Public or private health insurance?

Default GKV unless you have a specific reason for PKV. GKV is income-scaled, dependent-friendly (free Familienversicherung for low-earning spouse and minor children), and you can switch providers every 18 months without medical re-underwriting. PKV is age-scaled, premiums rise as you age and you cannot return to GKV after 55 if you spent more than half that time in PKV (§6 Abs. 3a SGB V). PKV makes sense for civil servants (Beihilfe + smaller premium share), high-earning singles without family, and short-term self-employed who plan to switch employer status before 55.

Jahresarbeitsentgeltgrenze (JAEG) is the gross-annual income threshold above which an employee may opt out of mandatory GKV into PKV. For 2026, it's 77,400 EUR (allgemeine JAEG). Below JAEG, GKV is mandatory and you cannot opt PKV. At or above JAEG, you have the option but the default still stays GKV freiwillig until you actively declare Versicherungsfreiheit. The threshold is set yearly by BMG.

Allgemeiner Beitragssatz is 14.6 percent of contributable income (split 50/50 employer/employee = 7.3 percent each). On top, each Krankenkasse charges a Zusatzbeitrag, also split 50/50. For 2026, TK and AOK Bayern are at 2.69 percent (cheapest mainstream), DAK at 3.20 percent, Barmer at 3.29 percent. The federal average is 2.9 percent. Above the BBG (Beitragsbemessungsgrenze 69,750 EUR / yr for 2026), the rates apply only up to the BBG cap.

TK (Techniker Krankenkasse) and AOK Bayern are tied at 2.69 percent Zusatzbeitrag, lowest of the major federally available providers. Total contribution = 14.6 + 2.69 = 17.29 percent (split with employer for employees). Some smaller Krankenkassen (HKK, BKK firmus, SBK) sit slightly cheaper, but limited regional reach and smaller networks. You can switch once you have been with a Krankenkasse for at least 12 months; the switch takes effect at the end of the second calendar month after you give notice.

If you're under 30 in a German degree program, mandatory studentische GKV applies. For students without children it costs about 141 to 151 EUR / mo in 2026, depending on the Krankenkasse and your age (TK: 146.29 EUR from age 23; Barmer: 151.42 EUR over age 23). Students with children pay a little less. Past 30 or after expulsion / dropout, studentische GKV is no longer available; freiwillige GKV at the self-employed floor (~223 EUR / mo) is the standard fallback. Family insurance on a parent's GKV plan is generally not available for international students (your parents need to be GKV-insured in Germany).

For 2026, the floor (Mindestbemessungsgrundlage) is 1,318.33 EUR / mo, producing a minimum GKV contribution of 222.80 EUR / mo (without Krankengeld coverage). The ceiling (BBG) is 5,812.50 EUR / mo, producing a maximum of 1,017.19 EUR / mo. The +11.9 percent jump from 2025 caught a lot of self-employed earners in 2026; budget accordingly. PKV typical premium for a healthy 30-year-old self-employed runs 350 to 650 EUR / mo, but rises with age.