How Much Is German Health Insurance?

In Germany, obtaining health insurance is a fundamental requirement for all residents. This mandatory system ensures that individuals have access to necessary medical care regardless of their financial standing. The German healthcare landscape operates on a dual system, offering both public, or statutory, health insurance and private health insurance options.

Public Health Insurance Contributions

Contributions to Germany’s statutory health insurance system are primarily determined by an individual’s gross income, reflecting the solidarity principle where contributions are proportional to earning capacity. The general contribution rate is fixed at 14.6% of gross income. In addition to this, individual health insurance funds levy an extra contribution, known as the Zusatzbeitrag, which varies by provider and averages around 2.5% in 2025.

For employees, these contributions are shared equally between the employee and the employer. Each pays half of the general contribution rate and the health fund-specific Zusatzbeitrag, totaling 7.3% of gross income plus half of the additional individual rate.

There is an income threshold for mandatory public insurance, known as the Versicherungspflichtgrenze, which for 2025 is set at €73,800 annually. Individuals earning below this amount are compulsorily insured in the public system. If an employee’s gross income exceeds this threshold, they gain the option to either remain voluntarily insured in the public system or switch to private health insurance.

Furthermore, there is a Beitragsbemessungsgrenze, or contribution assessment ceiling, which limits the maximum income amount on which health insurance contributions are calculated. For health and long-term care insurance in 2025, this ceiling is €66,150 annually, or €5,512.50 per month. Any income earned above this limit is not subject to further health insurance contributions.

While employment income is the primary basis for calculations, certain other income sources, such as pensions, are considered for voluntary public health insurance members. For compulsorily insured employees, contributions are based solely on their gross employment income up to the assessment ceiling.

A key feature of the public health insurance system is Familienversicherung, or family insurance. Under specific conditions, family members like spouses and children can be covered free of charge under the primary insured person’s policy.

Private Health Insurance Premiums

Private health insurance premiums in Germany operate on a fundamentally different principle than public contributions. They are not tied to an individual’s earnings, but determined by individual risk factors that assess the likelihood and potential cost of future medical care.

Primary factors influencing private health insurance premiums include the policyholder’s age at entry and their health status. Younger individuals with no pre-existing medical conditions face lower initial premiums. Conversely, older applicants or those with existing health issues may incur higher premiums or face exclusions.

The chosen level of benefits and coverage also impacts the premium. Private insurance offers customizable plans, from basic coverage to comprehensive policies including single hospital rooms, choice of doctors, or enhanced dental coverage. Opting for more extensive benefits or a broader network of providers will lead to higher premiums.

Deductibles, or Selbstbehalt, are a factor in determining private health insurance costs. Policyholders can choose to pay a certain amount out-of-pocket each year before coverage begins. Selecting a higher deductible results in lower monthly premiums, but means the insured person bears more initial financial responsibility in case of illness.

A unique aspect of private health insurance in Germany is the concept of Alterungsrückstellungen, or age-related provisions. Private insurers are legally required to build up financial reserves from policyholders’ premiums during their younger years. These reserves are intended to offset the natural increase in healthcare costs as policyholders age, thereby helping to stabilize premiums in later life.

The income threshold for eligibility to switch from public to private health insurance is the Versicherungspflichtgrenze. Only employees earning above this amount have the option to enter the private system. Unlike the public system, private health insurance requires separate policies or additional premiums for each family member.

Health Insurance for Specific Groups

The German health insurance system adapts its cost structures and rules for various demographic and employment groups. This ensures that the mandatory health insurance requirement is met, while accounting for different income situations and life circumstances.

Self-employed Individuals

Self-employed individuals, or Selbstständige, can choose between voluntary public health insurance or private health insurance. If they opt for voluntary public insurance, their contributions are income-dependent, but calculated differently than for employees. Contributions are based on estimated income, subject to minimum and maximum assessment ceilings, and they pay the full contribution themselves.

Students

Students benefit from special, reduced rates within the public health insurance system. As of 2025, students under 30 years old pay around €144.66 per month for public health insurance. This discounted rate is available up to age 30. Students 30 or older when commencing studies are not eligible for these reduced rates and must opt for standard public or private insurance.

Pensioners and Retirees

For pensioners and retirees, health insurance contributions are based on their prior insurance status. Those compulsorily insured in the public system as retirees (Krankenversicherung der Rentner – KVdR) pay contributions on their statutory pension income and certain other incomes. Voluntarily insured pensioners in the public system, or those with private health insurance, pay contributions on all their income sources. Both groups receive a subsidy on their health insurance contributions from the statutory pension insurance provider.

Unemployed Individuals

Unemployed individuals have their health insurance contributions covered by the state. If receiving unemployment benefit I or Citizen’s Allowance (Bürgergeld), the Federal Employment Agency pays the full public health insurance contributions. For those previously privately insured, the agency may provide a subsidy, but remaining in private insurance can be challenging.

Low-Income Earners

Low-income or minimum wage earners are mandatorily insured in the public health insurance system. Their contributions are calculated as a percentage of their gross income, up to the contribution assessment ceiling. The employer continues to pay half of these contributions for employed individuals.