Health Insurance in Germany

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Health insurance is one of the most important forms of coverage in Germany. Everyone who lives or works in Germany must have health insurance. Health insurance covers the costs of doctor’s visits, hospital stays, medications, and many other medical services.

The Two Types of Health Insurance

There are two health insurance systems in Germany:

1. Statutory Health Insurance (GKV)

Statutory health insurance is the most common form of coverage. About 90% of the population is covered by statutory health insurance.

Features of statutory health insurance:

• Mandatory coverage for most employees.
• Premiums are based on income and are paid jointly by the employer and the employee.
• Spouses and children without their own income can often be covered free of charge through family insurance.
• Health insurance providers cover the costs of medical treatments, hospital stays, and many medications. Small copayments apply for some services.

Among the best-known statutory health insurance providers are AOK, Techniker Krankenkasse (TK), and Barmer.

2. Private Health Insurance (PKV)

Private health insurance is primarily available to self-employed individuals, civil servants, and high-income employees.

Key features of private health insurance:

• Premiums are not based on income, but rather on age, health status, and the selected coverage.
• Each family member needs their own insurance policy.
• Private health insurance often offers more comprehensive coverage, though premiums can rise significantly with age.

Who is automatically covered by statutory health insurance?

The following are generally automatically covered by statutory health insurance:

• Employees whose income is below the applicable annual income threshold.
• Apprentices and many interns.
• Students up to age 30 or through the 14th semester of study.
• Retirees who meet the eligibility requirements.
• Unemployed individuals receiving unemployment benefits.
• Children and spouses without their own income, covered under family insurance.

Self-employed individuals and employees with an income above the mandatory insurance threshold must choose their own health insurance and enroll in a timely manner.

Health Insurance for EU Citizens

Citizens of Romania and other EU member states are generally required to have health insurance in Germany.

For Temporary Stays

Those staying in Germany only temporarily—for example, as tourists or posted workers—generally remain covered by health insurance in their home country. With the European Health Insurance Card (EHIC), you can receive medically necessary treatment in Germany.

For a longer stay or residence in Germany

Anyone who moves to Germany permanently or works here is generally subject to the German health insurance requirement.

• Employees are usually automatically covered by statutory health insurance.
• Self-employed individuals and certain other groups must obtain statutory or private health insurance on their own.
• Under certain conditions, social benefits may also provide health insurance coverage.

Registering with a Health Insurance Provider

If you start a job in Germany, you should register with a health insurance provider before you begin work. Your employer needs this information to register you for social insurance.

What happens when you move abroad?

Anyone who leaves Germany permanently and deregisters their residence is generally no longer subject to the German health insurance requirement. However, it is important to take out health insurance in your new country of residence immediately so that you do not lose your insurance coverage.

What happens if you don’t have health insurance?

Since health insurance is mandatory by law in Germany, not having health insurance can have serious consequences.

High Medical Costs

Without health insurance, you must pay the full cost of doctor’s visits, medications, and hospital stays yourself. Even a simple treatment can cost several hundred euros, and major surgeries can cost several thousand euros.

Retroactive Payments

If you don’t re-enroll in insurance until later, you’ll often have to pay premiums retroactively for the period you were uninsured. Late payment penalties may also apply.

Financial Problems

These retroactive payments can lead to significant debt. In some cases, this may result in collection proceedings or wage garnishment.

Limited Benefits

Without health insurance, you are not entitled to many benefits, such as sick pay or medical rehabilitation services.

Difficulties in Obtaining Insurance Later

Especially with private health insurance, getting coverage later on can be difficult or may only be possible under special conditions.

We’re here to help

Our service and interpreting agency supports Romanian clients with all questions regarding health insurance in Germany. We help you choose a health insurance provider, fill out forms, and communicate with health insurance providers and government agencies—reliably and in your language.

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