Student Health Insurance in Germany: Public vs Private

Health insurance is mandatory in Germany — not just recommended, but legally required. Without valid proof of health insurance, your university will not allow you to enrol. This applies to every student, regardless of nationality.

Public vs Private: Understanding the Two Systems

Germany has a dual health insurance system. As a student, you need to choose between public (gesetzliche Krankenversicherung) and private (private Krankenversicherung) insurance before you enrol. This is an important decision, because once you choose private insurance at the start of your studies, you generally cannot switch to public insurance for the rest of your time as a student.

Public health insurance

For most students, public insurance is the standard choice. It is specifically subsidised for students and costs approximately €125 to €135 per month, which includes both health insurance and long-term care insurance (Pflegeversicherung).

What you get for that price is comprehensive:

Doctor visits and specialist referrals
Hospital stays and surgery
Prescription medication (with small co-pays of €5–10)
Mental health treatment
Preventive care and vaccinations
Dental check-ups (though major dental work is only partially covered)

There are essentially no deductibles, and co-pays are minimal. The major public insurers that cater well to international students include:

Techniker Krankenkasse (TK): The largest public insurer in Germany, with good English-language support and a straightforward online sign-up process.
AOK: A strong regional network with offices in every city, helpful if you prefer in-person service.
Barmer: Another major insurer with a solid digital platform.

All public insurers offer the same core coverage — the differences are mostly in customer service, digital tools, and minor bonus programmes. You can sign up with any of them.

Private health insurance

Private insurance can be an option in certain situations. Monthly premiums for students often start lower than public insurance — sometimes as little as €30 to €50 per month — but the coverage, exclusions, and long-term implications vary significantly between providers.

Private insurance may make sense if:

You are over 30 (and no longer eligible for the subsidised public student rate)
You have specific coverage needs not met by public insurance
You are enrolled in a preparatory course or language programme that does not qualify for public student insurance

However, be aware of the downsides:

No switching back: Once you opt out of public insurance as a student, you cannot re-enter the public system until you start working in a job that requires it.
Coverage gaps: Cheaper private plans may exclude pre-existing conditions, mental health treatment, or pregnancy-related care. Read the fine print carefully.
Rising premiums: Unlike public insurance, private premiums are not fixed and can increase as you age or if you make claims.

Special Cases

EU citizens with a European Health Insurance Card (EHIC)

If you hold a valid European Health Insurance Card, you may be covered for basic medical treatment in Germany. However, the EHIC is designed for temporary stays and may not cover the full range of services you need as a student over multiple years. Most universities require you to either:

Register with a German public insurer (your EHIC country may cover the cost through a bilateral agreement), or
Obtain a certificate of exemption (Befreiung) from German public insurance, confirming that your home country coverage is equivalent.

Check with your home country's health insurance provider and your German university's student services office to clarify what applies to you.

Students over 30

The subsidised public insurance rate for students ends when you turn 30. After that, you can either:

Stay with public insurance at a higher voluntary rate (around €200 to €220 per month)
Switch to private insurance

If you know you will turn 30 during your studies, plan your budget accordingly — the jump in cost is noticeable.

Studienkolleg and language course students

If you are attending a Studienkolleg or an intensive language course before starting your degree, you may not yet qualify for the subsidised public student rate. In this case, many students take out a private travel or expat health insurance policy for the interim period and switch to public insurance once they officially enrol at a university.

When to Arrange Your Insurance

You need proof of health insurance at two key moments:

For your visa application: Most embassies require at least travel health insurance. Some accept a confirmation from a German public insurer that coverage will begin on arrival.
For university enrolment: You must present a valid insurance certificate (Versicherungsbescheinigung) to complete your enrolment. Without it, the university will not finalise your registration.

The simplest approach is to sign up with a German public insurer as soon as you have your admission letter. Most insurers allow you to register online from abroad and will send you the confirmation you need for enrolment.

What to Do When You Get Sick

Once you are insured, using the system is straightforward:

General practitioner (Hausarzt): Your first point of contact for most health issues. You do not need a referral to see a GP — just call and book an appointment. Some practices accept walk-ins.
Specialists: For specific issues (dermatologist, orthopaedist, etc.), you may need a referral from your GP, though some specialists accept direct appointments.
Emergencies: Go to the nearest hospital emergency room (Notaufnahme) or call 112 for an ambulance. Emergency care is always covered, regardless of your insurance type.
Pharmacy (Apotheke): Prescription medication is picked up at a pharmacy. With public insurance, you pay a small co-pay (usually €5 to €10) per prescription.

Wait times for specialist appointments can be long in Germany — sometimes several weeks. If you need urgent specialist care, mention this when booking or ask your GP to flag it as urgent.