Comparison · Health insurance
Public vs private health insurance in Germany
Statutory insurance charges a percentage of income and covers dependants at no extra cost; private insurance prices by age and health and charges per insured person. Most employees are in the statutory system by default. The important part is that switching from private back to statutory is restricted, so this is a long-term decision.
Last verified: 19 September 2026 · First weeks
At a glance
- Statutory (GKV)
- Contribution based on income, up to a ceiling
- Private (PKV)
- Premium based on age, health and chosen cover
- Dependants
- Often covered free in the statutory system; priced individually in private
- Who may choose
- Higher earners above a statutory threshold, self-employed, some others
- Reversibility
- Returning to statutory insurance is restricted
Side by side
| Statutory (GKV) | Private (PKV) | |
|---|---|---|
| Contribution basis | Percentage of income up to a ceiling | Individual premium by age, health and cover |
| Family members | Non-earning dependants often included | Each person insured and priced separately |
| Core benefits | Defined by law, largely identical between insurers | Defined by the contract you sign |
| Access | Open to employees below and above the threshold | Restricted to specific groups |
| Costs over time | Move with income | Can rise with age and medical inflation |
| Switching back | — | Restricted, especially later in working life |
| Paperwork | Card-based, mostly direct billing | Often pay-then-reimburse |
Who actually has a choice
Most employees are insured in the statutory system automatically. A choice arises mainly for higher earners above the statutory threshold, the self-employed, certain civil servants and some students. Which group you fall into is a question of your own income and status, and the thresholds are adjusted periodically — check the current figure rather than a number from an older article.
If you do not clearly belong to a group that may opt out, the decision is already made for you, and the practical question becomes which statutory insurer to join.
What newcomers often underweight
- Family plans: a partner and children can change the cost comparison substantially.
- Age: a premium that looks cheap at 30 is not the premium you pay at 55.
- Reversibility: the restriction on returning to statutory insurance is the part that cannot be undone.
- Administration: private cover often means paying the doctor and claiming back.
- Residence permit evidence: both can satisfy the requirement, but the office wants a confirmation document either way.
This is a personal financial decision
The right answer depends on income stability, family plans, health history and how long you intend to stay. Burokrat can lay out the process and the documents, but the choice itself deserves individual advice from an insurer or an independent adviser before you sign.
Common mistakes
- Choosing on the monthly premium alone without considering age or family.
- Assuming a switch back to statutory insurance will be possible later.
- Leaving a gap in cover while comparing options.
What happens next
- You enrol and receive a membership confirmation or insurance card.
- Your employer registers you with the insurer through payroll.
- The confirmation is used for the residence permit and, where relevant, university enrolment.
How Burokrat helps
Workflow support
Reading the answer is the first half. Burokrat turns it into a tracked workflow:
- A personalized step-by-step path for your situation
- A document checklist that shows what is still missing
- Progress tracking across connected tasks
- Reminders for deadlines and appointment dates
- Source-cited guidance, with the official page behind each step
- Trusted partner discovery where a professional is genuinely needed
Burokrat covers the process and documents; the choice itself needs personal advice.
Related questions
- Can I switch statutory insurers?
- Yes, within the statutory system, subject to notice and binding periods. Core benefits are set by law, so the differences are in additional contributions and services.
- Which one do immigration offices accept?
- Both can satisfy the requirement, as long as the cover is adequate for your stay. The office assesses the confirmation you present.
- What about my family if I go private?
- Each family member is normally insured and priced individually, which is the largest single cost difference for families.
Official sources
Last verified: 19 September 2026
This page is general information about a German administrative process. It is not legal, tax or immigration advice and it does not replace a decision by the responsible authority. Rules, fees and processing times change, and practice differs between cities and offices — always check the official source linked above for your own case.
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