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Top German Public Health Insurers In 2026 – By Number Of Insured People

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Bar chart of Germany's top 10 public health insurers by number of insured people on 1 January 2026, led by TK (12.26 million), BARMER (8.20 million) and DAK Gesundheit (5.37 million)

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Top public health insurance companies in Germany

Public Health Insurance CompanyTotal Insured
(Versichert)		Family members insured for freePaying members
(Mitglieder)		Insured for free (%)As of
Techniker Krankenkasse (TK)12,259,7512,710,8859,548,86622.11%1.1.2026
BARMER8,198,8701,395,7306,803,14017.02%1.1.2026
DAK Gesundheit5,373,488953,9184,419,57017.75%1.1.2026
AOK Baden-Württemberg4,613,9831,083,2803,530,70323.48%1.1.2026
AOK Bayern4,578,310970,8253,607,48521.2%1.1.2026
AOK PLUS3,463,644717,2742,746,37020.71%1.1.2026
AOK Niedersachsen3,079,965741,9542,338,01124.09%1.1.2026
AOK Rheinland/Hamburg2,980,892757,0812,223,81125.4%1.1.2026
AOK NordWest2,953,958737,0632,216,89524.95%1.1.2026
IKK classic2,846,753524,7342,322,01918.43%1.1.2026
Number of people insured
Source: gesetzlichekrankenkassen.de (insurer data as of 1 January 2026); TK annual report 2025
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Techniker Krankenkasse (TK) is Germany’s biggest public health insurance provider based on the number of insured members. TK has about 12.3 million insured people (1 January 2026).

Barmer is the second largest public health insurance company after TK, with about 8.2 million insured people (1 January 2026).

AOK is a group of independent regional health insurance companies. As of 1 October 2026, the AOKs together insure about 27.4 million people, almost one-third of the population.

Barmer (17%) and DAK Gesundheit (17.8%) have the lowest percentage of members insured for free in family insurance. On the other hand, AOK Rheinland/Hamburg has the highest percentage (25.4%) of members insured for free in family insurance.

On average, 21% of the total insured members are insured for free in public family insurance. The higher the number of members insured for free, the higher the cost burden on the paying members.

From 1 January 2028, under the GKV-Beitragssatzstabilisierungsgesetz (BGBl. 2026 I Nr. 228), a spouse or registered partner insured for free will cost the paying member a surcharge of 2.5% of their contributable income. Children stay free. Exceptions apply, for example, to parents with children under 12, caring relatives, and partners above the statutory retirement age.

Among the ten biggest insurers, TK has the lowest additional contribution (Zusatzbeitrag) in 2026: 2.69% (17.29% in total), the same as the regional AOK Bayern. Some smaller insurers open nationwide are cheaper, for example TUI BKK (2.50%), HKK (2.59%) and Audi BKK (2.60%).

If you earn at or above the 2026 contribution ceiling (€5,812.50 a month), switching from one of the most expensive insurers (for example BKK24, 4.39%) to TK (2.69%) saves you up to about €593 a year as an employee (your employer saves the same again), or about €1,186 a year if you are self-employed and pay the full contribution. If you earn less, you save less.

The official average additional contribution is 2.9% in 2026 and stays at 2.9% for 2027. If your insurer raises its additional contribution, you have a special right of termination: register with the new insurer by the end of the month in which the increase takes effect, and the switch takes effect at the end of the second month after the month in which you apply.

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.“

Register with TK

tk logo
  • Biggest public health insurance company in Germany based on number of members.
  • Enjoy low premiums
  • Get English customer support, website, and mobile app.
  • Complete the application process in English.
Register with TK

How confident are Germans in their health insurance policy?

In a 2023 forsa survey for the Robert Bosch Stiftung, only 40% of Germans trusted that healthcare policy will secure high-quality, affordable care, down from 70% three years earlier.

It’s a big and justified drop. The German healthcare system is struggling due to rising costs and declining revenue. 

Healthcare expenditure was 538.2 billion euros in 2024 and has risen every year since 2021, by 7.6% in 2024 alone [3].

Bar chart of health expenditure in Germany from 2021 to 2025, rising from €476.2 billion in 2021 to €538.2 billion in 2024 and an estimated €579.5 billion in 2025

The factors contributing to the rising healthcare expenditure are

  • Germany’s aging population. More old people (60 and above) means more medical expenses. 31% of the German population is 60 or above as of 2025. [4]
german aging population
German population by age, 2025 (Destatis population pyramid)
  • Inflation is increasing the cost of medical treatments, medicines, etc.
  • Medical science progress: Innovations in the medical field offer patients better and more treatment options. This leads to increased medical spending.
  • Longer life expectancy: Life expectancy in Germany is around 81 years [5].

To cover these healthcare costs, Germany needs more young earners to contribute to the public healthcare system. However, the population of young professionals is decreasing.

All these factors make people lose their trust in the German healthcare system. People fear that the German public healthcare system will no longer be able to offer high-quality service at an affordable price.

Moreover, experts predict that health insurance premiums will increase drastically in the future.

public health insurance premium forecast

Why are Germans leaving public health insurance?

The number of people with full private health insurance in Germany rose again in 2025, by 0.6% to 8.8 million (preliminary figures, PKV-Verband). There are three main reasons for people moving to a private healthcare system.

Moreover, private health insurance is better prepared for the future with 356.5 billion euros at the end of 2025 in aging reserves. On the other hand, the public health system has no aging reserve.

In our comparison and test, we found Allianz, LVM, and Signal Iduna private health insurance companies among the best.

Private health insurance is a complicated product. So, we recommend consulting a fee-based advisor or an insurance broker for personalized advice.

Book a free call with a health insurance expert

  • German health insurance is a complicated product. There are several factors that must be considered before deciding which health insurance is best for you. An expert can guide you and help you pick the best option for you.
  • An Insurance broker is liable for their advice. This means if the policy they recommended doesn’t offer the coverage you requested, they are liable to pay the damages incurred in the future.
Book a call

How many people have public health insurance in Germany?

As of 1 October 2026, around 74.4 million were insured in statutory health insurance, which is around 89% of the German population [Source: Bundesministerium für Gesundheit].

  • Total number of members paying contributions: 58.8 million
  • Total number of members insured free of charge through family insurance: 15.6 million

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.“

Register with TK

tk logo
  • Biggest public health insurance company in Germany based on number of members.
  • Enjoy low premiums
  • Get English customer support, website, and mobile app.
  • Complete the application process in English.
Register with TK

How many people have private health insurance in Germany?

By the end of 2025, there were around 41 million full and supplementary private health insurance policies in Germany. Full insurance grew by 0.6% and supplementary insurance by 2.8% compared with 2024.

  • Total number of people who have full private health insurance: 8.8 million
  • Total number of supplementary private health insurance policies: 32.2 million
  • Total number of private health insurance policies: 41 million

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