Statutory health.
Made easy.
Germany’s public health insurance system is called gesetzliche Krankenversicherung, or GKV. Contributions are linked mainly to income, core benefits follow national rules, and eligible family members may be covered without a separate premium. Unconfuse helps you understand the essentials and find a suitable specialist partner when you need individual guidance.
AT A GLANCE
How GKV works
You join a statutory health provider (Krankenkasse). The provider handles membership and pays for covered treatment under German rules. You usually show your electronic health card at a participating practice, rather than paying the full bill yourself.
Who can join?
Many employees below the annual insurance obligation threshold must be in GKV. Others, including some self-employed people and higher earners, may be able to join voluntarily if the legal conditions are met. Your status and prior cover matter.
What is shared?
The statutory core benefits apply across health providers. Providers differ in their additional contribution rate, service, optional extras and bonus programmes. Compare the whole package, not just the advertised rate.
What about family?
Children and a spouse or registered partner may qualify for contribution-free family insurance if the conditions are met. Income limits and, in some mixed-insurance families, the other parent’s income affect eligibility.
COSTS IN 2026
How are premiums calculated?
For most employees, the health contribution is the 14.6% general rate plus the additional rate set by their chosen provider. Employer and employee usually split both parts equally. The government’s 2026 average additional rate is 2.9%, but your provider’s actual rate may be different. Long-term care insurance is an additional contribution with its own rules.
A simple example
At €4,000 gross monthly pay, using a 2.9% additional rate, health insurance would be €4,000 × 17.5% = €700 a month in total. If split equally, the employee’s health share is €350. This is an illustration, not a quote; care insurance and other payroll deductions are extra.
The income ceiling
Contributions are calculated only on income up to the Beitragsbemessungsgrenze. In 2026 that is €5,812.50 a month (€69,750 a year) for health and long-term care insurance. Income above that ceiling does not increase those contributions. The ceiling changes over time.
Don’t forget Pflegeversicherung
Germany also requires long-term care insurance (Pflegeversicherung), which helps pay for support if you need ongoing care. With GKV, this is normally arranged automatically through the care insurance branch of your health provider. Its contribution is added to your health insurance payment.
In 2026, the standard care contribution is 3.6%, or 4.2% for people without children from age 23, subject to statutory exceptions. Parents with two or more children under 25 receive reductions of 0.25 percentage points for each eligible child from the second to the fifth. The same income ceiling applies.
Earning €69,750 a year or more?
At the 2026 contribution ceiling of €5,812.50 a month, here is what health and care insurance together can cost. This example uses the 14.6% health rate plus a 2.9% provider additional rate.
| Monthly contribution | With one child | Without children, age 23+ |
|---|---|---|
| Health insurance — 17.5% | €1,017 | €1,017 |
| Care insurance — 3.6% / 4.2% | €209 | €244 |
| Combined total | €1,226 | €1,261 |
| Your share as an employee | €613 | €648 |
Approximate monthly amounts, rounded to whole euros. Employee figures apply outside Saxony: the employer pays half the health contribution and 1.8% towards care; the employee pays the childless surcharge alone. Saxony has a different care split. Your provider’s additional rate and family circumstances can change these figures. The contribution ceiling is separate from the income threshold for switching to private insurance.
Self-employed? Budget for the full amount.
With no employer contribution, self-employed members generally pay the full combined amount themselves. At the ceiling, that means around €1,226 with one child or €1,261 without children aged 23+ in this example. This can make GKV expensive for higher-earning self-employed people.
The example includes statutory sick-pay entitlement. Without it, the health base rate is 14.0% instead of 14.6%. Contributions depend on assessed income — generally business profit, not turnover — and can include other income. Minimum contributions and special arrangements, such as the artists’ social insurance scheme, may apply. Ask your provider for your individual total.
Contribution examples checked 3 October 2026. Sources: BMG: health contributions, care contribution rates and mandatory care insurance.
THE CORE BENEFITS
What does GKV usually cover?
Medical
care
Medically necessary care from participating doctors, approved psychotherapy, hospital treatment and rehabilitation. Preventive check-ups are also included, with eligibility and the scope of cover set by statutory rules.
Medicines and
therapies
Covered prescription medicines, approved medical aids and therapies such as physiotherapy. Cover depends on medical need and the statutory benefit rules. You may still need to pay a share of the treatment costs.
Dental and
family care
Standard dental treatment and a fixed contribution towards necessary crowns or dentures, plus pregnancy, maternity and children’s healthcare. Cover and your share of the cost depend on the treatment.
WHERE COSTS CAN ARISE
What might you pay yourself?
Medically necessary care does not automatically mean every treatment option is covered. Under §12 SGB V, GKV benefits must be sufficient, appropriate and cost-effective, and must not exceed what is necessary. Treatment must still meet medical quality standards. The covered option may differ from the treatment, material or technique you would personally prefer.
A bridge or
an implant?
For a missing tooth, standard treatment may be a bridge. GKV normally contributes a fixed subsidy based on 60% of the average cost of standard treatment, rising to 70% or 75% with a qualifying check-up history. If you choose an implant instead, the same subsidy generally remains available, but the higher total cost usually leaves you paying substantially more yourself. Special medical and hardship rules can apply.
Standard fillings or
additional options?
GKV covers suitable fillings without extra charges, including tooth-coloured composite fillings in front teeth. Since January 2025, amalgam has generally been prohibited, and covered alternatives are available for back teeth. Choosing certain composite techniques, cosmetic refinements or an inlay can still mean paying extra. Ask your dentist to explain the covered option and any additional costs before you choose.
Other costs can include statutory co-payments for prescriptions, hospital stays, therapies and aids. Individual health services (IGeL), a private hospital room and many adult glasses are outside standard cover or covered only in defined cases.
Before agreeing to treatment, ask what GKV covers, what alternatives are available and what you would pay yourself. Request a written cost plan. Providers may offer voluntary extras. Annual limits can reduce eligible households’ statutory co-payments, but do not generally cap private upgrades or your dental bill.
Sources: §12 SGB V, §70 SGB V and KZBV guidance on dental subsidies and fillings.
PRACTICAL DECISIONS
Sick pay, family cover and choosing a provider
When you cannot work
Employees generally receive continued pay from their employer for up to six weeks of illness. If eligible, statutory sick pay (Krankengeld) can follow. Self-employed members should check whether they have chosen cover with a sickness-benefit entitlement.
When your family changes
A new child, partner’s earnings, job change or a move into private cover can change family-insurance eligibility. Tell your provider promptly and ask for a written membership assessment when circumstances are complex.
When comparing providers, look at the actual additional rate, English-language support, service access, optional benefits and any relevant bonus programme. If you are deciding between GKV and private insurance, include family costs and long-term plans in the comparison.
KEEP LEARNING
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Find your next step
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General information, reviewed 27 September 2026. Rates, limits and benefits can change; your eligibility and exact costs depend on your circumstances and provider. Sources: Federal Ministry of Health: GKV contributions, benefit catalogue, and insured members and family cover.