Best Public Health Insurance Company in Germany [2024 Guide]

Key takeaways

• Loosely speaking, 95% of the medical coverage is the same among all the public health insurance providers in Germany.
• Public health insurance companies vary drastically in their digital offerings, English customer support, and monthly premiums.

This is how you do it

• We find TK the best public health insurance company for expats in Germany. It offers the best digital services and English customer service.
• You can register with TK online.

Table of Contents

Best public health insurance for expats in Germany

We find TK to be the best public health insurance company for expats in Germany. If you can speak German, HKK is also a good option. 

TK and HKK both are one of the cheapest public health insurance companies in Germany as of 2024. You can register with TK online here.

How did we find the best public health insurance provider in Germany?

We considered the following parameters when comparing the public health insurance companies. 

• Digital services
• English customer care, website, and mobile app
• Monthly premium
• Difference in the services offered
  
  • Dental services
  • Homeopathy
  • Osteopathy
  • Glasses
  • Sports

We found little difference in the services public health insurance companies offered compared to TK. However, we found significant differences in their digital offerings and English customer support.

Additionally, certain public health insurance premiums are significantly higher than TK’s. Let’s take an example to demonstrate the difference in health insurance costs.

Your gross monthly salary	6000€
Public health insurer	TK	AOK Bayern	Barmer
Monthly insurance premium	1024€	1044€	1075€
Total premium paid in a year	12,288€	12,528€	12,900
Total premium paid as compared to TK	–	can save 236€ by switching to TK	can save 614€ by switching to TK

The table below summarizes the major differences in the medical coverage.

Comparison of public health insurance services

Parameter	HKK	TK (Our Choice)
Summary	➖ Second cheapest insurer as of Aug 2024 ➖ Offers digital services ➖ Offers basic English support	➖ Competitively priced insurance as of Aug 2024 ✅ Best insurer in digital service offerings ✅ Best insurer in English support
Premium	Additional contribution (Zusatzbeitrag): 0.98%	Additional contribution (Zusatzbeitrag): 1.2%
🇬🇧 English Support	💛 💛 🤍	💛 💛 💛
Website	Only in German	✅ Few parts of the website are in English
Mobile App	Only in German Play Store rating: 4.6 rated by 6.81k users App Store rating: 4.0 rated by 1 user	✅ Parts of the app are in English Play Store rating: 4.5 rated by 111k users App Store rating: 4.8 rated by 854 user
Customer Service	German and English Expect longer waiting times for customer support in English	✅ Good English customer care support.
🦷 Dental	💛 💛 🤍	💛 💛 🤍
Professional cleaning	Free teeth cleaning at certain dentists	Up to €40/year
Supplementary dental insurance Get dental insurance to cover dental treatment costs that are not covered by public health insurance.
🤰🏻 Pregnancy	💛 💛 🤍	💛 💛 🤍
Screening tests	Up to 300€ ✅ Chickenpox antibody test ✅ Fifth disease antibody test ✅ Strep antibody test ✅ Toxoplasmosis test ✅ chickenpox antibody test ✅ Extra ultrasound screening ❌ Triple-Test ❌ First trimester screening ❌ Neck fold measurement	✅ Chickenpox antibody test ✅ Fifth disease antibody test ✅ Strep antibody test ✅ Toxoplasmosis test ✅ chickenpox antibody test ✅ Extra ultrasound screening ❌ Triple-Test ❌ First trimester screening ❌ Neck fold measurement
Fertility treatment	First three attempts are legally insured. The insurer offers an additional subsidy of up to 200€ for the first three attempts.	✅ First three attempts are legally insured. The insurer offers an additional subsidy of up to 500€ for the first three attempts.
Midwife on call service Midwife on call means that you have a midwife available around the clock to support you while giving birth. Not all midwives offer this service.	Up to 300€ per annum (max 80%)	Up to 250€ per annum
💪 Sport	💛 💛 🤍	💛 💛 🤍
Sport medical examination Medical examination to check physical fitness. The examination is recommended for both beginners and experienced athletes.	✅ Up to 140€ per annum every 24 months.	Up to 120€ per annum (max 80 %) every 24 months.
Health courses You can reimburse part of the health courses cost in the areas of exercise, nutrition, relaxation, stress management and addiction. The course must be listed in the “Central Testing Center for Prevention.”	Up to 200€ per annum (max 80 %)	Up to 150€ per annum (max 80 %)
🧘🏻‍♀️ Osteopathy	💛 💛 💛	💛 💛 💛
Treatment Osteopathy is a form of alternative medicine that believes the body has an inherent ability to heal itself. It uses techniques like stretching, massaging, and manipulating muscles and joints to treat back pain, joint problems, and sports injuries.	✅ Up to 160€ per annum	Up to 120€ per annum
Homeopathy	💛 💛 💛	💛 💛 💛
Medicine	Up to 100€ per annum	Up to 100€ per annum

Are there significant differences in public health insurance companies in Germany?

No, you won’t find significant differences in the services offered by different public health insurers in Germany. The reason is that the German government regulates the services every public health insurance company must provide.

So, one can loosely say that 95% of the services are the same among all the public health insurance providers in Germany. The difference is in the services like alternative medicines, bonus programs, dental subsidies, etc. This difference is also not that big.

Cheapest public health insurance companies in Germany

The top five cheapest public health insurance companies in Germany are.

Health insurance contribution	14.6% (as of 2024)
Public health insurance company	Additional contribution (Zusatzbeitrag) 2024	Total Health insurance contribution 2024
BKK Firmus	= 0.9%	15,5% (14.6 + 0.9)
HKK	= 0,98%	15,58%
Audi BKK	⬇️ 1,0% (1.25% in 2023)	15,6%
Techniker Krankenkasse	= 1,2%	15,8%
HEK	= 1,3%	15,9%

Why are some public health insurance providers more expensive than others?

There are two factors that affect the cost of public health insurance.

• How the public health insurance premium is calculated.
• How does the health insurer use income from premiums to pay the medical expenses?

How is the public health insurance premium calculated?

Statutory health insurance premiums depend on your gross monthly income. It’s 14.6% of your gross income plus an additional contribution (Zusatzbeitrag in German). 

Each public health insurance company sets its own additional contribution percentage. As of 2024, the average additional contribution is 1.7% of your gross monthly income.

So, the total public health insurance premium is 16.3% (14.6 + 1.7%) of your gross monthly salary as of 2024.

As you can see, the premium depends on your salary. The more you earn, the more you pay. So, it would be beneficial for the health insurance company to have more high-earner members.

On the other hand, if the insurer has more low-earning or retired individuals, the income from premiums declines drastically. Additionally, more elderly members mean more medical expenses for the health insurer.

The ratio of young paying members to old retired members is crucial when determining the premium. The public health insurance provider can reduce the premium if it has a higher percentage of young earners as members than old members.

How does the health insurer use income from premiums to pay the medical expenses?

Public health insurance companies work in a backward system. This means they pay the medical expenses first and rely on their paying members to fund them. 

Moreover, everyone pays into the common health insurance fund. The insurance company uses the amount in this reserve to fund the medical expenses of all its members.

If the income from the premiums is not enough to cover the medical expenses. Health insurer has no choice but to increase the premiums.

Again, the ratio of young paying members to old retired members plays a significant role here. 

How do you switch public health insurance in Germany?

Changing public health insurance providers is straightforward. Moreover, you get support from your future health insurance provider. 

Changing your public health insurance provider is a 4 step process.

1. Find a new health insurance provider

There are 96 public health insurance companies in Germany. You can choose from any one of them.

We find TK the best public health insurance provider for expats. It offers its website, mobile app, and customer support in English.

2. Register with the new health insurance company

Most public health insurers offer online registration. The registration form asks for some standard personal and professional information. It takes only 2 minutes to complete and submit the registration form.

You can register with TK online here.

3. Cancelling your old public health insurance

Your new health insurer will take care of canceling your contract with the old insurer. So, you don’t have to do anything here. This also ensures uninterrupted coverage.

The old health insurance company will confirm your cancellation within 14 days. The new health insurance company will also inform you if the change was successful.

4. Inform your employer

You must also inform your employer about the change. Assuming you are employed and subject to social insurance contributions.

An email to your HR about the change is usually enough. Your employer can then ask for more information if required.

What should you keep in mind when changing public health insurance companies?

You must take care of the two things when making the switch.

• Notice period: Usually 2 months to the end of the month
• Commitment period: Usually one year

Notice period

When changing public insurance providers, you must serve a notice period, which is usually two full months to the end of the month. 

For example, suppose you decided to change health insurance companies on March 5, 2025. At the earliest, you can become a member of the new public health insurance company by June 1, 2025.

Commitment period

You have a one-year commitment period after switching your public health insurance company. This means you can only change your new statutory health insurance provider after one year has passed.

What is the special right to terminate your public health insurance?

Special right of termination means you can cancel your contract without serving the commitment period.

You have a special right of termination if your health insurance company increases the monthly premiums. In this case, the commitment period doesn’t apply. However, you must still serve the notice period.

You have until the end of the month from which the new premium applies to terminate your contract.

For example, suppose your health insurance company will increase the monthly premiums from 1st Feb. In this case, you have until the end of February to cancel your contract using your special right of termination. 

NOTE: You have a special right to termination only if the “additional contribution (Zuzsatzbeitrag)” increases. Don’t confuse it with an increase in insurance premiums in general.

Even if the additional contribution stays stable, public health insurance premiums still increase on average by 3.3% each year. 

Is private health insurance better than public?

Whether private health insurance is the right choice for you depends on your personal situation.

• Are you married?
• Do you have kids?
• How much do you earn?
• Does your partner earn?
• Your health condition

We know the German healthcare system is complex and can be confusing. So, we developed the “health insurance finder” tool to help you find which health insurance (public or private) is best for you and why.

However, private health insurance is the answer if you seek the best medical coverage. But to be eligible for private health insurance in Germany, you should earn at least 69,300 € gross per annum (as of 2024).

You should also check if you can afford private health insurance in the long term. It’s because returning to statutory health insurance is difficult.

Generally speaking, private health insurance is usually a better option for high-earners in Germany. This is because private insurance offers better medical coverage at a lower cost.

However, you cannot insure your non-working family members for free in private health insurance. You must get a separate private insurance policy for your non-working spouse and children.

So, if you are the sole earner in your family, private health insurance can be expensive.

Private health insurance is a complicated product. So, we recommend getting advice from a fee-based advisor or an insurance broker before deciding.

You can book a call with one of the insurance brokers we recommend here.