Public vs Private Health Insurance in Germany
The German health insurance system
Germany requires all residents to have health insurance. There are two main systems: public (gesetzlich) and private (privat). Your choice affects costs, coverage, and doctor access.
Public health insurance
Who must use it
Employees earning under €66,600/year (2024 limit). Students under 30. Most workers automatically enroll.
How it works
Premium is about 14.6% of gross salary, split between employer and employee. Covers spouse/children at no extra cost.
Main providers
- TK (Techniker Krankenkasse)
- AOK
- Barmer
Private health insurance
Who can choose it
Employees earning over €66,600/year. Self-employed. Civil servants. Some students over 30.
How it differs
Premiums based on age/health, not income. Often provides faster specialist access but higher out-of-pocket costs.
Key differences
- Public: Standard coverage for all
- Private: More flexible plans
- Public: Family coverage included
- Private: May require health checks
Switching between systems
Moving from public to private is usually permanent for employees. Private to public requires meeting specific conditions.
