International: Health insurance for foreigners in Germany

Since 2009, every person who has a permanent residence in the Federal Republic of Germany is required to have health insurance. Health insurance is also required for short-term stays in Germany, otherwise the issuance of a visa will be denied.

GermanyGeneral health insurancePrivate health insuranceStudentsGuest workersGuest scientistsAsylum seekersInterns / Au pairsTips / LinksSpecial features of the German health insurance system×1501.png

The German health insurance system is characterized by a dual system of statutory (GKV) and private health insurance (PKV). While the statutory health insurance is accessible to numerous people, special conditions apply to the private health insurance.

Citizens from countries of the European Economic Area¹ (EEA) and nationals from countries with which a social security agreement²exists can remain insured under the health insurance scheme of their home country. Insurance benefits in other countries can be significantly different compared to Germany. A financial personal contribution or the conclusion of a supplementary insurance may become necessary as a result.

Statutory Health Insurance (SHI) and the Solidarity Principle

The contributions of the statutory health insurance depend on income. The basis is the total gross income, from which a uniform contribution rate of 14.6 percent (as of 2020) is levied. This is divided equally between the insured and the employer at 7.3 percent each. In addition, most health insurance companies charge an additional contribution of varying amounts, which is also divided equally between the employee and the employer. Students, self-employed persons and insured persons without income pay the full additional contribution alone. If the income threshold (2020: 4,687.50 euros per month) is exceeded, the income above this threshold is irrelevant for the calculation of contributions. In the statutory health insurance, children and spouses can be co-insured free of charge via family insurance.

Some groups of persons must become members of a statutory health insurance. These include:

Salaried employees (gross income below the compulsory insurance limit)

Pensioners (if pre-insurance period is fulfilled)

Recipients of unemployment benefit IStatutory health insurance guideStatutory health insurance listStatutory health insurance testStatutory health insurance comparison

Individual benefits in private health insurance (PKV)

Membership in a private health insurance (PKV) is not possible for everyone. Employees can be insured in private health insurance from a gross income above the compulsory insurance limit (2020: € 5,212.50 per month). Persons concerned must apply for exemption from compulsory insurance. Often, private health insurance companies require a minimum period of permanent residence in Germany. Foreign policyholders must provide evidence of a long-term insurance period. Many private insurance companies offer special rates for this group, adapted to the needs and length of stay.

If private health insurance is applied for, detailed questions are asked about the health status (health check). The German insurance coverage expires as soon as the policyholder returns to his home country.

The following groups of people are often privately insured:

Salaried employees (gross income above the compulsory insurance limit)Civil servantsSelf-employed and freelancers

The premiums of a private health insurance are based on health status, age and scope of benefits, irrespective of income. The premiums are individual for each policyholder.

The range of benefits offered by private health insurance is hardly subject to state regulations and is in many cases more extensive than the statutory benefits. In addition, the benefits can be tailored precisely to the policyholder. The policyholder initially pays in advance for all treatment costs. The insurance company reimburses these costs against submission of an invoice (cost reimbursement principle).

Supplementary insurances

Supplementary insurance is used to close gaps in health insurance coverage. The contract is concluded with a private insurance company, regardless of income. Important supplementary insurances are, for example, supplementary long-term care insurance, supplementary dental insurance or supplementary health insurance.

Private health insurance guidePrivate health insurance changeDental supplementary insurance guidePrivate health insurance testSupplementary health insurance guideSupplementary dental insurance test

Health insurance for foreign students in Germany

All foreign students who start a specialized study program at a German university or college must have health insurance. Enrollment will not occur without proof of health insurance.

Health insurance in the country of origin Insurance options in Germany Additional conditions
Statutory health insurance Recognition with a statutory health insurance European Health Insurance Card (EHIC) of the health insurance company in the home country
Private health insurance Private health insurance Confirmation of the cash office of the home country;

Billing of services and medications with your own health insurance company

No health insurance Public or private health insurance from the age of 30, only private insurance is possible

Attention: Foreign students who have private health insurance in Germany but are not yet 30 years old often need a certificate of exemption from statutory health insurance for enrollment. After that, admission to the GKV within the study stay is no longer possible.

Insurance for
foreign students
Health insurance contribution Contribution to long-term care insurance Total contributions
Students without children
(23 years and older)
as of 01.10.2020:
76,04 Euro*

77,57 Euro*

24,55 Euro**

25,05 Euro**

100,59 Euro*

102,62 Euro*

Students until 23 years
or with child
from 01.10.2020:
76,04 Euro*

77,57 Euro*

22,69 Euro**

23,15 Euro**

98,73 Euro*

100,72 Euro*

*The contributions in the compulsory insurance for foreign students are the same for all health insurance companies. In addition, there is the individual additional contribution of the respective health insurance company.
**Care insurance contributions are 3.05 percent for students with a child and 3.30 percent for students 23 and older without a child.

In our list of health insurance contributions for students, the insurance contributions of all health insurance companies including additional contribution are listed in euros.

Working in Germany –
Health insurance for guest workers

As a general rule, an employee is covered by social insurance in the country in which he or she works. Even in the case of a short-term work stay, it is necessary to join a German health insurance scheme.

for EU citizens

Guest workers from EEA member states¹ and from states that have concluded a social security agreement² with Germany require health insurance in Germany, regardless of whether they are employed or self-employed. This also applies if the worker resides in another Member State or the employer has its registered office in another Member State. There are only two exceptions:

a person is simultaneously employed in one member state and self-employed in another member state ⇢ social insurance possible in both states2
temporary assignment abroad (maximum 12 months) ⇢ health insurance in the country of origin (form E 101 is required for this)Health insurance coverage for non-EU citizensIndependent of the duration of stay, employed persons outside the EU are subject to the German health insurance obligation, provided they can present a residence title in addition to the work permit. Third-country nationals can apply for this at the German mission abroad or at a foreigners authority in Germany.

Working and researching in Germany
Health insurance for guest workers and visiting scientists

Regulations for visiting scientists

Health insurance is also mandatory for visiting scientists (researchers) and accompanying family members. Therefore, it is urgently necessary for third-country nationals to inquire about insurance options even before departure: A residence permit will only be issued upon presentation of health insurance. The legal regulations at a glance:

Origin/mode of residence Health insurance regulations
Visiting scientists from EEA states¹ and states with social security agreements². Health insurance in home country also valid in Germany (European Health Insurance Card).
Form number 1 or 101 required from home health insurance fund or social security agency
Foreign scientists residing in Germany (for longer stays) Compulsory health insurance with an insurance company licensed in Germany Existing health insurance in the home country can be switched to a qualifying tariff for the period of the stay in Germany
Visiting scientist with employment contract German compulsory health insurance in the statutory or private health insurance necessary
Visiting scientist with scholarship only private health insurance possible

Health insurance for immigrants in Germany

Persons who wish to immigrate to Germany and thus seek permanent residence must take out health insurance. Otherwise, the issuance of the German visa will be refused.

Right of residence for EU citizens

In principle, citizens of a member state of the European Union have the right to live in any EU country, even if they are not gainfully employed there. However, the right of residence is subject to two conditions:1
Immigrants must prove sufficient “means of subsistence” to be able to support themselves in the EU country concerned2
Taking out health insurance in the “new” EU country

Regulations for nationals from non-EU countries

Immigrants from countries that require a visa to enter Germany must already provide proof of health insurance coverage at this time. Depending on whether an immigrant is employed or not, different conditions apply for both statutory and private health insurance.

Special regulations for asylum seekers in GermanyPersons seeking protection in Germany from political or other persecution are granted special status. In principle, asylum seekers are not covered by the statutory health insurance. In case of illness, they are entitled to benefits under the Asylum Seekers Benefits Act (AsylbLG). According to the law, different benefit levels apply depending on residence status and duration.

The entitlement according to § 4 AsylbLG includes:

In the case of acute illnesses: medical treatment, including the provision of dressings and medicines as well as other services to aid recoverynursing and medical care, including midwifery assistance as well as the provision of medicines and dressings for pregnant women and women who have recently given birthtaking advantage of preventive examinations and vaccinations Health insurance for students, interns and au pairsLegal compulsory insurance limit

Exchange students, foreign interns as well as au pairs who take up a position in Germany must have health insurance and accident insurance for the period of their stay. Foreign interns and au pairs only become legally liable for insurance if they earn more than 450 euros per month. However, you can take out private health insurance specifically tailored to the needs of foreign guests and visitors from the European Economic Area¹ and countries with a social security agreement².

Health insurance from home or in Germany?

Visitors from member states of the EEA¹ can be treated in Germany through the European Health Insurance Card (EHIC). If the home country has concluded a social security agreement² with Germany, including regulations on health insurance, benefits may be claimed in Germany under certain circumstances. The scope of the benefits is determined by the respective agreement. If the country of origin is not in the EEA¹ and there is no agreement in the area of social insurances², private health insurance must be taken out. For au pairs, the costs for PKV and accident insurance are to be borne by the host family.

Age restrictions for au pairs:Generally: 18 to 27 yearsFor applying for a visa: 18 to 26 yearsOrigin from non-EU countries: 18 to 24 yearsMaximum insurance period: 12 monthsIt is advisable to seek independent advice before going abroad in your home country or country of residence. This can be done, for example, at the responsible foreign missions, the responsible foreigners authority or specifically at the insurance companies.

Attention: The tariff offers and services differ depending on the provider – prices and services should therefore be checked in detail in advance. There are also tariffs for

Useful tips for non-nationals in Germany

What to do in an emergency? Especially when you need medical care in an emergency, it’s important to know who to turn to and how to get that help.

1. important telephone numbers in emergency situations

The following emergency numbers are necessary if medical treatment is needed quickly and immediately or in any other emergency situation:112 → Emergency doctor/ ambulance and/or fire department (applies throughout Europe)
110 → Police (All emergency numbers can be reached free of charge.)

2. medical on-call service

Opportunities to receive medical care outside of office hours:

  • 116117 → Medical on-call service of the Association of Statutory Health Insurance Physicians
  • Emergency room of the city hospital or university clinic on site
Educational Institutions Address
Foreign Office
Federal Office for Migration and Refugees
Federal Commissioner for Foreigners
The state refugee councils
German Academic Exchange Service (DAAD)
German Student Union (DSW) e.V.
Foundation for the Promotion of the German Rectors’ Conference
Secretariat of the Standing Conference of the Ministers of Education and Cultural Affairs of the Länder
Central Office for Foreign Education
Goethe-Institut e. V.
Society for Academic Study Preparation and Test Development e. V.
TestDaF Institute
Federal Ministry of Education and Research
Federal Insurance Office
Federal Agency for Civic Education (bpb)
German Liaison Office Health Insurance – Abroad (DVKA)
Healthcare Facilities Address
Federal Ministry of Health (BMG)
Federal Center for Health Education (BZgA)
German Federal Association for Prevention and Health Promotion (BVPG)
Independent Patient Counseling Service Germany (UPD)
German Red Cross (DRK)
Diakonie Germany
Caritas Germany
Federal Association of Voluntary Welfare Workers (BAGFW)
German AIDS Aid
German Centre for Addiction Issues (DHS)
German STI Society e.V.
Society for the Promotion of Sexual Health
German Society for Nutrition e. V.
The Healthy Cities Network

¹ EU/EEA states: EU member states and Liechtenstein, Norway, Iceland + Switzerland
² States that have concluded a social security agreement with Germany: Bosnia-Herzegovina, overseas departments of France (French Guiana, Guadeloupe, Martinique, Mayotte, Réunion), Israel³, Croatia, Morocco, Macedonia, Montenegro, Serbia, Turkey and Tunisia.
³ The agreement refers exclusively to maternity benefits within the health insurance system.