Health insurance is compulsory in Germany. Most Indian employees, students and families are better off in public insurance (GKV); private insurance (PKV) is only open above €77,400 a year and is hard to leave later.
Every resident in Germany must have health insurance. You cannot get or extend a residence permit without proof of cover, and your employer cannot register you for payroll without it. There are two systems: statutory public insurance (gesetzliche Krankenversicherung, GKV), which covers about 90% of the population, and private insurance (private Krankenversicherung, PKV).
Before you arrive, the embassy or VFS usually asks for travel or incoming insurance only until your German cover starts. Employees are insured from their first working day; students must show cover when they enrol. Bring your Indian policy only as a bridge — it does not replace German insurance.
As an employee, you pay half of the general rate (7.3%) plus half of your insurer's additional contribution (Zusatzbeitrag). The 2026 average additional contribution is 2.9%, so your health share is about 8.75% of gross salary. Your employer pays the same. Real rates differ: TK charges 2.69% for 2026, Barmer 3.29%, DAK 3.2%.
On top comes long-term care insurance (Pflegeversicherung): 3.6% in total. Employees with a child pay 1.8%; if you are 23 or older and childless you pay 2.4%. Parents with several children under 25 pay a little less per extra child.
Contributions stop rising once salary reaches the ceiling of €69,750 a year (€5,812.50 a month). Earn more and your contribution stays the same.
| Gross salary | Health (8.75%) | Care | You pay per month |
|---|---|---|---|
| €48,000 (€4,000/month), childless | €350.00 | €96.00 (2.4%) | about €446 |
| €60,000 (€5,000/month), childless | €437.50 | €120.00 (2.4%) | about €558 |
| €60,000, one child | €437.50 | €90.00 (1.8%) | about €528 |
| €85,000 (above ceiling), childless | €508.59 | €139.50 | about €648 (maximum) |
The €60,000 parent pays the same whether one or four family members are covered. Check your own figure with the GKV vs PKV calculator and your net pay with the salary calculator.
Self-employed and other voluntary members pay the full rate themselves (14.6% + their insurer's Zusatzbeitrag + care), with a minimum assessment base.
Under Familienversicherung, your spouse and children are covered free if their own regular income is no more than €565 a month in 2026 (€603 if the income is from a mini-job). Children are covered up to 18, up to 23 if not working, and up to 25 while in school or university. A spouse who joins you on a family-reunion visa and does not work yet is covered from arrival once you add them.
Exception: if you are married and your spouse is privately insured and earns more than you and above the PKV threshold, the children may not qualify for free family cover. Ask your Krankenkasse before you decide.
As an employee you can only choose PKV if your gross salary is above the compulsory insurance threshold (Jahresarbeitsentgeltgrenze) of €77,400 a year in 2026. Self-employed people and civil servants can also join. If you move from India straight into a job paying above €77,400, you can choose PKV from day one.
PKV premiums depend on age, health and tariff, not income. A young, healthy single person may pay less at first, and your employer pays half, up to a 2026 maximum of about €508.59 for health and €104.63 for care. But every family member needs their own policy, premiums usually rise with age, and pre-existing conditions can lead to surcharges or exclusions.
Getting back into GKV is the real problem. You return automatically only if your salary drops below the threshold while you are under 55. From age 55, §6(3a) SGB V blocks the return if you were not in GKV at any time in the previous five years and were PKV-eligible for at least half of that time. Many Indians plan to stay in Germany long term — think about where you will be at 55, not just at 30.
Blue Card holders: the standard Blue Card threshold is €50,700 (€45,934.20 for shortage occupations and recent graduates). That is below €77,400, so most Blue Card holders are compulsorily in GKV. Only those earning above the PKV threshold have a choice. See the Blue Card guide.
Students: students at German universities are compulsorily insured in student insurance (KVdS) until the end of the semester in which they turn 30. The 2026 contribution is based on a fixed €855 BAföG rate: about €112 for health at the average Zusatzbeitrag plus €31–36 for care, so roughly €143–148 a month. You can apply for exemption within three months of enrolment to take private student cover, but the exemption is binding for the whole of your studies. Language-course students and Studienkolleg students are usually not in KVdS and need private or incoming cover.
Yes. Every resident must be insured, and proof of cover is required for visas, residence permits and university enrolment.
Employees pay about 8.75% of gross salary for health plus 1.8–2.4% for care, up to a ceiling of €5,812.50 a month — at most about €648 a month for a childless employee.
Only if the gross salary is above €77,400 a year in 2026, or if self-employed. Most Blue Card holders are compulsorily in GKV.
Before 55, yes, if you become compulsorily insured again, for example by earning below the threshold. From 55 the return is usually blocked if you were not in GKV in the previous five years.
Yes, under GKV family insurance, if her regular income is no more than €565 a month (€603 from a mini-job).
Checked against these sources on 14 October 2026. Rules and fees change; confirm with the authority before you apply.
