Increase in Public Health Insurance Premiums Between 1970 and 2025

Key takeaways

• The maximum public health insurance premium is 1174€ per month (as of 2025).
• The public health insurance premium has increased 4.1% per annum between 2015 and 2025
• Experts predict public health insurance premiums will be 32% of your gross monthly salary by 2025.
• Public health insurance premiums increased from 50€ per month in 1970 to 1174€ per month in 2025, a 2248% increase in 55 years.
• Additional contribution (Zuzatzbeitrag) was first introduced in January 2009.
• Long-term care insurance (Pflegeversicherung) was first introduced in January 1995.
• Long-term care insurance premiums increased faster than public health insurance premiums.

This is how you do it

• Use our "Health Insurance Finder" tool to check which health insurance is best for you.
• We find TK the best public health insurance provider for expats. Its website, mobile app, and customer service are in English. You can register with TK online.
• In our comparison and test, we found Haellesche, Allianz, and Signal Iduna’s private health insurance plans to be the best.
• We recommend getting private health insurance via an insurance broker. They are experts and can help you find the best plan for your needs. You can book a call with an expert we recommend here.

Table of Contents

How is the public health insurance premium calculated?

Public health insurance premiums in Germany depend on your gross monthly income and comprise two parts.

• Basic contribution: It’s set by the federal government of Germany and is the same for all public health insurance companies. 
• Additional contribution: It’s set by the public health insurance companies and varies from insurer to insurer.

On top of public health insurance, you also pay for long-term care insurance. 

Here is how the statutory health insurance companies calculate your premiums.

• Public insurers consider your gross monthly income when calculating the premium. The minimum and maximum income the insurer considers are 1,248.33€ (as of 2025) and 5,512.5 € per month (as of 2025), respectively.
• The public health insurance premium is a percentage of your gross annual income.
  • Basic contribution: 14.6% as of 2025
  • Additional contribution: 2.5% (as of 2025)
  • Long-term care insurance: 4.2% of your gross monthly salary (as of 2025)

Example:

You earn 5000€ gross per month. This is how much you’ll pay for public health insurance every month in 2025.

Basic contribution	14.6% of 5000	730€
Additonal contribution	2.5% of 5000	125€
Long-term nursing insurance	4.2% of 5000	210€
Total	21.3% of 5000	1065€

The maximum income public insurer considers for calculating the premium is 5,512.5 € per month (as of 2025). Thus, the maximum public health insurance premium you pay is 1174€ per month (as of 2025).

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

You can register with TK online for free in 2 minutes using our “TK registration service.“

Change in maximum income considered when calculating public health insurance premiums

The German government revises the maximum income considered to calculate the public health insurance premium each year. As you can see, the maximum income has increased yearly except in 2022.

Year	Income threshold (Gross income per annum)	Maximum monthly income considered to calculate the public health insurance premium	Percentage increase in maximum income considered
1970	7,362.60 €	613.55 €	–
1980	19,326.84 €	1,610.57 €	162%
1990	28,990.26 €	2,415.85 €	50%
2000	39,574.00 €	3,297.83 €	36.5%
2010	49,950.00 €	3,750.00 €	13.7%
2020	62,550.00 €	4,687.50 €	25%
2021	64,350.00 €	4,837.50 €	3.2%
2022	64,350.00 €	4,837.50 €	0%
2023	66,600.00 €	4,987.50 €	3.1%
2024	69,300.00 €	5,175.00 €	3.76%
2025	73,800.00 €	5,512.50 €	6.52%

The increase in the “maximum income considered” was highest during the 1970 -1980 decade. Since 2020, the German government has increased the maximum income by 3.2% per annum on average.

In 2025, we saw a big increase of 6.52% compared to the previous year. This sudden increase is due to the following reasons.

• Germany’s aging population. It’ll worsen with each passing year. By 2050, one-third of the German population will be above 60. On average, older people cost three times more to health insurance companies than young individuals.
• Inflation: Inflation has increased the cost of medical equipment, medicines, and medical fees.
• Medical advancement: As medical science advances, more treatment options are available to patients, increasing the average cost of medical treatment.

The trend is likely to continue in the future. This is why you must save for your retirement. Otherwise, you’ll be unable to pay health insurance premiums in old age.

How much have public health insurance premiums increased since 1970?

Year	Maximum monthly income	Basic contribution		Additional contribution (Germany-wide average)		Total public health insurance premium	Percent increase in public health insurance premium
		in %	In Euros	in %	In Euros
1970	613.55 €	8.20	50.31 €	Earlier, there was no additional contribution. It was added from 1 Jan 2009.		50.31 €	–
1980	1,610.57 €	11.40	186.75 €			186.75 €	272%
1990	2,415.85 €	12.50	301.98 €			301.98 €	61.8%
2000	3,297.83 €	13.50	445.21 €			501.27 €	66%
2010	3,750.00 €	14.00	525.00 €	0.9	33.75 €	558.75 €	11.47%
2015	4,125.00 €	14.60	602.25 €	0.9	37.13 €	639.38 €	14.45%
2020	4,687.50 €	14.60	684.38 €	1.1	51.56 €	735.94 €	15.11%
2021	4,837.50 €	14.60	706.28 €	1.3	62.89 €	769.17 €	4.51%
2022	4,837.50 €	14.60	706.28 €	1.3	62.89 €	769.17 €	0%
2023	4,987.50 €	14.60	728.18 €	1.6	79.80 €	808.98 €	5.2%
2024	5,175.00 €	14.60	755.55 €	1.7	87.98 €	843.53 €	4.27%
2025	5,512.50 €	14.60	804.83 €	2.5	137.81 €	942.64 €	11.75%

Let’s understand this table in three parts: basic contribution, additional contribution, and overall increase in the public health insurance premiums.

• The basic contribution was 8.2% in 1970 and has increased gradually. It’s been 14.6% since 2015.
• The additional contribution was first introduced in January 2009. Since then, it has increased consistently every year. In 2025, we saw the highest jump. This is because of the factors mentioned earlier, i.e., an aging population, inflation, and medical advancement.
• The overall public health insurance premium is increasing at 4.1% per annum between 2015 and 2025. Experts predict that public insurance premiums will increase to 32.1% of your gross monthly salary by 2050. 

Increase in long-term care insurance between 1970 and 2025

Year	Maximum monthly income	Long-term care insurance premium (without child)		Percent increase in long-term care insurance premium
		in %	In Euros
1970	613.55 €	Earlier, there was no long-term care insurance contribution. It was added from 1 Jan 1995.
1980	1,610.57 €
1990	2,415.85 €
1995	2,991.06 €	1.00	29.91 €	–
2000	3,297.83 €	1.70	56.06 €	87.5%
2005	3,525.00 €	1.95	68.74 €	22.6%
2010	3,750.00 €	2.20	82.50 €	20%
2015	4,125.00 €	2.60	107.25 €	30%
2020	4,687.50 €	3.30	154.69 €	44.2%
2021	4,837.50 €	3.30	159.64 €	3.2%
2022	4,837.50 €	3.30	159.64 €	0
2023	4,987.50 €	4.00	199.50 €	25%
2024	5,175.00 €	4.00	207.00 €	3.7%
2025	5,512.50 €	4.20	231.52 €	11.8%

Long-term care insurance covers long-term care costs for individuals who need assistance due to age, illness, or disability. For example, expenses related to home care, nursing homes, and other caregiving services.

Long-term care insurance was introduced in January 1995 and is mandatory for everyone in Germany. The insurance contribution varies depending on the number of children you have.

The table above shows the contribution rate for people who don’t have children. As you can see, the long-term care insurance premium has increased more than 400% in the past 30 years.

The long-term care insurance premium has increased faster than the public health insurance premiums. In addition, the German government reduced the medical services covered in this insurance over time.

How the total contribution in public health insurance has changed since 1970

Year	Maximum monthly income	Basic contribution (in %)	Additional contribution (in %)	Long-term nursing care (in %)	Total public health insurance premium		Percent increase in total public health insurance premium
					in %	in €
1970	613.55 €	8.20			8.2	50.31 €	–
1980	1,610.57 €	11.40			11.4	186.75 €	271%
1990	2,415.85 €	12.50			12.5	301.98 €	61.7%
1995	2,991.06 €	13.40		1.00	14.4	424.73 €	40.6%
2000	3,297.83 €	13.50		1.70	15.2	501.27 €	18%
2005	3,525.00 €	14.30		1.95	16.25	572.82 €	14.3%
2010	3,750.00 €	14.00	0.9	2.20	17.1	641.25 €	12%
2015	4,125.00 €	14.60	0.9	2.60	18.1	746.63 €	16.4%
2020	4,687.50 €	14.60	1.1	3.30	19	890.63 €	19.2%
2021	4,837.50 €	14.60	1.3	3.30	19.2	928.81 €	4.3%
2022	4,837.50 €	14.60	1.3	3.30	19.2	928.81 €	0
2023	4,987.50 €	14.60	1.6	4.00	20.2	1,007.48 €	8.5%
2024	5,175.00 €	14.60	1.7	4.00	20.3	1,050.53 €	4.2%
2025	5,512.50 €	14.60	2.5	4.20	21.3	1,174.16 €	11.7%

Everyone in Germany is legally required to have valid health insurance. As of 2025, 87.6% of the German population is insured under public health insurance.

Public health insurance premiums have increased consistently since 1970. They were 50€ per month in 1970 and 1174€ per month in 2025, a 2248% increase in 55 years. 

Viewing the increase in the insurance premium over 50 years can help us interpret how the future might look. We projected the public health insurance premiums in the future based on different rates it increased in the past.

Increase in public health insurance premium.

• Since 1970 (55 years): 2248%
• Since 1990 (35 years): 288%
• Since 2000 (25 years): 134%
• Since 2015 (10 years): 57%

Assuming a similar increase in the next years, the public health insurance premium will be

• around 27,565€ per month in 2075 (a 2248% increase)
• around 4555€ per month in 2055 (a 288% increase)
• around 2747€ per month in 2045 (a 134% increase)
• around 1843€ per month in 2035 (a 57% increase)

The increases in public health insurance premiums are inevitable. So, it’s vital that you save for your retirement.

Based on our calculations, if you save 200€ per month, the amount you save should be enough to cover your health insurance premiums in old age completely.

Opening an ETF savings plan is the easiest way to start saving for your retirement. You can open a free account with Scalable Capital* or Finanzen.net Zero*.

You can also open a daily savings account* to start saving. 

Average increase in private and public health insurance premiums over 20 years

Although private health insurance costs increase by a large percentage abruptly, the average increase in premiums over 20 years is 3.1% per annum between 2005 and 2025. 

Conversely, public health insurance costs have increased by 3.8% per annum between 2005 and 2025.

Average private and statutory health insurance premium increase in over 10 years

Health insurance costs in Germany have increased faster in the last ten years (2015 to 2025) than in the last twenty years.

• Private health insurance costs increased by 3.9% per annum between 2015 and 2025.
• Public health insurance costs increase by 4.1% per annum between 2015 and 2025.

Should you switch to private health insurance?

With a deteriorating public healthcare system and increasing premiums, people have lost faith in state healthcare. Experts predict that public health insurance won’t be able to offer good coverage at an affordable price.

As a result, many people are switching to private health insurance. Another reason for the switch is that private health insurance is better prepared for the future. 

The private healthcare system has built a retirement provision of 344 billion euros as of 19 Feb 2025. On the other hand, public health insurance has a deficit of 6 billion euros.

Considering all these factors, moving to a private system seems reasonable. However, switching to private insurance is a lifelong decision. So you should educate yourself before making the switch.

NOTE: Health insurance premiums of both private and public systems will increase at a similar rate. 

We recommend getting private health insurance via an insurance broker. They are experts and can help you find the best plan for your needs. You can book a call with an expert we recommend here.