InsuoraHow does German health insurance work?
Germany has two parallel health insurance systems: the statutory GKV (Gesetzliche Krankenversicherung), which covers about 90% of the population, and the private PKV (Private Krankenversicherung). Most employees earning below the mandatory insurance threshold (€73,800/year in 2025, up from €66,600 in 2024) must be in GKV. Higher earners, the self-employed, and civil servants can opt for PKV.
GKV contributions are purely income-based: a fixed percentage of your gross income up to a ceiling. There is no underwriting, no exclusions for pre-existing conditions, and dependants (spouse, children) with low income can be covered for free under Familienversicherung.
How the GKV contribution is calculated
Your monthly GKV contribution = (14.6% + Zusatzbeitrag) ÷ 2 × min(gross income, €5,512.50)
- 14.6% base rate — set by law, identical for all health funds.
- Zusatzbeitrag — fund-specific surcharge, ranging from about 1.2% to 3.8% in 2025 (average ~1.9%, up from ~1.7% in 2024). Shared equally between employee and employer.
- Contribution ceiling (BBG) — €5,512.50/month (€66,150/year) in 2025, up from €5,175/month (€62,100/year) in 2024. Income above this is contribution-free. The maximum employee health contribution is therefore roughly €447–470/month depending on your fund.
- Employer pays half — for employees, the employer matches your contribution exactly. Self-employed pay the full rate themselves.
Long-term care insurance (Pflegeversicherung)
In addition to health insurance, a mandatory long-term care contribution is collected alongside GKV. The 2025 rate is 3.6% total, split 50/50 between employee (1.80%) and employer (1.80%). Childless employees aged 23 and over pay an additional 0.60% Kinderlosenzuschlag — this extra falls entirely on the employee (a tiered system based on number of children has applied since July 2023). Note: the calculator above still uses the 2024 values (3.4% / 0.35%) and will be updated in a future release.
Key thresholds for 2025
- Beitragsbemessungsgrenze (BBG): €5,512.50/month (€66,150/year) — contributions are capped here (2024: €5,175/month).
- Versicherungspflichtgrenze (VPG): €6,150/month (€73,800/year) — exceed this consistently and you can switch to PKV (2024: €5,550/month).
- Familienversicherung income limit: €538/month — dependants below this threshold are covered for free on your policy (2024: €505/month).
- Self-employed minimum basis: €1,131.67/month — even if your income is lower, contributions are assessed on at least this amount (2024: €1,178.33/month).
- Student special basis: €771.00/month — students pay a flat reduced rate regardless of actual income (2024: €736.53/month).
GKV vs. PKV — who benefits from which?
- GKV advantages
- Free family coverage (Familienversicherung) for a non-working spouse and children. No medical underwriting. Contribution-free parental leave. Automatic coverage if you lose your job. Stable costs in old age (premium doesn't rise with age).
- PKV advantages
- Usually cheaper premiums for young, healthy, high-earning individuals. Better benefits: private ward, chief physician treatment, faster appointments. Free choice of specialist without referral.
- PKV risks
- Premiums rise sharply with age. No free family coverage — each family member needs their own policy. Re-entry into GKV as an employee is extremely difficult once you leave. Medical history is reviewed on entry; pre-existing conditions may raise premiums or be excluded.
How to switch Krankenkasse
You can switch your statutory health fund at any time after being insured for at least 12 months. If your current fund raises its Zusatzbeitrag, you gain a Sonderkündigungsrecht (special right of termination) that lets you leave immediately, regardless of how long you have been a member.
When comparing funds, look beyond the Zusatzbeitrag: some funds offer better benefits, apps, or bonus programmes (Bonusprogramme) that partially offset a slightly higher rate.
Frequently asked questions
- Is this calculator free?
- Yes — completely free, no account needed. It runs in your browser and nothing you type is saved.
- Do I have to give personal information?
- No. The calculator uses broad categories only — no name, address, or social security number is required.
- What does my employer actually pay?
- For employees, the employer pays exactly half the total GKV rate (health + long-term care), matched to your own contribution, up to the BBG. The Kinderlosenzuschlag (0.60% in 2025) is an exception — that extra falls entirely on the employee, with no employer match.
- I'm self-employed. Can I join GKV?
- Yes. Self-employed who were previously in GKV can remain as voluntary members. However, you pay the full contribution rate yourself (no employer half), with a minimum monthly basis of €1,131.67 in 2025 even if your income is lower. Many freelancers find PKV cheaper, especially when young.
- How much does it cost as a student?
- Students under 25 (or within 14 semesters) pay a flat rate regardless of actual income, assessed on a special basis of €771.00/month in 2025. At TK's 2.45% Zusatzbeitrag (2025 rate), that works out to about €130/month for health insurance, plus approximately €37/month for long-term care — around €167/month total.
- I earn more than €6,150/month — should I switch to PKV?
- That depends on your age, health, whether you have dependants, and long-term income expectations. PKV is often cheaper in your 30s and 40s but can become very expensive past 60. If you have a non-working partner or children, GKV's free Familienversicherung provides significant value that PKV can't replicate. Get an independent insurance broker's opinion before switching. Note that the threshold rose to €73,800/year (€6,150/month) in 2025.