Public or Private Health Insurance in Germany – What’s Better for Expats?

Moving to Germany comes with a lot of paperwork – and one of the most important decisions you’ll make is choosing between public (GKV) and private (PKV) health insurance. But which system is right for you as an expat? In this guide, we’ll break it all down – in plain English.

What’s the Difference Between Public and Private Health Insurance in Germany?

Germany has a dual healthcare system:

• Public health insurance (Gesetzliche Krankenversicherung / GKV) is run by nonprofit providers and funded through income-based contributions.
• Private health insurance (Private Krankenversicherung / PKV) is provided by private companies and offers more flexibility, but you need to meet certain criteria to qualify.

Who Can Choose Private Health Insurance?

Not everyone in Germany is eligible for private health insurance. You can consider PKV if you are:

• An employee earning over €69,300/year (2024 threshold: €66,600)
• Self-employed or freelance (regardless of income)
• A civil servant (Beamter)
• A student under 30 (or a PhD student not working full-time)

If none of the above applies, you’ll likely stay in the public system – and that’s okay, too! But if you do have the choice, it’s worth comparing.

Key Differences at a Glance

Why Many Expats Choose Private Health Insurance

For high earners and self-employed expats, private health insurance can be more cost-efficient and offer much better services. Some of the most common reasons our clients switch to PKV:

• Lower premiums for healthy individuals (especially if single and under 40)
• Access to top-tier medical care
• Better hospital conditions and faster treatment
• Customizable plans based on personal needs

💡 Bonus: PKV providers often offer incentives for staying healthy – like cash-back if you don’t submit claims for a year.

When Public Insurance Might Be the Better Fit

Public insurance can still be the better option if:

• Your income is low or irregular
• You have a spouse and multiple kids, none of whom are working
• You’re dealing with pre-existing conditions that may lead to higher private premiums

Can You Switch from GKV to PKV Later?

Yes – but only under certain conditions. If you’re an employee, your income must remain above the yearly threshold (JAEG) for at least a year. For freelancers, you can switch anytime, but should plan ahead to avoid gaps in coverage.

We’ve created a quick Eligibility Check Tool to help you figure out if switching makes sense for you.

Final Thoughts: What’s Right for You?

There’s no one-size-fits-all answer. The right system depends on your income, family status, health, and future plans in Germany.

As independent health insurance brokers, we help expats find the best option – 100% objective, in English, and at no cost to you.