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Health insurance when you start a job in Germany

Starting a job in Germany means choosing a health insurer within two weeks. How to choose a Krankenkasse, and how to switch later.

The rates live on one page. The 2026 contribution rates, the average additional rate and the income ceilings are on salaries and pay, and the income line for private insurance is in after you arrive. This page links there rather than repeating them, so there is one place to check each January.

Is it optional?

No. Health insurance is compulsory in Germany.[1] As an employee, your contributions come straight out of your salary,[1] which is why your employer needs to know your insurer before your first payday.

Public or private

Public insurance — gesetzliche Krankenversicherung, GKV — is where most employees belong.[1] Private insurance — PKV — is only open to employees above a set income line.[1] The after you arrive guide gives that line for 2026 and the reasons not to choose private casually.

The rest of this page is about public insurance, because that is where most employees are.[1]

Choosing a public insurer

There are many public health insurers — Krankenkassen — and you choose one.[1] An insurer may not turn you down.[2]

The clearest difference between them is the price. Every insurer charges the general rate, the same for all, plus its own additional rate — the Zusatzbeitrag — which each insurer sets for itself.[3] Your employer pays half of that additional rate too.[3] The GKV-Spitzenverband, the insurers' national association, publishes a list of every insurer's current additional rate.[3]

Beyond price, three things are worth comparing if you are new to Germany — our suggestion, not a rule:

  • Service in English — a website, app or phone line you can use.
  • An app for sending documents, instead of post.
  • Extras the insurer advertises. Read what each one actually covers.

We do not recommend insurers, and nothing on this site is paid to point you at one.

The deadline: two weeks

When you become insured through a job, you have two weeks to tell your employer which insurer you chose.[2] If you do not, your employer registers you itself — with your previous public insurer if you had one, otherwise with one it picks.[2]

So choose before your first day, or in your first week. Sign up with the insurer and give your employer the confirmation.

Your family

Children, a spouse or registered partner can usually be insured with you through family insurance, the Familienversicherung, with one adult paying into public insurance.[1] Ask your insurer what it needs to add them.

Changing insurer later

  • You are bound for twelve months. After choosing, you stay with that insurer for at least twelve months.[2]
  • Then it takes about two months. After that, you can give notice, and the change takes effect at the end of the second calendar month after the month you gave notice in.[2]
  • Unless the price goes up. If your insurer raises its additional rate — or introduces one — you have a special right to leave without waiting for the twelve months.[3][4]

Before your job starts

If you are moving from abroad, there can be a gap between arriving and your first day at work. Make it in Germany advises arranging travel health insurance before you arrive, and checking the requirements with the German embassy or consulate that handles your visa, so that you are covered the whole time.[1]

What we cannot do

We cannot recommend an insurer or check your cover. This page is general information, not advice about your case.

This guide is about Germany. Switzerland works quite differently — you buy basic insurance yourself — and so does Austria. See working in Switzerland and working in Austria.

Where to check

Checked on 28 September 2026 against the sources below. Rates change every January; the rules about choosing and switching change rarely.

Sources

  1. Make it in Germany: Health insurance — health insurance is required; statutory insurance for most employees, private above an income threshold; a wide choice of statutory insurers; contributions deducted from salary; family insurance for children, spouses and registered partners; travel health insurance before arrival, checked with the German mission. Checked 28 Sep 2026. ↑↑↑↑↑↑↑↑

  2. § 175 SGB V (Ausübung des Wahlrechts), on gesetze-im-internet.de — the insurer may not refuse membership; if no choice is made within two weeks of becoming insured, the employer registers the person with the previous insurer or an eligible one; a minimum of twelve months with the chosen insurer; notice takes effect at the end of the second following calendar month (German). The official site blocks our checking tool; the wording was checked in a reproduction at sozialgesetzbuch-sgb.de. Checked 28 Sep 2026. ↑↑↑↑↑

  3. Federal Ministry of Health: Beiträge — the general rate of 14.6%; each insurer sets its own additional rate; employers pay half of it; the GKV-Spitzenverband lists current additional rates; members have a special right to leave when an insurer raises its additional rate (German). Checked 28 Sep 2026. ↑↑↑↑

  4. Association of Substitute Health Funds (vdek): Krankenkassenwahlrecht — a twelve-month binding period; a special right to leave when an insurer first charges or raises its additional rate (German). Checked 28 Sep 2026. ↑

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