Statutory and private health insurance: the differences explained

Everyone in Germany needs to be covered by health insurance. This ensures that we all get the care we need should we fall ill. However, you have the freedom to choose your health insurance provider. What’s more, employees who earn more than

77,400

EUR per year and the self-employed can opt between statutory and private health insurance.

Do you earn above this limit and are faced with this choice? The comparison below breaks down the advantages of statutory cover compared to private insurance.

Good to know: around 90% of German residents have statutory health insurance.

A comparison of statutory and private health insurance

Statutory health insurance	Private health insurance
What you pay depends on how much you earn. However, your contributions do not continue to increase as you earn more once the contribution assessment ceiling has been reached. In 2025, this has been set at 5,812.50 EUR (gross) per month.	The premium depends on your risk profile (health and age), the insured scope of benefits, and the deductible. Your income is not taken into account. As your risk profile changes, so do your premiums. If you have pre-existing conditions, you may have to pay risk surcharges. Furthermore, cover may not be provided for certain diseases or, in some cases, denied completely.
You generally pay less if you have an occupational disability or when you retire.	Your contributions do not go down in the case of occupational disability or when you retire. In fact, your contributions may increase as you age. After the age of 55, you cannot switch back to statutory health insurance.

Statutory health insurance	Private health insurance
Your children* and married and civil partner (if they have no or only minimal income) can be insured as dependants for free.	Children and married partners are not insured for free as dependents; a separate contract must be taken out for each family member.

*Additional requirements: The other parent also has statutory insurance. If they are privately insured, their income must be below the income threshold for compulsory insurance. The child is not older than 23 and is not employed. If the child is in school or vocational training, the age limit is 25 years.

Health insurance contributions for family members

Statutory health insurance	Private health insurance
As a rule, you do not have to pay contributions when you are receiving sick pay or maternity benefits.	There is no exemption from contributions. You have to pay your contributions in full even when receiving sick pay or maternity benefits.

Statutory health insurance	Private health insurance
We pay sick pay to employees from the 7th week of sickness. As an employee you receive up to 90 percent of your net salary (for a maximum of 78 weeks for the same illness).	No benefits included; daily sickness allowance must be additionally insured (for employees from the 7th week)*.

*Up to the 6th week, wages are usually continued to be paid by the employer.

Statutory health insurance	Private health insurance
Statutory health insurance offers standardised benefits mandated by law. This ensures access to essential medical services, hospital stays and basic dental care. Medical providers are legally obliged to inform you of the possible costs of individual health services in advance.	The insurance cover provided depends on the plan you have selected. Invoices issued by the doctor may not be covered by the selected plan.
Doctors bill their services directly through the eHealth card with TK. You do not have to make an advance payment.	The doctor issues the invoice directly to you. You may have to make an advance payment. To be reimbursed, you must submit the paid invoice to the private health insurance.

Statutory health insurance	Private health insurance
You do not have to have a health check.	Health examinations are usually required to conclude and amend private health insurance cover.

Statutory health insurance	Private health insurance
The contributions for the self-employed are calculated according to their annual income. If you fall into this category, you need to provide regular confirmation of your income with the tax assessment notice. This, in turn, also means that your contributions can be reduced if your income decreases. If you are self-employed you can opt out of sick pay as of the 7th week of illness and therefore pay a reduced rate.	The self-employed can only switch back to statutory health insurance if they become employed again. However, this is only possible up to the age of 54. You will find further details on this at the link below: Voluntary insurance: when is private cover an option and what are the risks?

Statutory health insurance

Private health insurance

The contributions for the self-employed are calculated according to their annual income. If you fall into this category, you need to provide regular confirmation of your income with the tax assessment notice. This, in turn, also means that your contributions can be reduced if your income decreases. If you are self-employed you can opt out of sick pay as of the 7th week of illness and therefore pay a reduced rate.

The self-employed can only switch back to statutory health insurance if they become employed again. However, this is only possible up to the age of 54. You will find further details on this at the link below:

Voluntary insurance: when is private cover an option and what are the risks?

Further information on statutory health insurance in Germany from the National Association of Statutory Health Insurance Funds