Health insurance in Germany for Ukrainians: costs and how to apply
Health insurance (Krankenversicherung) is compulsory in Germany for everyone who lives here, regardless of nationality or status. For Ukrainians holding a residence permit under § 24 AufenthG the question usually comes down to one thing: who pays the contributions — the Jobcenter, your employer or you.
Below you will find the four typical situations, the 2026 costs, the application process and answers to frequently asked questions.
Who pays for your insurance: four situations
- How you are insured
- Compulsory membership of the fund you choose under § 5 (1) no. 2a SGB V, with the full range of medical services.
- Who pays the contributions
- The Jobcenter — both health insurance and Pflegeversicherung.
- What to do
- Choose a fund, submit the application and pass your insurance number to the Jobcenter.
- How you are insured
- You do not become a member of the fund: it provides services on behalf of the authority (§ 264 SGB V), with the same range of care.
- Who pays the contributions
- Sozialamt.
- What to do
- Name the fund you have chosen at the Sozialamt and obtain a card or a Behandlungsschein there.
- How you are insured
- Compulsory insurance with a statutory fund. Between 603,01 and 2000 € the reduced Übergangsbereich (Midijob) applies — your share of the contribution is lower.
- Who pays the contributions
- Half and half with your employer; your part is deducted from your salary.
- What to do
- Choose a fund before your first working day and pass the insurance number to payroll.
- How you are insured
- There is no compulsory insurance. Possible routes: Familienversicherung through a working spouse, voluntary membership under § 417 SGB V, or private insurance.
- Who pays the contributions
- You do.
- What to do
- Apply within 6 months of registering your residence — later, joining under § 417 SGB V is no longer possible.
How much health insurance costs in Germany in 2026
The contribution to a statutory health fund has two parts: the general rate of 14,6 % is the same everywhere, while each fund sets its own Zusatzbeitrag — in 2026 it averages 2,9 %. The difference between the cheapest and the most expensive fund on a gross salary of 2500 € is about 10 € a month on your side.
Long-term care is charged separately — Pflegeversicherung: 3,6 % shared with the employer, and 4,2 % for childless members aged 23 and over, with the 0,6 % surcharge borne by the employee alone.
Familienversicherung — the biggest saving for a family. One working family member takes out the insurance, and a non-working spouse and children up to 25 are covered free of charge if their own income does not exceed 565 € a month (603 € if it is a Minijob). Family cover is applied for separately — details on the page family insurance.
Which fund to choose
The catalogue of services of statutory funds is set by law, so it is roughly 95 % identical everywhere. Three things differ: the size of the Zusatzbeitrag, the bonus programme (Bonusprogramm — from a few dozen to a few hundred euros a year) and extras such as osteopathy, professional teeth cleaning or fully online service.
The most common questions are about AOK, TK, DAK, HEK and Barmer. AOK is a network of regional funds with offices in almost every town — convenient if you prefer to call in person. TK (Techniker Krankenkasse) is the largest fund in Germany, with one of the lowest supplements and fully digital service; the application form is also available in Russian. HEK accepts applications in German and English — apply to HEK online.
A full comparison of rates and conditions for all funds is on the page statutory health insurance in Germany. A detailed look at Techniker Krankenkasse and the Russian-language application form are on the TK page.
How to apply, step by step
- Choose a health fund. There are no restrictions for Ukrainians: every fund is obliged to accept your application. You may switch funds after 12 months of membership, giving two months notice.
- Submit the application (Mitgliedsantrag). Most funds let you do this online, without visiting an office.
- Attach the documents: passport, residence permit under § 24 AufenthG or a Fiktionsbescheinigung, city registration (Anmeldung), tax number (Steuer-ID) and — depending on your situation — an employment contract or the Jobcenter decision.
- For your family, submit a separate application for Familienversicherung: your spouse and children are covered by your insurance free of charge.
- Pass your insurance number to your employer or the Jobcenter — without it the contributions will not be transferred.
- Receive your documents. The Mitgliedsbescheinigung arrives within a few days, the electronic card (eGK) usually within 2–4 weeks.
What to do while you have no card
Until the eGK arrives, the Mitgliedsbescheinigung is enough at the doctor. Those who are not yet registered with a fund and receive social benefits get a Behandlungsschein from the Sozialamt; emergency care before registration is covered under § 6a AsylbLG.
If you are not covered by compulsory insurance
A Minijob of up to 603 € a month does not create statutory cover: the employer pays a flat-rate levy, but that is not your insurance. Three options remain — Familienversicherung through a working spouse, voluntary membership under § 417 SGB V, or private insurance.
§ 417 SGB V is a special provision for people who came from Ukraine. The application must be filed within 6 months of registering your residence in Germany and only if you do not receive benefits under SGB II or SGB XII. If the deadline has passed, what remains is private health insurance (private Krankenversicherung) and guest insuranceguest insuranceguest insurance, which covers emergencies only.
Still have questions? Write to @finber_support or to [email protected].
Frequently asked questions
Is health insurance compulsory for Ukrainians in Germany?
Yes. The insurance obligation applies to everyone whose residence is in Germany, regardless of nationality. The only difference is who pays the contributions: the Jobcenter, your employer together with you, or you alone.
How much does health insurance cost in Germany in 2026?
In employment your share is about 8,75 % of gross pay plus 1,8 % for long-term care: on 2500 € gross that is roughly 264 € a month, and the employer pays the same. For voluntary membership without work and without benefits the minimum contribution is 270,26 € a month, or 278,17 € for childless members aged 23 and over. For recipients of social benefits the insurance is paid by the Jobcenter or the Sozialamt.
Who pays my insurance if I receive Grundsicherungsgeld (formerly Bürgergeld)?
The Jobcenter. You become a compulsory member of the fund you choose under § 5 (1) no. 2a SGB V, and the Jobcenter transfers the contributions for health and long-term care insurance. All you have to do is choose a fund, submit the application and pass your insurance number to the Jobcenter.
Can my spouse and children be covered free of charge?
Yes, through Familienversicherung. A non-working spouse and children up to 25 in education are insured free of charge if their own income does not exceed 565 € a month; for a Minijob the limit is 603 €. A separate application is required.
Which health fund should a Ukrainian choose?
Any of them — every fund is obliged to accept you. By law the range of services is about 95 % identical, so three things are worth looking at: the size of the Zusatzbeitrag, the bonus programme and the service languages. AOK is convenient for its local offices, TK for its low supplement and Russian-language application form, HEK accepts applications in English.
Do I need a qualifying period or previous cover (Wartezeit)?
No. Neither a Wartezeit nor a Vorversicherungszeit is required for refugees from Ukraine. Treatment is available as soon as you are registered, and until the eGK arrives the Mitgliedsbescheinigung is enough.
What changes if the Rechtskreiswechsel law is adopted?
As of 22 August 2026 the law has not been adopted. If it comes into force, Ukrainians who first received a permit under § 24 AufenthG from 1 April 2025 will move from SGB II benefits to the AsylbLG. Instead of full insurance the scope of § 4 AsylbLG would apply: treatment of acute illness and pain, pregnancy and childbirth, vaccinations. For minors the scope has been equal to standard care since 12 June 2026. Those who arrived before 1 April 2025 are not affected.
I work a Minijob of up to 603 € — am I insured?
No. A Minijob does not create compulsory insurance: the employer pays a flat-rate levy, but that is not your cover. The options are Familienversicherung through a spouse, voluntary membership under § 417 SGB V or private insurance. Compulsory insurance starts at an income of 603,01 € a month.
This material is for general information and does not replace individual advice. Each fund sets its own Zusatzbeitrag — check the current figure with the fund you choose.
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