Statutory Health Insurance Requirement in Germany 2026: Who Must Join, Who May Choose?

Every employee earning under the JAEG threshold of €77,400/year (2026) is Pflichtversichert under § 5 (1) SGB V. Public tariff: 17.8% of gross with DAK-Gesundheit, split 50/50 employer/employee.

Employees above €77,400 gross/year (JAEG 2026), self-employed, freelancers, and civil servants may opt for PKV or a recognized Incoming tariff like Care Expatriate (from €58/month) instead of GKV under § 6 SGB V.

The employer registers DAK-Gesundheit under § 28a SGB IV; 17. Yes — from day one of the employment contract, regardless of nationality. 8% of gross is deducted, half by the employer, half by the employee.

Only if the gross salary exceeds €77,400/year (JAEG 2026) for three consecutive years, or if the foreigner is self-employed/freelancer under § 6 SGB V. Care Expatriate (from €58/month) is a common private choice.

The Mitgliedsbescheinigung of the Krankenkasse (DAK-Gesundheit issues it same-day) or, if PKV/Incoming, a § 257 SGB V-compliant certificate — Care Expatriate provides this as a PDF from €58/month.

Only if your gross income exceeds the Versicherungspflichtgrenze (73,800 EUR/year in 2026) or if you are self-employed. Most employees below this threshold are required to join the GKV. For an overview of available options, see our product overview.