Public health insurance in Germany

Usually 24–48 hours. We send you a short form in English, hand the paperwork to a Krankenkasse, and you get a confirmation of coverage you can use for your visa, job start, or Anmeldung immediately, well before the physical insurance card arrives in the mail.

Yes. Public health insurance meets the coverage thresholds for every German residence permit: student, job-seeker, freelance, EU Blue Card, family reunification, and permanent residency. The Krankenkasse issues an official confirmation of coverage (Versicherungsbescheinigung) that the Ausländerbehörde accepts without exception.

Your Krankenkasse notifies the Deutsche Rentenversicherung as soon as you're enrolled, and the number arrives by post in 3–6 weeks. You can start your job before it arrives. Your employer uses your Krankenkasse confirmation as a placeholder. See our social insurance number page for the full process.

Your electronic health card (eGK) arrives by post in 2–4 weeks. Until then, you can visit any doctor in Germany using just your Krankenkasse membership confirmation. The doctor bills the insurer directly.

Most employees earning below the annual threshold (€77,400 gross in 2026), plus students, apprentices, pensioners, and unemployed people receiving benefits. Freelancers and self-employed people can opt in voluntarily. High earners, the self-employed, and civil servants typically have the option to choose private insurance instead, and for many of them private is the better-value option.

Walk into any doctor's office that accepts public insurance. Roughly 90% of German practices do. Show your eGK card (or membership confirmation), get treated, walk out. No upfront payment, no reimbursement forms, no paperwork. The doctor bills your Krankenkasse directly.

Non-working spouses and children under 25 are covered for free under the Familienversicherung, provided their own income stays below €565 per month in 2026 (€603 for a minijob). This is one of the biggest cost advantages over private insurance.

Public insurance covers checkups, cleanings, and basic fillings in full. Crowns, bridges, implants, and orthodontics are only partially covered, typically 60–75% of a standard benchmark cost. If extensive dental work matters to you, a private dental add-on (Zahnzusatzversicherung) is usually worth the €15–30/month.

Yes. Public insurance is legally required to accept you regardless of your health history, and all pre-existing conditions are covered from day one with no waiting period. This is the single biggest structural difference from private insurance, which can decline or surcharge high-risk applicants.

Yes. Every resident is legally required to have health insurance. Gaps in coverage can trigger retroactive contributions when you re-enroll, and you can't register your address, sign most job contracts, or apply for a visa without proof of coverage.

After a minimum 12-month membership, you can switch to another Krankenkasse with two months' notice. If your current fund raises its supplementary rate, you get a special right to switch immediately. The new fund handles the paperwork. You mostly just sign.

Employers pay roughly half of your public health insurance contribution directly to the Krankenkasse. You never see this money, but it's a significant part of your total compensation. The calculator above shows only your portion.

See our overview of public health insurance providers and our in-depth review of DAK.