Health insurance explainer

It's not optional

Health insurance is not optional in Germany. Employees working for a wage — including trainees — are compulsorily insured in the statutory health insurance system by law. Source ↗

You choose your fund — not your employer

You choose your own health insurance fund (Krankenkasse) — by law you are a member of the fund you select, not one your employer picks for you. Your employer needs the fund's confirmation of membership (Mitgliedsbescheinigung), not the right to decide. Source ↗

Your first job: the sequence

When you start a job, you declare your choice to the Krankenkasse you picked — it may not refuse you, and it may not talk you out of joining with false or incomplete advice. Tell your employer which fund you chose right away: if you haven't named one within two weeks of starting, the employer registers you with your previous fund — or, if you have never been insured in Germany, with a fund the employer picks and tells you about in text form. The fund then confirms your membership to the employer electronically; there is no paper for you to chase. Source ↗

1. 1Pick a statutory fund and declare your membership to it — the fund may not refuse you, and may not talk you out of joining.
2. 2Tell your employer which fund you chose — right away, at the latest within two weeks of starting.
3. 3Miss the two weeks and you don't go uninsured: the employer registers you with your previous fund, or picks one for you if you've never been insured in Germany.
4. 4The fund confirms your membership to your employer electronically — nothing to print. The KV line then appears on your payslip.

What you pay (the KV line on your payslip)

The statutory health-insurance contribution is 14.6% of gross pay plus a supplement set by your individual fund, and it is split roughly half-and-half between you and your employer — which is why KV appears on your payslip. Source ↗

See where it lands on your payslip →

What actually differs between funds

The core benefit catalogue of statutory insurance is set by law and applies whichever fund you join. On top of it, a fund may offer statute-based extras (Satzungsleistungen) only in areas the law lists — prevention and rehabilitation, midwife services, artificial insemination, dental treatment, non-prescription pharmacy medicines, therapies and aids, digital health apps, home nursing and household help. That legal margin, plus the fund-specific supplement, is where funds actually differ. Source ↗

The care itself is set by law. These are the categories worth comparing before you declare — we name them, we don't rank funds.

Zusatzbeitrag

The fund's own supplement on top of the uniform base rate — the price difference between funds

Satzungsleistungen

Statute-based extras in the areas the law allows — prevention, dental, therapies, digital health apps and more

Wahltarife / Bonusprogramme

Optional tariffs and bonus schemes — read the conditions; binding periods can delay a later fund switch

Service & Sprache

English-language service, apps and digital claims, local offices — purely practical, and where newcomers notice the biggest differences

Family cover can cost nothing

Family members can be covered at no additional contribution (Familienversicherung): a spouse or registered partner and children living in Germany, provided they are not otherwise insured and their own income stays under the legal limit. Children are covered to 18, to 23 if not employed, and to 25 while in education or training. Source ↗

Statutory (GKV) or private (PKV)

Employees whose regular annual pay exceeds the annual earnings threshold (Jahresarbeitsentgeltgrenze — set each year by federal regulation) become exempt from compulsory statutory insurance, and may take private insurance (PKV) instead. Below the threshold, the statutory system is compulsory. Source ↗

Going private is hard to undo

Moving to private insurance is hard to reverse: the law keeps people exempt from statutory insurance if they become subject to it after turning 55 and were not statutorily insured in the previous five years. This is a legal fact worth knowing before you choose — and a reason to take independent advice, not a sales pitch. Source ↗

Health-insurance terms, translated

The words you'll meet on forms and in your employer's onboarding — what each means, not which one you should pick.

Krankenkasse

Your statutory health insurance fund

GKV (gesetzliche Krankenversicherung)

The statutory health insurance system

PKV (private Krankenversicherung)

Private health insurance

Versicherungspflicht

Compulsory insurance — you must be insured

Mitgliedsbescheinigung

Your fund's confirmation of membership — what your employer asks for

Zusatzbeitrag

The supplement your individual fund charges on top of 14.6%

Familienversicherung

Family cover at no additional contribution

Jahresarbeitsentgeltgrenze

The annual earnings threshold above which you may leave the statutory system

Beitragsbemessungsgrenze

The income ceiling above which no further contributions are charged

Gesundheitskarte (eGK)

Your health insurance card — you show it at the doctor

Zuzahlung

A co-payment you make yourself (e.g. on prescriptions)

Satzungsleistungen

Extra benefits a fund writes into its own statutes on top of the legal catalogue

Wahltarif

An optional tariff with its own conditions and a binding period