Public health insurance in Germany

Yes. Everyone living in Germany generally needs qualifying health insurance.

Depending on your employment, income and personal situation, you may be insured through public health insurance (GKV) or private health insurance (PKV).

Most employees whose relevant salary is below the applicable annual income threshold are required to have public health insurance.

Employees above the threshold may be able to choose between GKV and PKV.

Different rules apply to self-employed people, students, civil servants and certain other groups.

GKV contributions are mainly based on income. PKV premiums are calculated individually based on factors such as age, health and the benefits you choose.

Family coverage is another important difference. GKV can provide family insurance for eligible spouses and children, while each family member generally needs their own PKV plan.

From 2028, however, family insurance for many spouses and registered partners in GKV will no longer be completely contribution-free.

GKV contributions are calculated as a percentage of your relevant income up to the contribution assessment ceiling (Beitragsbemessungsgrenze).

Each health insurance fund also charges an additional contribution (Zusatzbeitrag), which can differ between funds.

For employees, the regular health insurance contributions are generally shared between the employee and employer according to the applicable rules.

The Zusatzbeitrag is an additional contribution charged by each public health insurance fund on top of the general GKV contribution rate.

The percentage differs between funds and can change over time.

This means your choice of health insurance fund can affect how much you pay, even though the core GKV benefits are largely defined by law.

No. The core GKV benefits are largely defined by law, but health insurance funds differ in their additional contribution, extra benefits and service.

Differences can include travel vaccinations, preventive programmes, osteopathy, bonus programmes, digital services and support for international members.

These are the areas worth comparing before you choose a fund.

There is no single best GKV fund for every Indian expat.

The right choice depends on the current additional contribution, extra benefits, English-language service, digital services and what matters to you and your family.

NEOdirect compares suitable public health insurance funds based on your individual situation.

Currently, eligible spouses and children can often be covered through contribution-free family insurance (Familienversicherung), provided they meet the legal requirements.

This changes for many spouses and registered partners from 2028.

From 2028, many GKV members with a family-insured spouse or registered partner will pay an additional contribution of 2.5% of their relevant contributable income.

There are important exceptions, including certain families with children under 12, families with disabled children, people caring for relatives and people who have reached the statutory retirement age.

Children themselves can continue to be covered through contribution-free family insurance if they meet the eligibility requirements.

From 2028, contribution-free family insurance for spouses and registered partners will be restricted.

In many cases, the GKV member will pay an additional contribution of 2.5% of their relevant contributable income when their spouse or registered partner is family-insured.

Important exceptions apply. For example, the additional contribution does not apply in certain households with children under 12, disabled children or relatives requiring care.

Contribution-free family insurance for eligible children remains in place.

This change can be particularly important for couples where one partner works and the other has little or no income.

Yes. The 2028 reform does not abolish contribution-free GKV family insurance for children.

Eligible children can continue to be covered through Familienversicherung without their own health insurance contribution.

The major change from 2028 concerns family-insured spouses and registered partners.

Yes. GKV members can generally switch to another health insurance fund once the applicable requirements are met.

The exact rules depend on factors such as how long you have been with your current fund and whether a special switching right applies.

NEOdirect can check your situation and help coordinate the switch.

GKV generally does not provide the same protection in India that you receive when accessing healthcare in Germany.

For trips to India, separate travel health insurance (Auslandsreisekrankenversicherung) is therefore worth considering.

Depending on the plan, it can cover eligible medical treatment abroad and medically necessary return transport to Germany.

GKV provides comprehensive essential healthcare, but some treatments and additional services may not be covered or may only be partly covered.

Examples can include higher-quality dental treatment, certain dentures, private hospital accommodation and other optional services.

Private supplementary insurance can add cover in the areas that matter to you.

If you start employment in Germany and need GKV, you first choose an eligible public health insurance fund and complete the membership application.

Your employer receives confirmation of your membership, and your health insurance fund arranges your electronic health card.

NEOdirect can help you compare funds and complete the registration process in English or Hindi.

Possibly. Employees can generally consider private health insurance once they meet the applicable eligibility requirements.

But eligibility alone does not mean PKV is the better choice.

Your age, health, income, family situation and long-term plans in Germany should all be considered before switching. Returning from PKV to GKV later can be difficult.

Not automatically.

The new contribution for some family-insured spouses changes the financial comparison between GKV and PKV, but it does not make one system automatically better.

GKV and PKV differ in contributions, benefits, family coverage and how costs can develop over time.

For couples with one main earner, children or a non-working spouse, it becomes even more important to compare the long-term family costs rather than looking only at today's monthly premium.

Yes. NEOdirect helps Indians in Germany compare public health insurance funds and understand the differences in English or Hindi.

We compare factors such as additional contributions, extra benefits and service, help with the application and remain available for insurance questions after you join.