# Which Health Insurance Do You Need in Germany? (2026) > GKV or PKV: who is allowed which, what it costs and how you join. Statutory funds, private substitute cover, supplementary add-ons and the routes for students and the self-employed. By Jules de Bruin · URL: https://www.guide-germany.com/insurance/health-insurance **The verdict** Health cover is **mandatory** in Germany, and there is no tax-funded service that covers you by default. The system splits into the **GKV**, the statutory funds, and the **PKV**. On the catalogue's reference profile the GKV runs from **EUR 377.65/month** to **EUR 386.57/month**. **Who may join which, and what is paid** Which one you may join is decided by **income**, **employment status** and **profession**. In the GKV the contribution is **14.6 percent** of gross income plus a fund-specific **Zusatzbeitrag**, and it is split with your employer. The PKV is private substitute cover, rated on your entry age and state of health. ## Is health insurance mandatory in Germany? Yes. Everyone resident in Germany must hold health cover. Proof of it is required for a [residence permit](/moving/proof-of-funds) and for [university enrolment](/moving/student-visa), and an employment contract cannot be registered cleanly without it. This is where Germany differs from countries with a tax-funded national health service: there is no baseline you are born or moved into. You are either a member of a statutory fund or fully privately insured, and there is nothing in between. Until you reach one of the two systems, [incoming cover](/insurance/travel-insurance) fills the gap. It is designed as a bridge and the catalogue is explicit that it does not substitute for the statutory cover regular employment requires. [Health cover for your first weeks→](/insurance/health/best-for-new-arrivals) ## What is the difference between GKV and PKV? PKV is not an addition to the GKV, it is a substitute for it. Someone with full private cover is not simultaneously a statutory member. Moving back is tied to narrow conditions, which makes this the most consequential decision in the whole vertical. ### GKV, the statutory funds - Contribution as a percentage of gross income: 14.6 percent plus the fund's own Zusatzbeitrag - Split half and half with your employer - No health questions, no risk surcharges, no exclusions, no waiting period - A non-earning partner and children co-insured at EUR 0 - 17 funds in the catalogue, and the choice between them is free ### PKV, private substitute cover - Premium rated on entry age and state of health, independent of salary - Full underwriting, with surcharges or exclusions possible - Waiting periods typically of 3 and 8 months - A private room and chief-physician treatment in the upper tariffs - 15 insurers in the catalogue, and every person pays a separate premium Which system you may join is not a matter of preference: employees below the compulsory-insurance threshold are statutory members by law, while civil servants, the self-employed and employees above the threshold may go private. Within the GKV, however, the choice of fund is entirely free, and that is the lever most arrivals overlook. ## Which statutory fund is cheapest in 2026? Every statutory fund pays the same benefit catalogue, so they differ almost only in their Zusatzbeitrag and their service. The three below sit on the catalogue's shared reference profile and are therefore directly comparable. BKK firmus ### BKK firmus 4.52.18%, Germany's cheapest Zusatzbeitrag 2026 [Go to BKK firmus](https://www.bkk-firmus.de)Monthly contributionEUR 377.65/monthWaiting period?Waiting period The gap between signing and the day cover starts. Anything that appears during it is never paid, not even later, so shorter is better. NonePrivate room and chief physicianNoDentalbasic statutoryEnglish supportlimitedMore detailsReference profileReference profile; Zusatzbeitrag 2.18%, lowest of all 93 funds 2026 (guaranteed stable for 2026); student ~EUR 141.93/moPre-existing conditionsFull cover, open enrolmentPremium varies byincomeBinding period12 monthsClaimsapp, eGKPrices as of August 2026, verify on the provider site. Pros - **2.18%**, Germany's cheapest Zusatzbeitrag 2026 - Rate guaranteed stable through 2026 Cons - Open in 10 of 16 states only (not SH, RP, Saarland, Thuringia, MV, Berlin) - German-only service Best for Anyone in one of its open states who is optimising the contribution alone hkk ### hkk Krankenkasse (Handelskrankenkasse) 4.42.59%, cheapest Ersatzkasse 2026 [Go to hkk](https://www.hkk.de)Monthly contributionEUR 384.82/monthWaiting period?Waiting period The gap between signing and the day cover starts. Anything that appears during it is never paid, not even later, so shorter is better. NonePrivate room and chief physicianNoDentalbasic statutoryEnglish supportlimitedMore detailsReference profileReference profile; Zusatzbeitrag 2.59% since 01.01.2026, cheapest of the six nationwide ErsatzkassenPre-existing conditionsFull cover, open enrolmentPremium varies byincomeBinding period12 monthsClaimshkk app, eGKPrices as of August 2026, verify on the provider site. Pros - **2.59%**, cheapest Ersatzkasse 2026 - Nationwide open to everyone Cons - German-only website and documents - Limited English phone support Best for Anyone wanting a nationwide fund that is still cheap Techniker Krankenkasse ### Techniker Krankenkasse (TK) 4.8Cheapest large fund: Zusatzbeitrag 2.69% (2026), below 2.9% average [Go to TK](https://www.tk.de)Monthly contributionEUR 386.57/monthWaiting period?Waiting period The gap between signing and the day cover starts. Anything that appears during it is never paid, not even later, so shorter is better. NonePrivate room and chief physicianNoDentalbasic: check-ups, amalgam/composite fillings, fixed 60-65% subsidy on dentures (Festzuschuss)English supportYesMore detailsReference profileEmployee, 30, childless, EUR 3,500/mo gross: employee share KV 302.58 + PV 84.00 at Zusatzbeitrag 2.69% (2026). Income-based: 8.645% KV + 2.4% PV of gross up to BBG EUR 5,812.50/moPre-existing conditionsCovered in full; no health questions, no risk surcharges, no exclusions (statutory open enrolment)Premium varies byincome (only), chosen Wahltarif optional rebate plans, childless PV surchargeBinding period12 monthsClaimsapp (TK-App), online portal, eGK card at point of care (Sachleistung, no upfront payment)Prices as of August 2026, verify on the provider site. Pros - Cheapest large fund: Zusatzbeitrag **2.69%** (2026), below **2.9%** average - 12.26 million members, Germany's largest fund Cons - Dental prosthetics only 60-**65%** fixed subsidy - No private hospital room or chief-physician cover Best for Anyone who needs service and documents in English These figures are not prices. They are the contribution on a single gross income, and they move with your salary. The only thing genuinely comparable between funds is the Zusatzbeitrag. ## Which private health insurer fits? Unlike the statutory funds, these three premiums are NOT comparable with one another. Each applies to a different profile: a different entry age, a different tariff, and in Debeka's case a civil servant with a 50 percent Beihilfe subsidy. Read the reference profile row before you place two figures side by side. HanseMerkur Krankenversicherung ### HanseMerkur private Krankenversicherung (impuls / professional tariffs) 4.2Competitive young-entry premiums [Get a HanseMerkur quote](https://www.hansemerkur.de)Monthly contributionEUR 223/monthWaiting period?Waiting period The gap between signing and the day cover starts. Anything that appears during it is never paid, not even later, so shorter is better. 3/8Private room and chief physicianupper tiersDentalby tierEnglish supportlimitedMore detailsReference profile27-year-old employee, employee share after employer subsidy: ~EUR 223/mo; 35-year-old ~EUR 271/mo (impuls broker publication, 2026)Pre-existing conditionsFull underwritingPremium varies byentry age, health, tier, deductibleBinding period12 monthsClaimsappPrices as of August 2026, verify on the provider site. Pros - Competitive young-entry premiums - Premium refunds up to **EUR 800**/year Cons - Agent/broker distribution - German-first Best for Young employees entering early Debeka Krankenversicherungsverein ### Debeka Krankenversicherung (tariffs B/BC/WL + B-EASY; Beamte specialist) 4.3Largest PKV insurer, ~2.5M fully insured [Get a Debeka quote](https://www.debeka.de)Monthly contributionEUR 246.21/monthWaiting period?Waiting period The gap between signing and the day cover starts. Anything that appears during it is never paid, not even later, so shorter is better. 3/8 standardPrivate room and chief physicianyes (100% Chefarzt in KomfortPlus)Dentalyes 90% in KomfortPlusEnglish supportlimitedMore detailsReference profile30-year-old Beamter with 50% Beihilfe, tariffs B30/B20K/WL30/WL20K/BC incl. PVN: EUR 246.21/mo (2026 market publication); B-EASY entry tariff for young Beamtenanwärter from ~EUR 44/mo. Full 100% tariffs for non-Beamte rated individually (~EUR 400-600 at 30-35)Pre-existing conditionsFull underwritingPremium varies byentry age, health, Beihilfe share (50-80%), tierBinding period12 monthsClaimsMeine Debeka appPrices as of August 2026, verify on the provider site. Pros - Largest PKV insurer, ~2.5M fully insured - Beamte specialist with 50-**80%** Beihilfe fit Cons - Preventive check-ups void the premium refund (unique quirk) - Employee full tariffs less competitive than Beamte tariffs Best for Civil servants and trainees with a Beihilfe entitlement ottonova Krankenversicherung ### ottonova Krankenversicherung (full PKV, digital-first) 4.5Full English app, contracts and support [Get a ottonova quote](https://www.ottonova.de)Monthly contributionEUR 264.54/monthWaiting period?Waiting period The gap between signing and the day cover starts. Anything that appears during it is never paid, not even later, so shorter is better. 3/8 (often waived)Private room and chief physicianKomfort/PremiumDental80-100% by tierEnglish supportYesMore detailsReference profile30-year-old employee, Komfort tariff BC100-10 incl. PVN, after 50% employer subsidy: EUR 264.54/mo net (Verivox 03/2025); gross ~EUR 529. ottonova publishes live quotes online per age/healthPre-existing conditionsFull digital underwriting; surcharges possible (example published: 10% surcharge case)Premium varies byentry age, health, tier (Smart/Komfort/Premium), deductible 10-100%Binding period12 monthsClaimsottonova app (invoice photo, 48h target)Prices as of August 2026, verify on the provider site. Pros - Full English app, contracts and support - 48-hour reimbursement target Cons - Young insurer (founded 2015), less aging-reserve history - Premium adjustments follow medical inflation like all PKV Best for Anyone who needs the contract, app and service in English [View all 32 policies→](/insurance/price-research) ## How do students, freelancers and families get covered? When no employer puts you into the GKV, three separate routes lead in. All three are statutory membership with the full benefit catalogue; only the way the contribution is worked out differs. ### Students: the KVdS student rate A flat rate set by law rather than a percentage: EUR 146.29/month at Techniker Krankenkasse on the catalogue's profile. Enrolled student under 30 (or within 14 semesters), childless, 23+: KV EUR 87.38 + Zusatzbeitrag on EUR 855 base + PV EUR 35.91. 2026 totals: BKK firmus ~EUR 141.93, hkk ~EUR 145.43, TK EUR 146.29, AOK Bayern EUR 146.29, DAK EUR 150.65, BARMER EUR 151.42; with child (or under 23): ~EUR 5.13 less (PV EUR 30.78) Ends at age 30, then jumps to ~EUR 275+/mo voluntary rate ### Freelancers: voluntary GKV membership Freelancer, 30, childless, no/low income: minimum base EUR 1,318.33/mo (2026) x (14.0% reduced rate + fund Zusatzbeitrag + 4.2% PV) = EUR 268.68 (BKK firmus) to EUR 297.81 (BKK24); average-fund value EUR 278.17. Contributions scale with ALL income (incl. rent, dividends) up to BBG; max ~EUR 1,261/mo childless Prior GKV membership effectively required for direct entry ### Families: Familienversicherung Non-earning spouse/civil partner and children of a GKV member: EUR 0, unlimited duration for children (to 18; 23 if not working; 25 if in education) Not available to PKV members' dependants on same terms ## What do the private add-ons cover? A supplementary policy is not a small version of PKV. It sits ON TOP of a statutory fund and replaces nothing: you stay a statutory member and buy back precisely the gaps the benefit catalogue leaves open. ### Dental add-on (Zahnzusatzversicherung) Covers the 60-65% denture gap GKV leaves 43-year-old, no pre-existing dental issues, 100% denture tariff: Stiftung Warentest 2025 test winners EUR 25-58/mo; 'very good' basic tariffs from ~EUR 6/mo; ottonova Zahn from ~EUR 15.42/mo; Feather dental Basic EUR 10.90 / Advanced EUR 28.55/mo (young adult entry) ### Hospital add-on (stationäre Zusatzversicherung) Upgrades any GKV hospital stay to 1-2-bed room 30-year-old, healthy, 2-bed room + chief physician (Chefarzt) tariff: market range ~EUR 15-30/mo (Finanztip 2025 comparison; named competitive tariffs: Hallesche Mega Clinic AR, ERGO SZL, SDK Klinik 2-Bett SP2, Inter Quali Med Z S2R, Barmenia Mehr Komfort 2-Bett K); 1-bed top tiers ~EUR 30-50/mo ## How do you join a health insurer? For the GKV you pick a fund and apply to it directly; your employer then registers you with the fund you chose. The catalogue records every statutory fund as joinable without local registration, so joining is not gated on your [Anmeldung](/moving/address-registration). The fund issues the membership confirmation digitally, and that document is exactly what the Auslaenderbehoerde and the university ask for. PKV works the other way round: first the application with full underwriting, then the offer. The catalogue does not record the private substitute insurers as available without local registration, and their documents are in German throughout, ottonova excepted. Switching between statutory funds is possible, but the funds in the catalogue bind you to a 12-month period. So the time to look for the cheapest fund is before you join, not after. ## How We Compared These Health Insurance Options We compared 17 statutory funds and 15 private substitute insurers from this repository's catalogue, on the Zusatzbeitrag or premium at the stated reference profile, waiting periods, treatment of pre-existing conditions, hospital cover, dental cover, binding period, English-language documents and editorial rating. Statutory and private products are never mixed into one ranking, because they are not open to the same reader at the same time. Where an insurer publishes no premium, the card says why. Nothing is estimated. ## Related Guides [### Insurance in Germany What is mandatory and what is not.](/insurance)[### Best cover for new arrivals Incoming cover until GKV or PKV opens.](/insurance/health/best-for-new-arrivals)[### Dental insurance The gap above the Festzuschuss.](/insurance/dental-insurance)[### Insurance price research Every catalogued policy in one table.](/insurance/price-research) ## Frequently Asked Questions ### Is health insurance mandatory in Germany? Yes. Everyone resident in Germany must hold health cover, and proof of it is required for a residence permit and for university enrolment. There is no tax-funded service that covers residents by default: you are either in the GKV or in the PKV. ### Can I freely choose between GKV and PKV? No. Access depends on income, employment status and profession. Employees below the compulsory-insurance threshold are members of the GKV by law. Civil servants, the self-employed and employees above the threshold can go private. Within the GKV, however, the choice of fund is free. ### What does statutory health insurance cost? The contribution is a percentage of gross income rather than a price: 14.6 percent plus the fund's own Zusatzbeitrag, split with your employer. On the catalogue's reference profile that runs from EUR 377.65/month at BKK firmus to EUR 386.57/month at Techniker Krankenkasse. Students pay a flat rate set by law, EUR 146.29/month. ### What does private health insurance cost? There is no list price. The premium is calculated at underwriting from your entry age and state of health, so every figure applies to one profile only. The catalogue records EUR 223/month for a 27-year-old employee at HanseMerkur and EUR 264.54/month for a 30-year-old employee on the ottonova Komfort tariff, both as the employee share after the employer subsidy. ### Does the GKV ask health questions or impose waiting periods? No. Every statutory fund in the catalogue records full cover, open enrolment, a zero waiting period and no risk surcharges. PKV is the opposite: full underwriting, possible surcharges or exclusions, and waiting periods typically of 3 and 8 months. ### Are family members covered too? In the GKV yes: a non-earning spouse or registered partner and children are co-insured at EUR 0 through Familienversicherung, for children to 18, to 23 if not working and to 25 if in education. In the PKV every person costs a separate premium. --- Source: https://www.guide-germany.com/insurance/health-insurance Last updated: n/a Format: LLM-readable Markdown twin (.md) of the canonical HTML page.