Gesetzliche Krankenversicherung (GKV)

What is the GKV?

The Gesetzliche Krankenversicherung (GKV) is Germany's statutory, public, health insurance system. Around 88 % of the German population is insured through it, across roughly 90 individual Krankenkassen (health funds) that all deliver the same legally defined coverage at similar cost. The legal basis is the entire 5th book of the Sozialgesetzbuch (SGB V).

It is compulsory for employees earning below the JAEG threshold (€77,400 gross per year in 2026). Above the JAEG, employees may choose between staying in the GKV voluntarily or switching to the PKV. Freelancers and self-employed can join the GKV voluntarily or choose the PKV at any income.

How the contribution works

The GKV runs on a pay-as-you-go (Umlageverfahren) model: this year's contributions pay this year's bills. Contributions are a percentage of gross income, not based on age or health.

For 2026:

• 14.6 %, general contribution rate (§ 241 SGB V, unchanged since 2015)

• +2.9 %, average Zusatzbeitrag across all funds (each fund sets its own rate within a narrow band)

• Total: 17.5 % of gross income, up to the BBG of €69,750/year

• Employer pays half; employee pays the other half. Zusatzbeitrag is also split 50/50 since 2019

Maximum monthly contribution in 2026 (KV only, at the BBG):

• Combined: ca. €1,017 per month

• Employee share: ca. €509 per month

• Employer share: ca. €509 per month

Add roughly €209 for the mandatory Pflegeversicherung (with children) and this is the full GKV maximum burden. See the Beitragsbemessungsgrenze entry for the full breakdown.

What the GKV covers

Standard coverage across all Krankenkassen includes:

• Doctor and specialist visits

• Prescription medication (with a small co-payment)

• Hospital stays (general ward, no chief-physician access)

• Dental: basic treatment fully covered; dental prosthetics with variable subsidies depending on the Bonusheft (patient bonus booklet) record

• Preventive check-ups and vaccinations (STIKO-recommended)

• Sick pay (Krankengeld) from week 7 after the employer's 6-week wage continuation

• Free co-insurance for non-earning spouses (below €565/month in 2026) and children

Individual Krankenkassen can offer additional services on top, homeopathy, professional teeth cleaning, health apps, but the baseline is legally identical.

Key differences to the PKV

• Income-based, not risk-based: A 55-year-old pays the same rate as a 25-year-old if their income is the same

• No underwriting: Acceptance is automatic, no Gesundheitsprüfung

• Family co-insurance: Built in and free for eligible dependants

• Fewer comfort upgrades: Standard ward, no chief physician, no single-room entitlement

• Contributions rise with income: At higher salaries, GKV becomes more expensive in absolute terms, but only up to the BBG, then it plateaus

Is the GKV cheaper than the PKV?

It depends almost entirely on your profile. A single, high-earning professional in good health typically pays less overall in the PKV. A family of four with one earner and a stay-at-home spouse typically pays less in the GKV. See the PKV entry for a fuller comparison.

The frequently repeated claim that "GKV contributions are stable, PKV premiums keep rising" does not match the data. Over 2005-2025, GKV contribution growth at the top of the pay scale was marginally faster than average PKV premium growth (WIP-Analyse 2005-2025). Both systems face the same underlying cost pressure; they just distribute it differently.