Navigating the German healthcare system is often the most confusing part of relocating for a new job. In 2026, the stakes are higher than ever. For the first time in history, the combined monthly contribution for top-tier earners has officially crossed the €1,000 threshold, making it essential to understand your exact “net” take-home pay before you sign that employment contract.
Whether you are applying for a Blue Card or a standard Work Visa, this guide breaks down the mandatory insurance costs, the new 2026 salary thresholds, and how to secure the right “incoming” coverage for your visa appointment.
Statutory Health Insurance (GKV): The 17.5% Reality
Public insurance remains the standard choice for the vast majority of expats. However, 2026 has brought a noticeable “sticker shock” due to the rising Zusatzbeitrag (additional contribution).
What Makes Up the Cost
- The main rate is 14.6%. This is the same for all public insurance companies like AOK, TK, or Barmer.
- There is an extra fee called Zusatzbeitrag. On average in 2026, it is 2.9%. This is higher than last year.
- The total rate is about 17.5%. You and your employer split this cost equally. Each pays half, or 8.75%.
The Maximum Limit
- There is a monthly limit called the assessment ceiling. In 2026, it is €5,812.50.
- If you earn more than this amount per month, you only pay on €5,812.50. Your payment does not go higher.
- The maximum monthly payment for health insurance (your share) is now over €1,000 when you add nursing care. This is new in 2026.
A Helpful Tip
If you do not go to the doctor often, some plans give money back. For example, TK has a plan called TK-Flex. You can get up to €90 back in a year if you skip some services you do not need. This helps save a little money if you stay healthy.
Public insurance covers doctor visits, hospital stays, medicine, and more. It is good and reliable for most people.
Nursing Care (Pflegeversicherung): The Childless Surcharge
You must have nursing care insurance with your health insurance. It helps pay for care if you get old and need help. In 2026, the cost changes based on if you have children.
The Rates
- The basic rate is 3.6% for people with children. You and your employer share this.
- If you are over 23 and have no children, you pay an extra 0.6%. You pay this full extra amount yourself. No help from employer.
- For people without children, the total is 4.2%.
- At the maximum salary limit, a person without children pays about €244 per month for this insurance (their share).
Important Rule: If your yearly salary is under €77,400, you must use public insurance. You cannot choose private.
Nursing care insurance is required by law. It protects you and your family in the future.
Private Health Insurance (PKV) & The “77,400 Gap”
People who earn a lot sometimes choose private insurance. It can cost less or give better services. But in 2026, it is harder to switch to private.
The Salary Rule
- You need to earn more than €77,400 per year to choose private insurance. This number went up in 2026.
- Many people who earn around €75,000 now must stay in public insurance. They cannot switch.
Employer Help
- If you choose private, your employer still pays part. But the maximum they pay is about €424 per month in 2026.
How Private Costs Work
- Private insurance looks at your age and health when you join. Premiums depend on that.
- New plans in 2026 must save some money for when you are old. This stops costs from going too high later.
A Safety Option
- All private companies must have a basic plan. It gives the same coverage as public insurance. You can switch to it if private becomes too expensive.
Private insurance can be good for young and healthy people. But think carefully. It is hard to go back to public later.
“Incoming” Insurance: Your Visa Appointment Essential
Before you start your job and get on the German payroll, you need temporary insurance. This is a bridge. It helps you get your long-term national visa approved.
What It Must Cover
- It needs to be Schengen-compliant. This means at least €30,000 coverage for medical issues and going home if needed. It covers the first months.
- It must meet German law called Sec. 11 SGB V. The policy should say this. If not, the consulate may say no.
Popular Choices
- Plans like Dr-Walter Provisit Visum are well-known and accepted in 2026.
Easy Options
- You need a digital certificate fast. You upload it online for your visa.
- Companies like Expatrio or Feather have plans that work with blocked accounts and visa applications. They are easy for expats.
This incoming insurance is only short-term. Once you start work, you switch to public or private.
2026 Insurance Cost Comparison Table
Here is a simple table. It shows employee share for health + nursing care (for people without children). Costs are monthly.
| Salary Level | GKV (Employee Share) | Nursing Care (Childless) | Total Monthly Deduction |
|---|---|---|---|
| €50,700 (Blue Card Min) | €369.69 | €118.30 | €487.99 |
| €65,000 (Experienced) | €473.96 | €151.66 | €625.62 |
| €77,400+ (Ceiling) | €508.59 | €162.75 | €671.34 |
These numbers use average rates. Your exact cost may change a little based on your insurance company.
Final Checklist for Your Visa
Here are key things to remember:
- Check the salary rule. Make sure your job pays over €77,400 if you want private insurance.
- Get digital proof. Use a PDF for upload. Do not bring only paper in 2026.
- Confirm the law part. Your incoming insurance must follow SGB V rules.
Follow these steps to make your visa process smooth.
Are you not sure about your insurance or fund? Tell us your expected salary in comments. We can help estimate your take-home pay for 2026!
Disclaimer: This article is for information only. It is not advice. Please check with official sources or experts before you decide.