer subsidy applies if you are employed.

Accepted for visa and residence permit

A compliant PKV policy satisfies German residence permit requirements, unlike many international expat plans.

Who can get private health insurance in Germany?

Eligibility depends on your employment status and, for employees, your salary. Who can get private health insurance covers every scenario in detail, but here is the short version.

Employees can opt into PKV only if their gross annual salary exceeds the compulsory insurance threshold (Versicherungspflichtgrenze). This figure is adjusted every year, so check the current amount before you apply. Freelancers and the self-employed can join PKV regardless of income. Civil servants receive partial cost coverage from the state through Beihilfe, making PKV the standard choice for them. Some international students qualify under specific conditions. Blue Card holders often earn enough to clear the threshold, but not always, so verify against the current figure. Details on this are in our guide to health insurance with the Blue Card.

One restriction worth knowing: if you are already in GKV and over 55, switching to PKV is heavily restricted under German law. If you are new to Germany and older than 55, the picture is different, but premiums will be higher. And if you work for yourself, health insurance for freelancers explains your specific options in full.

PKV, GKV or international plan: which fits you?

Three systems, very different rules. The right choice depends on how you work, how long you plan to stay, and whether you have dependants.

Criterion	PKV often the better fit for eligible expatsPKV (private)	GKV (public)
Best suited for	High earners, freelancers, long-term expats	Most employees, families with children
Visa/residence compliance	Yes, accepted for residence permit	Yes, fully compliant
Cost basis	Age at entry, health, chosen benefits	Percentage of gross salary
Family coverage	Each family member needs a separate contract and premium	Spouse and children covered at no extra cost
Doctor access	Direct specialist booking, shorter waits	GP referral often required for specialists, longer waits
Typical duration	Long-term	Long-term

In short: PKV fits high earners and freelancers; GKV fits families and lower-income employees. International plans are often not accepted on their own for a German residence permit.

What does private health insurance cost?There is no single answer, because PKV premiums are calculated individually. Your age at entry is the biggest factor: the younger you are when you join, the lower your starting premium. Insurers also assess your medical history before offering a quote. A higher deductible (Selbstbeteiligung) lowers your monthly payment. The level of benefits you choose and the mandatory long-term care supplement (Pflegeversicherung) both add to the total. If you are employed, your employer contributes roughly half your PKV premium up to a legal maximum, which can make PKV competitive for higher earners. Families need to budget separately for each member: there is no free family coverage in PKV. Cost of private health insurance has a full breakdown with example figures. Pre-existing conditions can lead to surcharges or benefit exclusions, so private health insurance with pre-existing conditions is worth reading before you apply. Answer the health questions honestly: incorrect answers can void your cover.

How to get started

German law requires continuous cover with no gaps. Arrange your policy before your employment start date or registration appointment.

Check your eligibilityConfirm whether your salary or employment status lets you choose PKV. Employees need to be above the annual compulsory insurance threshold. Freelancers and the self-employed can apply regardless of income.
Fill in the comparison formGive us your basic details: age, employment status, and the cover level you need. We compare all major German private insurers against your profile.
Talk to André, in EnglishAndré Disselkamp, our English-speaking co-founder and insurance specialist, walks you through your options with no sales pressure. He translates German insurance terms into plain language and checks that your chosen plan satisfies visa and residence permit requirements.
Receive your policy and certificateOnce you have chosen a tariff and answered the health questions honestly, your policy and the insurance certificate your employer or the Ausländerbehörde needs are issued. André also helps with the correct start date to ensure seamless cover.

How Insurancy helps you find the right plan

We are a broker, which means we compare all major German private insurers and recommend the plan that fits you. Our advice is free and entirely in English. André Disselkamp, our co-founder, handles expat cases personally. He checks that your chosen plan satisfies visa and residence permit requirements and walks you through the contract terms before you sign anything.

André also handles the practical side of relocation: the insurance confirmation documents your employer or the Ausländerbehörde needs, the correct start date to ensure seamless cover, and what to do if your first weeks in Germany are covered by incoming health insurance.

Once health insurance is sorted, the next step for most newcomers is personal liability insurance. It covers accidental damage you cause to others, and many landlords expect it. For families thinking ahead, our guide to private health insurance for families explains how PKV works when you have dependants.

Conclusion: is PKV right for you?PKV suits high earners, freelancers, and long-term expats who want flexible, premium cover and are ready to manage their own benefits package. Your premium depends on your age, health, and the level of cover you choose, so a personal comparison is the only reliable way to find the right price. GKV remains the better fit for families with dependants or employees who earn below the threshold. International plans work for frequent movers but are often not accepted for German residence purposes. Start the comparison form below or book a free call with André, and have your policy ready before your first day in Germany.

Frequently asked questions: private health insurance for expats

Your question is not here?André and the team are happy to help.

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Can I switch from public to private health insurance in Germany?

Yes, if you are eligible. Employees can switch once their salary is above the compulsory insurance threshold for the current year and is expected to stay above it the following year. If you start a job in Germany with a salary already above the threshold, you can usually choose PKV right away. Returning to GKV later is difficult, particularly after age 55. Our guide on private vs public health insurance covers the switching rules in detail.

Is private health insurance mandatory for Blue Card holders?

No specific type of plan is mandatory, but health insurance itself is. Blue Card holders often earn enough to qualify for PKV, though some choose GKV. The right answer depends on your salary, family situation, and how long you plan to stay. See our dedicated guide to health insurance with the Blue Card for the full picture.

How does private health insurance work for families in Germany?

Each family member needs their own PKV contract with their own premium. There is no free family coverage as there is in GKV, where a spouse and children can be covered at no extra cost. For families with children or a non-working partner, GKV's family coverage often makes more financial sense. Our guide to private health insurance for families compares both options side by side.

What is incoming health insurance and is it enough?

Incoming health insurance is temporary cover for newcomers, typically valid for a few months up to several years depending on the plan. It can satisfy visa requirements for entry into Germany, but it does not count as long-term compliant cover for a permanent residence permit. You will need PKV or GKV for that. More detail is in our guide to incoming health insurance.

Is the advice from Insurancy really free and in English?

Yes. We are paid by the insurer whose policy you take out, so you pay nothing for the comparison or the consultation. André Disselkamp and our team advise entirely in English, from the first call through to the final policy document.

Free checklist

Health insurance checklist for moving to Germany

Every step from visa to residence permit on two pages, so you don't miss a document.

Compare private health insurance in Germany, free and in English

Fill in the comparison form or book a free call with André Disselkamp. Have your policy ready before your first day in Germany.