Germany is renowned for its well-developed healthcare system, providing citizens and residents with access to high-quality medical care. Within this system, there is extensive state insurance statutory health insurance, covering both statutory and voluntary healthcare. In this article, we will look at the four leading insurance companies in Germany — Mhplus, Techniker Krankenkasse, HEK and Ikk Classic. Обратите внимание: касса оплачивает лечение, но не комфорт в клинике — одноместная палата и лечение у главврача покрываются только дополнительной страховкой.
What is the difference between private medical insurance and state health insurance?
In Germany, there are two types of healthcare: public and private insurance. The contribution amount to the Gesetzliche Krankenkasse (GKV, public insurance) depends solely on income — on average, this is 17,5% from income and does not depend on age and underlying health conditions. In addition, the employer pays half of the contribution for employees.
Whilst state medical insurance covers a large part of the population, private medical insurance provides the opportunity for employees whose incomes over €77,400 a year (2026) choosing between public health insurance funds and private health insurance companies (private Krankenversicherung or PKV). Private insurance providers offer a wider range of services. Premiums depend on age, gender, state of health at the date the contract is concluded and the chosen services. They are not linked to the level of income.
State insurance
Private insurance
Amount of contributions
- On average, 17.5% of income
Amount of contributions
- Fixed contributions, depending on the tariff, age and medical conditions
Family insurance
- Partner with a salary of up to 565 (self-employed) or 603 euros (employee) and children are included in the insurance for free
Family insurance
- Additional payment for each family member
Insurance cover
- Single tariff for all insured persons
Insurance cover
- A wide range of tariffs, from the most basic to the maximum ones, including experimental treatment methods
Payment for treatment
- Between the hospital/practice and the insurance company directly
Payment for treatment
- The patient settles the bill themselves and is subsequently reimbursed by the insurance company.
Maternity leave
- Exemption from contributions, special rules for voluntarily insured persons
Maternity leave
- It depends on the chosen tariff
Who can be insured under state insurance?
The following groups of people are eligible to be insured in the German statutory health insurance system:
- Employees whose employment remuneration exceeds 603 euros per month, but does not exceed the annual income threshold of 77,400 euros (for 2026)
- Recipients of unemployment benefit or maintenance allowance under Book Three of the Social Code (SGB III) and – under certain conditions – recipients of unemployment benefit II (ALG II)
- Pupils and students under 30 years of age
- Pensioners with a certain insurance record
- Recipients of a survivor's pension or a corresponding survivor's allowance granted by a occupational pension institution
- Agricultural and forestry entrepreneurs, family members working alongside them, and agricultural old-age pensioners
- Disabled people
- Artists and publicists
- Persons who have no other entitlement to health insurance benefits, who were most recently insured under statutory health insurance or are still insured with the GKV
- Late repatriates who have moved to Germany for permanent residence (IMPORTANT! This option is only available during the first six months after receiving documents in Germany)
In these cases, an option is provided between voluntary state insurance and private insurance:
- Excess of income over the threshold for employees (€77,400 for 2026).
- Self-employed people who, since starting work, are no longer subject to compulsory insurance
Who cannot be insured under the state health insurance scheme?
- Students over the age of 30 cannot be insured on the GKV student tariff. After this age, they may need to switch to a private insurance company, for example CareConcept.
- Persons holding certain types of visas: for example, this may be a short-stay or tourist visa. Find out more here.
- Entrepreneurs and the self-employed who were not previously insured under the state insurance scheme in the European Union. For this category of persons, available is private medical insurance.
2. To be covered by a family insurance policy.
Family insurance
Children, spouses or registered same-sex partners are exempt from paying contributions to statutory health insurance if they live together in Germany and have an income that does not regularly exceed a certain level. Once family insurance ends, it is usually possible to continue the contract within the statutory health insurance system, even if one of the partners has become self-employed.
What is the income limit for those included in family insurance?
The income limit is €565 a month for the self-employed and €603 (for 2026) for employees. Alimony payments are not taken into account when determining total income.
Features of family insurance
For compulsorily insured persons, it makes no sense to switch to family insurance during maternity leave and parental leave, as they are exempt from paying contributions on parental allowance.
For a voluntarily insured person (freiwillige) who, prior to parental leave or receiving parental allowance, was voluntarily insured in the statutory health insurance system because their regular earnings exceeded the compulsory insurance threshold, the following rules apply: after receiving maternity allowance, they are entitled to free insurance for the duration of parental leave or while receiving parental allowance. This is only possible if their spouse or partner is a member of statutory health insurance. Otherwise, (minimum) contributions must be paid.
Self-employed people receiving child benefit must continue to pay (minimum) contributions.
Inclusion of a child in the family tariff is excluded if the spouse or partner:
- has private health insurance and an income exceeding €74,400 (2026) per year
- and the income is regularly higher than that of the spouse or partner insured under the statutory insurance system.
Children are exempt from paying insurance contributions - to what extent?
Usually this relief ends with:
- on turning 18.
- For non-working children — until they reach the age of 23.
- If a child is at school, undergoing vocational training or performing voluntary service (voluntary military service in the Bundeswehr — BFD; voluntary social year — FSJ; voluntary ecological year — FÖJ), family insurance coverage ends upon reaching the age of 25.
- If education at a school or vocational institution was interrupted or delayed due to the child's voluntary service or voluntary military service, insurance may continue beyond the age of 25 for a maximum of twelve months.
Without age limits, children can only be insured if they are unable to support themselves independently due to physical, mental or psychological health issues (disability). It is also required that the disability already existed at the time when family insurance was in place.
Students are required to be insured after family insurance ends, up to a maximum age of 30. In doing so, they pay a particularly low contribution of 115.17 euros per month (in 2025) for health insurance, plus the additional contribution that health insurance funds may levy on their members.
Students at vocational educational institutions can become voluntary members of the state health insurance scheme after family insurance ends and pay the same amount as university students.
Tariff comparison
The base rate of 14,6 % is set by law and identical at every fund — only the fund’s supplementary rate differs. The average supplementary rate for 2026 is 2,9 %, announced by the Federal Ministry of Health in the Bundesanzeiger on 10 November 2025. The rates below are as of 22 August 2026: a fund may change its supplementary rate during the year, as IKK classic did on 1 August. The cheapest in this comparison is the Techniker Krankenkasse. Techniker Krankenkasse.
- Professional dental cleaning
- €40 a year from the age of 18
- Osteopath
- 3 sessions up to €40/session per year
- Vaccinations
- Flu for everyone, HPV up to 26 years, all travel vaccinations recommended by STIKO
- Additional maternity and childbirth payments
- 100%: Transfer of Medicines
- Artificial insemination
- €500 subsidy for married couples for each attempt, up to a maximum of 3 attempts
- Sports and fitness courses
- 100% for online courses, 1 course = up to €100
- Homeopathy and alternative remedies
- Free of charge with contract homoeopathy providers via the KV card.
- Skin cancer screening
- 100%: every two years from the age of 15
- Professional dental cleaning
- €10 a year from the age of 16 + 1 free time during pregnancy
- Osteopath
- 80%, up to 3 sessions at up to €30 per session per year
- Vaccinations
- Flu for everyone, all recommended vaccinations with an extra charge
- Additional maternity and childbirth payments
- €100 medication coverage
- Artificial insemination
- €200 subsidy for married couples per attempt, maximum of 3 IVF or ICSI attempts
- Sports and fitness courses
- 80% and no more than €250 per year
- Homeopathy and alternative remedies
- Homeopathic contract with KV-Karte free of charge.
- Skin cancer screening
- 100%: every two years from the age of 18
- Professional dental cleaning
- €40 a year + 1 free visit with an insurance-partnered doctor
- Osteopath
- 80%, 2 sessions at up to €60 per session per year
- Vaccinations
- Flu for everyone, HPV up to 26 years, all travel vaccinations recommended by STIKO
- Additional maternity and childbirth payments
- +€400 to the basic pregnancy budget (€150)
- Artificial insemination
- 100% cover for married couples, provided both are insured with mhplus; the maximum age for the female partner has been increased to 42 years
- Sports and fitness courses
- 80% 1 course = up to €70 and no more than 2 courses per year
- Homeopathy and alternative remedies
- Free of charge with contract homoeopathy providers via the KV card.
- Skin cancer screening
- 100%: from the age of 15, at least every 2 years (in some regions, every year)
- Professional dental cleaning
- €40 a year
- Osteopath
- 4 sessions up to €40/session per year
- Vaccinations
- Recommended vaccinations with an additional charge
- Additional maternity and childbirth payments
- €100 medication coverage
- Artificial insemination
- €500 if both partners are insured with IKK
- Sports and fitness courses
- 1 course = up to €90 and no more than 2 courses per year
- Homeopathy and alternative remedies
- There are no offers for homeopathy
- Skin cancer screening
- Up to €30 every 2 years up to the age of 35
Separate rules for self-employed artists, publicists and people in the arts.
In accordance with Artists' Social Insurance Act (KSVG), self-employed artists and journalists are subject to compulsory medical, pension and social insurance, just like employees.
Artists' Social Security Fund
Like employees, self-employed artists and publicists pay half of the contributions to Artists' Social Security Fund (Künstlersozialkasse or KSK); the other half is collected via the KSK through a federal subsidy and contributions. As with employees, the contribution amount depends on earned income.
The minimum insured income is €3,900 a year; there are exceptions for unstable income and for those just starting their career.
Frequently asked questions about public health insurance
Employees whose income is below the annual threshold — 77.400 € in 2026. As long as income stays below it, public insurance is compulsory. Above the threshold you can choose: stay in a statutory fund voluntarily or move to private insurance. Students, apprentices, unemployed people and pensioners are covered by separate rules.
The base rate of 14,6 % of income is the same at every fund; on top of it each fund charges its own supplementary rate. The average supplementary rate for 2026 is 2,9 %, so on average that comes to 17,5 %. For employees the employer pays half. On top comes long-term care insurance: 3,6 %, or 4,2 % for people without children from the age of 23.
The catalogue of compulsory benefits is set by law and identical everywhere — a fund may neither cut it nor extend it at will. There are only two differences: the size of the supplementary rate and the voluntary extras beyond the compulsory minimum. That is why funds should be compared on exactly these two points, not on «quality of treatment».
Yes, this is Familienversicherung: a spouse and children without their own income are covered with you and pay no separate contribution. The condition is that the family member’s income is below the set limit. Additional age limits apply to children; they are described earlier on this page.
The minimum period of membership is 12 months; after that you can move to another fund with two months’ notice to the end of a month. If your fund raises its supplementary rate, a special right of termination applies and the period does not. You do not have to submit a cancellation yourself: the new fund handles the switch.
With an identical catalogue of compulsory benefits, the supplementary rate decides. The cheapest in our comparison is the Techniker Krankenkasse — 2,69 % against a market average of 2,9 %, and the TK has been at the top of the independent ratings for years:
In a statutory fund the contribution is based on income and does not depend on age or state of health, and the family is covered free of charge. In private insurance the contribution is based on age, state of health and the chosen range of benefits, every family member pays separately, but the range of benefits is wider. A detailed comparison is in the first section of this page.
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