YOU WILL DEFINITELY BE PAYING FOR THIS IN GERMANY🇩🇪
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The only question is: “How much?”.
If you are still choosing a Krankenkasse (statutory health insurer) or plan to switch, there is a separate guide: which Krankenkasse to choose and how to switch. This is solely about money: exactly how much will be deducted from you and what that depends on.
What is in this article
Germany has a statutory health insurance law that applies both to citizens of the country and to those who have obtained a residence permit in Germany. On the one hand, it’s all straightforward; on the other hand, there are nuances 😉.
There are two types of health insurance in Germany:
State health insurance — gesetzliche Krankenversicherung (GKV) and private health insurance — private Krankenversicherung (PKV).
Let’s first look at statutory health insurance (GKV), what its pros and cons are, who it is suitable for, and who it isn’t.
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You could say that public health insurance (GKV) has levelled the playing field for everyone: young and old, poor and wealthy, healthy and sick. Under this insurance, everyone is treated equally and everyone receives the same standard of care, regardless of their contribution.
The GKV provides reliable health protection for nearly 90 percent of the population. Over 70 million citizens are insured here to receive the best possible medical care.
Solidarity as a principle
GKV operates on the principle of solidarity: contributions depend on income, while medical services are the same for everyone — regardless of how much a person pays. Currently, 93 Krankenkassen, 47 of which are open to residents nationwide, provide medically necessary services to their members as well as approximately 16 million family members who are co-insured through family insurance. Thus, the basic principle of the statutory health insurance system is solidarity between the healthy and the sick, between high earners and low earners, between the young and the elderly, and between single people and families.
IMPORTANT! The amount of the contribution to statutory health insurance (GKV) depends on income and amounts to 14.6 % plus a surcharge levied by the Krankenkasse — on average 2.9 % in 2026. The basic rate is the same everywhere, whilst each Krankenkasse sets its own surcharge.
What makes up the contribution in 2026
The contribution is calculated based neither on age nor on the number of illnesses, but on the pre-tax salary. It comprises three parts.
- The base rate is 14.6 %. It is the same for all Krankenkassen and is laid down by law. There is also a reduced rate of 14.0 % — for those who are not entitled to sick pay.
- The Krankenkasse’s top-up — 2.9 % on average. Each Krankenkasse sets its own, and this is exactly where the Krankenkassen differ from one another.
- Long-term care insurance — 3.6 %. For childless employees aged 23 or over — 4.2 %, with the employee paying the 0.6 percentage point surcharge themselves, without the employer contributing.
The medical part—the main contribution along with the additional payment—is split 50-50 between the employee and the employer. With an average additional payment, the amount coming out of the salary is 8,75 %, and the employer matches that amount.
How much is that in euros
Below is what is deducted from you personally, along with care insurance. The employer pays roughly the same amount on top, and you do not see this money on your payslip.
- €3,000 gross — €316.50 a month. Without children €334.50.
- €5,000 gross — €527.50 a month. Without children, €557.50.
- €6,500 gross and above — €613.22 a month. Without children, €648.09.
Calculation based on the average top-up of 2.9 %. With a Krankenkasse whose top-up is above or below the average, the amounts shift in the same direction.
Cap: above which salary contributions do not grow
The contribution is not calculated from the entire salary, but only up to a certain limit. In 2026, it is €5,812.50 a month, or €69,750 a year. Anything you earn above this is no longer subject to contributions.
Hence the practical conclusion: the exact same amount goes to the Krankenkasse from a salary of €6,500 and a salary of €12,000. This is the point where the solidarity system stops growing alongside income — and when it makes sense to consider private insurance.
What has changed since 2025
- The average Krankenkasse top-up rose from 2.5 % to 2.9 %. With a salary of €3,000, that is roughly an extra €6 a month personally out of your own pocket.
- The threshold up to which the contribution is calculated has risen to €5,812.50 a month.
- The threshold above which an employee can switch to private health insurance has risen from €73,800 to €77,400 a year.
- The care insurance contribution rate remains unchanged at 3.6 %; for those without children, it is 4.2 %.
How to pay less
The standard contribution rate is the same everywhere, so it makes sense to choose a Krankenkasse based on the additional contribution rate and extra services. Every percentage point of difference on a salary of €3,000 is about €15 a month personally for you, which works out at €180 a year.
Switching Krankenkasse the usual way. You need to have been a member of the current Krankenkasse for at least 12 months. Notice must be given two months before the end of the month: an application in March means the transfer takes effect from 1 June.
If your Krankenkasse has raised its top-up, a special right of termination arises. This can be claimed until the end of the month in which the contribution rate was raised, and the duration of membership is no longer important. The two-month notice period remains, and the old Krankenkasse will continue to withhold the increased supplementary contribution during all this time.
There is no need to terminate the contract yourself: it is enough to join a new Krankenkasse, and it will notify the previous one itself.
GKV IS DEFINITELY RIGHT FOR YOU:
◾️For everyone who earns little.
- For individuals who are unsure whether their income in old age will be as high and stable as it was in their youth.
◾️For employees.
◾️For students.
◾️For children and spouses who have no income of their own.
Pros of state health insurance:
🔹Minimum contribution for low-income earners.
You don’t need to pay extra for non-working spouses and children (from 2028, a surcharge of 2.5 % of income for a spouse unless there is a child under 12 in the household).
🔹Good protection in the event of a long-term loss of earnings, for example due to illness or maternity leave.
🔹It can be supplemented with private medical insurance.
🔹You don’t need to pay anything yourself when visiting the doctor.
Disadvantages of state health insurance — gesetzliche Krankenversicherung:
➡️There is no fixed contribution rate: the higher the income, the larger the contribution.
➡️Restriction on the choice of clinics and doctors. Some doctors prefer to work only with private patients who have private medical insurance.
If various treatment options are possible, preference is given to the cheaper one.
Some services are included in the insurance at a minimal level.
➡️ Long waiting times for an appointment with a medical specialist.
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If state health insurance suits you, all that is left is to choose the Krankenkasse that is right for you.
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Any questions? Leave a comment or get in touch for a consultation.
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Valery Melech
When can I switch to private health insurance?
An employee is entitled to switch to private insurance if their income exceeds €77,400 a year — that is €6,450 a month. The excess must be consistent: income must be above the threshold in the current year and forecast to be so in the next.
For the self-employed, freelancers and civil servants there is no such threshold – private insurance is available to them regardless of their income level.
It is calculated in a fundamentally different way: not based on salary, but on age, state of health and the chosen level of cover. For a young, healthy person with a high income, it often works out cheaper than the state system while offering a noticeably wider range of services. But this is a long-term decision: the way back to the state system is not always open.
Detailed breakdowns: how private medical insurance works and what to consider when switching from statutory to private health insurance. If you are self-employed — health insurance for the self-employed.
What statutory insurance actually pays for
Frequently asked questions
What percentage of the salary goes towards health insurance in 2026?
The basic rate is 14.6 % plus the Krankenkasse’s top-up, averaging 2.9 %. This amount is split equally between the employee and the employer, meaning that around 8.75 % is deducted from your salary. Long-term care insurance is calculated separately: 3.6 %, or 4.2 % for those without children.
Does the contribution increase indefinitely along with the salary?
No. The contribution is only calculated on amounts up to €5,812.50 per month. Anything you earn above this is not subject to contributions.
Do I need to pay for a non-working spouse and children?
No. Under family insurance, they are insured free of charge. The condition is that the family member’s own income does not exceed €565 a month, or €603 for a mini-job. From 2028, you will pay a surcharge of 2.5 % of the income your contributions are based on for a spouse, unless a child under 12 lives in the household or another exemption applies; you still pay nothing for children.
Why does an acquaintance have a different contribution with the same salary?
Most likely, you are with different Krankenkassen. The base rate is the same everywhere, but each Krankenkasse sets its own top-up.
Does state insurance cover everything?
No. A single room, treatment by the head physician and a significant portion of dental care remain outside its scope. These gaps are covered by supplementary insurance policies — for example, hospital insurance.
About the author. Valery Melech, Finber. Versicherungsmakler (insurance broker) licensed under Section 34d(1) GewO and Immobiliardarlehensvermittler (real estate loan broker) under Section 34i GewO, registered with the IHK Rhein-Neckar. Intermediary register numbers: D-HIAG-TDBW7-60 and D-W-153-ABGZ-14. Over 20 years of practice, approximately 6’000 clients, upwards of 400 partners.
Sources: Bundesministerium für Gesundheit (Federal Ministry of Health); GKV-Spitzenverband (national association of statutory health insurers), Rechengrößen 2026 (key social insurance figures); AOK, Rechengrößen in der Sozialversicherung 2026; Verbraucherzentrale (consumer advice centre) — rules for switching Krankenkasse.
Status. Rates and limits are reviewed annually and take effect from 1 January. The data was checked in August 2026; the page is reviewed at least once a year.
This material is for informational purposes only and does not constitute individual advice. A Krankenkasse can only be selected, or a transition to private insurance calculated, after reviewing your situation.
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Hello! Right now I am working and have state insurance. My employer pays for it. But I am soon to receive a private widow’s pension, which is about 300,000 euros. Will this affect the amount of my insurance if I continue working? And also, if I no longer work, will I have to pay more in connection with receiving the private pension?
If you continue working, this will in no way affect your state health insurance.
The cost of state health insurance is determined as a percentage of the income of the insured person and their employer. In most cases, life insurance payouts are not considered income and do not affect the cost of state health insurance.