Health Insurance in Germany: All Your Options Compared
See how public insurance (GKV), private insurance (PKV), and incoming cover stack up across the categories that matter most to expats.
13 Categories Compared
A detailed breakdown of how GKV and PKV stack up against each other in every important area of health coverage.
Income-based: 14.6% + ~1.7% supplementary rate, split with employer. Maximum contribution ~€450/month for employees.
Risk-based: depends on age, health, and chosen coverage level. Typically €350-700/month. Employer contributes up to ~€403/month.
GKV is cheaper for lower incomes and families with non-working dependents. PKV can be cheaper for young, healthy individuals and high earners.
Access to all GKV-contracted doctors. Referrals often needed for specialists. Some private-only practices not accessible.
Access to all doctors including private-only specialists. No referrals needed. Priority treatment common.
PKV members enjoy unrestricted doctor access, including top specialists who only accept private patients. This is a significant advantage in cities with high demand.
Longer wait times for specialist appointments, typically 3-6 weeks. Emergency care is always immediate.
Significantly shorter wait times. Specialist appointments often within days. Preferred scheduling at many practices.
Private patients typically receive appointments 2-4x faster than public patients due to higher reimbursement rates for doctors.
Standard ward (shared rooms, 3-4 beds). Treatment by assigned doctor. Limited hospital choice based on GKV contracts.
Private or semi-private rooms. Chief physician (Chefarzt) treatment. Free choice of any hospital, including private clinics.
PKV offers superior hospital comfort and access to senior specialists. Chief physician treatment ensures the most experienced doctors handle your care.
Basic coverage: ~60% of standard treatments, up to 75% with regular checkup bonus. Implants and premium prosthetics mostly out of pocket.
Comprehensive coverage: typically 80-100% for most dental work including implants, crowns, and orthodontics depending on tariff.
PKV dental coverage is substantially better, often covering expensive procedures like implants that GKV barely supports.
Coverage available but very long wait times (3-6 months for therapy start). Limited to approved therapy methods. 50-80 sessions covered.
Faster access to therapists. Coverage varies by tariff but generally broader. Many tariffs cover alternative therapy approaches.
While both systems cover mental health, PKV advantage lies in faster access and broader therapy method coverage.
Co-payment of €5-10 per prescription. Some medications not covered. Generic substitution required where available.
Full coverage of prescribed medications in most tariffs. No mandatory generic substitution. Brand-name drugs covered.
PKV prescription coverage is more comprehensive with fewer out-of-pocket costs and no forced generic substitutions.
Very limited: glasses only covered for severe prescriptions (above 6 diopters) or children. No routine eye exams covered.
Generous coverage for glasses, contact lenses, and regular eye exams. Allowances of €200-400 per year common.
GKV vision coverage is minimal for adults. PKV offers meaningful support for corrective eyewear and preventive eye care.
Standard health checkups covered at defined intervals. Cancer screenings by age. Vaccination coverage for recommended vaccines.
Comprehensive preventive care with more frequent checkups. Executive health screenings. Broader vaccination coverage including travel vaccines.
PKV offers more generous preventive care options beyond the standard GKV screening schedule.
Free co-insurance for non-working spouse and children (Familienversicherung). One premium covers the whole family.
Each family member needs their own policy. Children ~€100-150/month each. Non-working spouse needs separate coverage.
GKV family co-insurance is a major advantage for single-income families. PKV costs multiply with each family member.
Limited to EU/EEA countries via EHIC. No coverage outside Europe. Separate travel insurance needed for non-EU destinations.
Worldwide coverage typically included for 1-6 months. Some tariffs offer permanent worldwide coverage. Better for frequent travelers.
PKV international coverage is far superior, making it ideal for expats who travel frequently or maintain connections abroad.
Easy to switch between GKV providers. Can always return to GKV (if under 55 and meeting income conditions). Simple process.
Switching between PKV providers loses aging reserves. Return to GKV is very difficult after age 55. Long-term commitment.
GKV offers much more flexibility. The difficulty of returning from PKV to GKV is a critical consideration, especially after age 55.
Costs rise with income up to the ceiling. Stable in retirement with pension-based contributions. Predictable.
Premiums increase with age, though aging reserves help. Can become expensive in retirement without careful planning. Tariff optimization possible.
GKV costs are more predictable long-term. PKV requires active management and planning, but tariff optimization can help control costs.
Monthly Cost
Income-based: 14.6% + ~1.7% supplementary rate, split with employer. Maximum contribution ~€450/month for employees.
Risk-based: depends on age, health, and chosen coverage level. Typically €350-700/month. Employer contributes up to ~€403/month.
GKV is cheaper for lower incomes and families with non-working dependents. PKV can be cheaper for young, healthy individuals and high earners.
Doctor Access
Access to all GKV-contracted doctors. Referrals often needed for specialists. Some private-only practices not accessible.
Access to all doctors including private-only specialists. No referrals needed. Priority treatment common.
PKV members enjoy unrestricted doctor access, including top specialists who only accept private patients. This is a significant advantage in cities with high demand.
Wait Times
Longer wait times for specialist appointments, typically 3-6 weeks. Emergency care is always immediate.
Significantly shorter wait times. Specialist appointments often within days. Preferred scheduling at many practices.
Private patients typically receive appointments 2-4x faster than public patients due to higher reimbursement rates for doctors.
Hospital Choice
Standard ward (shared rooms, 3-4 beds). Treatment by assigned doctor. Limited hospital choice based on GKV contracts.
Private or semi-private rooms. Chief physician (Chefarzt) treatment. Free choice of any hospital, including private clinics.
PKV offers superior hospital comfort and access to senior specialists. Chief physician treatment ensures the most experienced doctors handle your care.
Dental Coverage
Basic coverage: ~60% of standard treatments, up to 75% with regular checkup bonus. Implants and premium prosthetics mostly out of pocket.
Comprehensive coverage: typically 80-100% for most dental work including implants, crowns, and orthodontics depending on tariff.
PKV dental coverage is substantially better, often covering expensive procedures like implants that GKV barely supports.
Mental Health
Coverage available but very long wait times (3-6 months for therapy start). Limited to approved therapy methods. 50-80 sessions covered.
Faster access to therapists. Coverage varies by tariff but generally broader. Many tariffs cover alternative therapy approaches.
While both systems cover mental health, PKV advantage lies in faster access and broader therapy method coverage.
Prescriptions
Co-payment of €5-10 per prescription. Some medications not covered. Generic substitution required where available.
Full coverage of prescribed medications in most tariffs. No mandatory generic substitution. Brand-name drugs covered.
PKV prescription coverage is more comprehensive with fewer out-of-pocket costs and no forced generic substitutions.
Vision Care
Very limited: glasses only covered for severe prescriptions (above 6 diopters) or children. No routine eye exams covered.
Generous coverage for glasses, contact lenses, and regular eye exams. Allowances of €200-400 per year common.
GKV vision coverage is minimal for adults. PKV offers meaningful support for corrective eyewear and preventive eye care.
Preventive Care
Standard health checkups covered at defined intervals. Cancer screenings by age. Vaccination coverage for recommended vaccines.
Comprehensive preventive care with more frequent checkups. Executive health screenings. Broader vaccination coverage including travel vaccines.
PKV offers more generous preventive care options beyond the standard GKV screening schedule.
Family Coverage
Free co-insurance for non-working spouse and children (Familienversicherung). One premium covers the whole family.
Each family member needs their own policy. Children ~€100-150/month each. Non-working spouse needs separate coverage.
GKV family co-insurance is a major advantage for single-income families. PKV costs multiply with each family member.
International Coverage
Limited to EU/EEA countries via EHIC. No coverage outside Europe. Separate travel insurance needed for non-EU destinations.
Worldwide coverage typically included for 1-6 months. Some tariffs offer permanent worldwide coverage. Better for frequent travelers.
PKV international coverage is far superior, making it ideal for expats who travel frequently or maintain connections abroad.
Switching Flexibility
Easy to switch between GKV providers. Can always return to GKV (if under 55 and meeting income conditions). Simple process.
Switching between PKV providers loses aging reserves. Return to GKV is very difficult after age 55. Long-term commitment.
GKV offers much more flexibility. The difficulty of returning from PKV to GKV is a critical consideration, especially after age 55.
Long-term Cost Trajectory
Costs rise with income up to the ceiling. Stable in retirement with pension-based contributions. Predictable.
Premiums increase with age, though aging reserves help. Can become expensive in retirement without careful planning. Tariff optimization possible.
GKV costs are more predictable long-term. PKV requires active management and planning, but tariff optimization can help control costs.
Which Option Fits Your Situation?
The best choice depends entirely on your personal situation. Here is a quick guide.
GKV Is Better For
- Families with non-working spouses and children
- Employees earning under the JAEG threshold (€77,400)
- People who value flexibility to switch providers easily
- Those planning to stay in Germany long-term into retirement
- People with pre-existing conditions (no medical underwriting)
PKV Is Better For
- High earners (above JAEG) who are young and healthy
- Self-employed and freelancers without family dependents
- Civil servants (Beamte) who receive Beihilfe subsidies
- People who want premium medical care and shorter wait times
- Expats who need strong international coverage
Incoming Insurance Is Best For
- New arrivals in Germany during their first months
- Expats waiting for work contracts or residence permits
- Job seekers or language course students
- People who need immediate cover before enrolling in GKV or PKV
- Short-term stays (under 5 years) without long-term plans
Need Help Deciding?
Take our quick assessment to find which insurance type fits your situation, or read through our detailed guide covering GKV, PKV, and incoming options.