In Germany, health insurance is mandatory for everyone, including students. The two main options are public insurance (GKV) and private insurance (PKV). Here's what you need to know to decide which one fits your situation.
GKV vs PKV: Core Differences
| Aspect | Public (GKV) | Private (PKV) |
|---|---|---|
| Premium calculation | Based on income (percentage) | Based on age, health, and coverage |
| Coverage for pre-existing conditions | Accepts everyone | May reject or exclude conditions |
| Doctor access | May have longer wait times | Often faster appointments, priority for specialists |
| Family coverage | Spouse/children covered free | Each family member pays separately |
| Dental/vision | Basic coverage; extras out-of-pocket | Depends on plan; can be comprehensive |
| Switching difficulty | Easy between public insurers | Hard to switch back to public after certain age/income |
Student Public Insurance: Rates and Conditions
For most international students, public insurance (GKV) is the default and usually better choice.
Student rate (2026): approximately €120–130 per month (varies slightly by insurer). This rate applies if:
- You are under 30 years old (or started your degree before turning 30)
- You are officially enrolled (have a university admission letter)
- You have not exceeded 14 semesters of study
If you exceed any of these conditions, the premium jumps to the standard employee rate (€400–800 per month).
Popular Public Insurers for Students
- TK (Techniker Krankenkasse): Great service, strong English support, most popular among international students
- AOK: Operates regionally, widest coverage, often best in smaller cities
- DAK Gesundheit: Competitive pricing, good for young and healthy individuals
- Barmer: Long history, nationwide coverage
Basic medical coverage is legally mandated and nearly identical across all public insurers. The main differences are in service quality and digital tools. TK's app and English customer service are why many foreigners choose it.
Student Private Insurance: When to Consider
Private insurance may be attractive for students in these cases:
- You are over 30 or have studied more than 14 semesters: the student public rate no longer applies, and some private plans (e.g., Mawista, CARE Concept, DR-WALTER) may be cheaper than the standard public rate
- Your parents are privately insured and can include you at a low cost
If you are under 30 and within standard study semesters: there is usually no reason to choose private insurance — public insurance offers full coverage, easier switching, and better long-term value.
After Graduation or Dropping Out: Don't Let Insurance Lapse
Health insurance is a legal requirement for everyone in Germany. After graduation, leave of absence, or dropping out:
- Student public insurance ends (you can no longer use the student rate)
- If you find a job: you automatically re-enter public insurance through your employer, who covers about half the premium
- If you are job-seeking: you can continue public insurance as a voluntary member, with premiums based on your income (or a minimum rate of about €200–250/month)
- If you plan to leave Germany: formally cancel your insurance in writing before departure, otherwise you must keep paying
Common Reimbursement Questions
- What do I need to bring to a doctor's appointment?
- Your electronic health card (Gesundheitskarte), which your public insurer sends you. Present it at reception on your first visit. No extra payment is needed.
- Do I have to pay for prescription drugs?
- Most prescription medications (verschreibungspflichtige Medikamente) are covered by public insurance, but you may have a small co-payment (Zuzahlung, usually €5–10 per box). Over-the-counter (OTC) drugs are fully out-of-pocket.
- How does dental coverage work?
- Public insurance covers basic dental care (cleanings, standard fillings). Major treatments like implants or high-quality crowns require extra payment. You can add a dental supplementary insurance (Zahnzusatzversicherung, about €10–20/month) for better coverage.
- Is psychotherapy covered?
- Public insurance covers psychotherapy (Psychotherapie), but finding a therapist with availability can be very difficult (wait times of 6+ months). Private therapists usually require full out-of-pocket payment (€80–150 per hour).
Summary
For most international students, public insurance (e.g., TK) is the best choice at around €120–130 per month. Sign up directly on the insurer's website using your university admission letter. If you are under 30 and within standard semesters, there is no compelling reason to choose private insurance. After graduation, make sure to arrange your insurance transition in advance — never let it lapse.
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