International Health Insurance in Germany for Expats

Yes – since 2009, health insurance has been mandatory for all residents of Germany without exception. This applies to Americans moving to Germany regardless of their visa type or employment status. Proof of health insurance is required to register your address in Germany (Anmeldung) and to obtain a residence permit or work visa. Without valid health insurance documentation, your registration and visa applications cannot be processed. This means you must arrange health insurance before arriving in Germany or immediately upon arrival.

GKV (gesetzliche Krankenversicherung) is Germany’s statutory public health insurance system, which covers around 90% of the population. Contributions are income-based at approximately 14.6% of gross salary, split between employer and employee. GKV is mandatory for employees earning below the annual income threshold (approximately €73,800 in 2025). PKV (private Krankenversicherung) is available to employees earning above this threshold, self-employed individuals, freelancers and civil servants. PKV premiums are risk-based rather than income-based and can be tailored to include premium benefits, but premiums increase with age. Americans on short-stay visas may use expat health insurance as a bridge before entering the GKV or PKV system.

Once enrolled in GKV, you receive a health insurance card (Versichertenkarte) which you present at clinics and hospitals. Under GKV, most medical care is provided at no direct cost at the point of use – you do not need to pay upfront and claim back. Under PKV, you typically pay upfront and submit receipts for reimbursement. In both cases, a GP (Hausarzt) is your first point of contact for most healthcare needs. English-speaking doctors and international practices are available in all major German cities.

Short-term expat health insurance is available for Americans arriving in Germany before they are eligible for or have set up GKV or PKV. These plans provide coverage for the initial period after arrival – typically up to five years – and are accepted for visa applications and Anmeldung (address registration). They cover emergency and non-emergency medical care, hospital treatment and in many cases prescription medications. However, they are not a permanent solution for long-term residents – Germans and permanent residents must be enrolled in GKV or PKV. ExpatInsure can help you find the right plan for your initial period in Germany.

No. US Medicare does not provide coverage outside the United States in most circumstances. This is particularly important in Germany where health insurance is legally mandatory and proof of coverage is required for your residence registration. You cannot rely on a US insurance plan for your German residency requirements. ExpatInsure can help you find the right expat health insurance plan for your arrival in Germany and advise on your options for transitioning into the GKV or PKV system.