How much does health insurance cost in Germany?

What does each system cost per month in 2026?

In 2026 public health insurance in Germany costs 21.1% of gross income for someone with children and 21.7% for someone childless, including compulsory long-term care cover, capped at €1,226 to €1,261 a month. Private cover is priced per person rather than by income, commonly €300 to €650 a month for a healthy applicant.

The two columns are not really comparable as prices, because they answer different questions. One is a share of what you earn. The other is a price for a defined set of benefits. Which comes out lower depends far more on your household than on the insurers.

What does public health insurance (GKV) really cost?

Public cover is a percentage of gross income, not a price for a product. In 2026 the total is 21.1% for members with children and 21.7% for members without, and both figures already include the compulsory long-term care contribution (Pflegepflichtversicherung). Any figure quoted as 14.6% or 17.5% has left something out.

Three things then shape what you actually pay.

The cap. Contributions are charged only on income up to the Beitragsbemessungsgrenze, which is €5,812.50 a month in 2026. Everything above that line is contribution free. This is why the public system has a maximum: €1,261 a month childless, €1,226 with children. Someone earning €200,000 pays exactly the same as someone earning €70,000. In 2027 the cap is set to rise to €6,375 a month; what changes in 2027 shows the new maximum.

The split. Employees do not carry that alone. The employer pays roughly half, so the figure on a payslip is about €613 to €631 at the cap rather than the full amount. The split is close to even but not exactly even, because the employer does not share every component equally.

Self-employment. Freelancers and the self-employed pay both halves themselves, which is what makes the public system expensive for them rather than the rate itself. There is also a floor: contributions are calculated on a minimum assessment base of €1,318.33 a month in 2026 even if you earned less, so a quiet year does not produce a small bill. The base is not your turnover but your profit, and alongside it the fund counts other income such as rent and investments, because the law asks it to look at your whole economic capacity.[1] Getting the estimate wrong has consequences of its own, which is a trap worth reading about separately.

For the full step by step, see how GKV calculates your premium, or put your own salary into the GKV calculator.

What does private health insurance (PKV) really cost?

A private premium has no income input at all. It is calculated at signing from five things: your age at entry, your health at underwriting, the scope of the tariff, the deductible you accept, and any optional add-ons. In 2026 a healthy applicant in comprehensive cover commonly pays €300–€400 a month at age 25 to 30 and €450–€650 a month at age 35 to 40.

Entry age is the factor worth acting on. The age you join at is fixed for the life of the contract. A healthy 28 year old might join at around €380 a month; the same cover for a 42 year old new entrant could be €550 to €650. Read that as a price list by entry age, not as a forecast of your own future bill. Joining at 42 costs more than joining at 28, but nobody's premium climbs from €380 to €600 because they had birthdays.

One thing the ranges above do not include: Krankentagegeld, the daily allowance that replaces income while you are ill. Employees usually need it, because private cover has no equivalent of statutory sick pay, and it is a separate premium on top. The ranges do include the statutory surcharge on the health-cover premium, which is what the worked example below breaks out.

The deductible is the lever you set yourself. Moving from no Selbstbeteiligung to €600 a year typically takes 10 to 15% off the premium, and €1,200 a year can take 20 to 25% off. That only works in your favour if you would genuinely absorb a bad year: at €1,200 you are betting roughly €1,000 of annual saving against €1,200 of worst case exposure. It suits someone with reserves and not someone without. Which costs the deductible applies to depends on the tariff. Some apply it to outpatient treatment only and leave hospital cover untouched, others run across everything up to an annual amount, so the headline number is not the whole story.

Two profiles are priced outside these ranges. Civil servants need only a top-up covering the 30 to 50% their Beihilfe does not, which typically lands at €150 to €300 a month. Applicants with a documented chronic condition may see a risk surcharge of 20 to 100% on the base premium, or a permanent exclusion for treatment related to that condition. Both are decided at underwriting, and both can be tested anonymously before any formal application is made.

What actually leaves your account

The quoted premium and the amount you pay are two different numbers. For an employee, three adjustments sit between them.

The figures are illustrative of mid-range comprehensive cover and are not a quote. The structure is not illustrative: the statutory surcharge[2] and the care component are always in there, and the employer subsidy always covers half of the premium, up to €613.22 a month in 2026 and €584.15 in Sachsen.[3] It is tax free,[4] and any unused portion can go towards privately insured family members.

Which costs do people forget?

Four, reliably.

Long-term care insurance. Compulsory in both systems, and the single most common omission from a quoted figure. Every total in this article includes it. The one place it is shown separately is the worked example below, where the private premium is broken into its parts on purpose.

How the premium behaves later. Private premiums are not fixed for life; they are recalculated when claims costs across a tariff move. Part of every premium goes into an ageing reserve (Altersrückstellung) built precisely to cushion that, and there are levers to prepare for it. What matters at the point of choosing is that the year one figure is not a lifetime figure, in either system. The long view on private premiums in retirement is a separate calculation and worth doing before you sign, not after.

The family arithmetic. This is the one that reverses the answer most often. Public cover includes non-earning spouses and children through Familienversicherung at no additional contribution. Private cover charges a premium per person, typically €150–€250 a month per child in 2026. A single earner comparing €600 privately against €700 publicly is comparing the wrong pair of numbers if there are three other people to insure: two children alone can add €300 to €500 a month on the private side and nothing at all on the public one. The family comparison sets that out properly.

Gross versus net. Almost every premium quoted socially is the gross one, before the employer's half. Almost every public percentage quoted socially is the total, including the employer's half. People routinely compare one system's gross figure against the other's net.

GKV or PKV: how do you run your own numbers?

Start with the side that is arithmetic rather than judgement. Your public contribution is fully determined by your income, so put your gross salary into the GKV calculator and you have one of the two numbers exactly, with no estimate involved.

The private side cannot be calculated the same way, because it depends on your health at underwriting, and that is assessed rather than computed. A realistic private figure comes from an anonymous pre-inquiry, which tests what insurers would actually offer someone with your history without creating a formal application in your name. That distinction matters more than it sounds, and it is covered in what happens to a declined application.

Then compare the two properly:

1. Use net against net, or gross against gross. Not one of each.
2. Count every person who needs cover, not only yourself.
3. Run it at a later age too, not only at today's.
4. Check whether you may even choose. Employees below the income threshold of €77,400 in 2026 do not have the option, whatever the numbers say. Who can choose is a separate question from what it costs.

Cost is the input that people research first and the one that decides fewest cases on its own. A private premium that looks good at 30 and a public contribution that looks high at 30 can both be the wrong basis for a decision that is difficult to reverse after 55.

If you want your own two numbers rather than these ranges, book a free 30-minute call. We run an anonymous pre-inquiry as a matter of course, so you see realistic private terms without anything going on record.