For many financially comfortable expats, relocating to Germany with a family opens doors to new opportunities, excellent infrastructure, and high living standards. However, understanding and navigating the local health insurance system can be a significant challenge—especially when you’re used to very different healthcare structures in your home country.

One of the most important decisions expats face upon arrival is whether to choose statutory health insurance (Gesetzliche Krankenversicherung, GKV) or private health insurance (Private Krankenversicherung, PKV). While GKV is mandatory for many, PKV is often the better choice for healthy, high-earning expats who move to Germany with their spouse and children.

This article outlines everything you need to know about private health insurance in Germany, especially when relocating as a family.

Health insurance is mandatory for all residents in Germany

Germany operates under a universal health insurance mandate. This means every legal resident must have valid health coverage. Whether you’re employed, self-employed, or retired, you’re legally required to be insured either through the public system or a certified private provider.

The system is highly structured and relies on a dual framework: public insurance serves the majority of the population, while private health insurance is available to those who qualify based on income, employment status, or residency status.

Who qualifies for private health insurance in Germany?

Private health insurance in Germany is not available to everyone. Eligibility depends on several factors:

  • Income level: Employees earning more than the annual threshold (€69,300 in 2024) can opt out of public insurance and choose private coverage instead.
  • Profession: Freelancers, self-employed professionals, civil servants, and certain expat categories are generally allowed to choose PKV regardless of income.
  • Nationality and residence: Many non-EU expats can qualify, especially if they are not automatically enrolled into GKV through an employer.

Families moving together often benefit from a private plan, especially if one partner has a higher income and the family consists of healthy individuals without pre-existing conditions.

Why expat families often choose private health insurance

While public insurance offers solid basic coverage, private plans can be more attractive to families with specific needs or higher expectations. Key advantages include:

  • Shorter waiting times for specialist appointments
  • Access to English-speaking doctors
  • Greater flexibility in choosing treatment options and hospitals
  • Coverage for private hospital rooms and additional medical services

Premiums are based on personal health and age, not income. For families with young, healthy members, this can result in better coverage at a competitive cost.

Many expats also prefer private plans due to the higher quality of customer service and English-language support available.

Including your family in a private plan

Unlike in the public system, dependents are not automatically covered for free in private insurance. Each family member—partner and children—needs to be insured individually.

This is an important distinction, especially for families with multiple children. While it increases the total cost, it also means each family member receives individualized, often superior, medical coverage.

Understanding how to structure your family’s policy can be complex. Many providers offer specialized packages for families, and it’s crucial to compare options thoroughly.

Here’s an in-depth guide to private health insurance with family to help expat households evaluate coverage options.

Premium costs and what to expect

One of the most commonly asked questions is: How much will PKV cost for a family?

Premiums for private insurance are calculated individually for each insured person and are based on factors such as:

  • Age
  • Medical history
  • Level of coverage
  • Optional add-ons (e.g. dental, vision, maternity)

On average, a healthy adult in their 30s might pay around €400–€600 per month. Children’s premiums can range from €100–€200, depending on the provider and benefits selected.

While this might seem high, the level of coverage—particularly in private clinics or for dental work—often far exceeds what is offered through statutory insurance.

Switching from public to private insurance

Expat professionals who start with public insurance often consider switching to PKV later. However, switching is not always straightforward.

If you’re employed and your income rises above the threshold, you can apply for private coverage. However, once you leave GKV, returning is often only possible under specific circumstances.

Before making the switch, it is important to carefully assess long-term affordability and how coverage may evolve as your family grows or your employment situation changes.

Specialized private insurance for medical professionals

Medical professionals—especially doctors and dentists—who relocate to Germany enjoy access to tailored private insurance packages. These packages often include discounted premiums and enhanced medical services.

For more information on specialized tariffs for healthcare professionals, you can explore Private insurance for doctors, which outlines the unique offerings available for expats working in the medical field.

What to consider when choosing a provider

Not all private insurers offer the same level of quality or benefits. When evaluating providers, consider the following:

  • Is the policy documentation available in English?
  • Are customer service agents fluent in English?
  • What are the cancellation terms?
  • Are there premium increases with age?
  • Does the insurer offer worldwide coverage?

Expat families should prioritize insurers with a solid reputation for working with international clients. It’s also helpful to consult brokers who understand both German regulations and expat needs.

The role of brokers and financial advisers

Many expat families benefit from working with English-speaking health insurance brokers in Germany. These professionals understand both the legal requirements and the available policies and can help navigate the often complicated paperwork.

A good adviser can assess your current and future family situation and guide you toward a plan that fits your budget and medical expectations.

Keep in mind that in Germany, brokers are typically compensated by the insurance companies, meaning you often don’t pay extra for their services.

Understanding how the German healthcare system works

To make an informed choice, it’s essential to understand the core structure of the German healthcare system. It operates on solidarity and subsidiarity principles. Public insurance contributions are shared between employers and employees, while private plans are funded directly by the insured.

Knowing these fundamentals helps you assess your legal obligations and rights as an insured resident.

What expats should do before signing any contract

Before committing to any policy, it’s vital to:

  • Request multiple quotes and compare coverage levels
  • Read the fine print regarding what’s included and excluded
  • Ask about long-term costs and premium increases
  • Understand what happens in case of unemployment or departure from Germany

It’s also wise to have a medical check-up in advance, as insurers require health questionnaires and sometimes medical exams before approving coverage.

Why early planning ensures better coverage and fewer surprises

Private health insurance in Germany offers excellent coverage options for expat families, but it requires careful planning and understanding of the rules. By taking time before or just after arriving in Germany to evaluate your family’s health needs, income situation, and long-term plans, you will be better positioned to choose a plan that serves your best interests.

DISCLAIMER – “Views Expressed Disclaimer – The information provided in this content is intended for general informational purposes only and should not be considered financial, investment, legal, tax, or health advice, nor relied upon as a substitute for professional guidance tailored to your personal circumstances. The opinions expressed are solely those of the author and do not necessarily represent the views of any other individual, organization, agency, employer, or company, including NEO CYMED PUBLISHING LIMITED (operating under the name Cyprus-Mail).