Health care in Germany

Everyone living in Germany must have health insurance, by law: statutory insurance for most, private insurance for those the law leaves free to choose it. 74,512,362 people were in statutory health insurance in 2025, on average, and about 8.7 million had full private insurance in 2024.

The duty is in the Insurance Contract Act, section 193, paragraph 3; people in statutory insurance, or bound to be, are exempt from it because they are covered there. The health ministry dates the general duty to 1 April 2007 for statutory insurance and to 1 January 2009 for the rest; the private insurers' association says since 2009. Since 2007 statutory insurance also takes in people with no other cover who were last insured there, or never insured before (Social Code V, section 5, paragraph 1, number 13).

Sources: Bundesministerium der Justiz und für Verbraucherschutz and Bundesamt für Justiz, gesetze-im-internet.de, Gesetz über den Versicherungsvertrag (Versicherungsvertragsgesetz, VVG), § 193 (the Insurance Contract Act, section 193, the duty to insure), § 193 para. 3, read 20 October 2026. Bundesministerium der Justiz und für Verbraucherschutz and Bundesamt für Justiz, gesetze-im-internet.de, Sozialgesetzbuch (SGB) Fünftes Buch (V), Gesetzliche Krankenversicherung (the Social Code, Book V, statutory health insurance, as published on 20 October 2026), § 5 para. 1 no. 13, read 20 October 2026. Bundesministerium für Gesundheit (Federal Ministry of Health), Basistarif in der privaten Krankenversicherung (the health ministry's page on the basic tariff in private insurance), read 20 October 2026. Verband der Privaten Krankenversicherung (the association of private health insurers, not a government body), Wer kann in die private Krankenversicherung? (the private insurers' association's page on who may insure privately), read 20 October 2026.

The statutory count is the health ministry's yearly average for 2025 (its monthly statistics, KM1), read again in its final accounts for 2025 (KJ1) and in the statutory insurers' association's key figures, 74.51 million. Members and their family members insured with them are counted together. The private count is the private insurers' association's own, about 8.7 million in 2024; the statutory insurers' association gives 8.74 million for 2024, from the private insurers' figures. Both put statutory insurance at about 9 in 10 people.

The statistics office asked people themselves in its 2023 microcensus: 73.3 million said they were in statutory insurance and 9.0 million insured privately, 89 and 11 in 100 (its press release and its table).

Sources: Bundesministerium für Gesundheit (Federal Ministry of Health), Gesetzliche Krankenversicherung. Mitglieder, mitversicherte Angehörige und Krankenstand, Jahresdurchschnitt 2025 (KM1/13) (statutory health insurance, members and insured family members, yearly average 2025), Versicherte gesamt, 12099, read 20 October 2026. Bundesministerium für Gesundheit (Federal Ministry of Health), Gesetzliche Krankenversicherung. Endgültige Rechnungsergebnisse 2025 (KJ1), Stand 29. Juli 2026 (statutory health insurance, final accounts for 2025), Versicherte gesamt, 09983, read 20 October 2026. GKV-Spitzenverband (the national association of statutory health insurers, a public body set up by law), Kennzahlen der gesetzlichen Krankenversicherung, September 2026 (key figures of statutory health insurance, September 2026), pages 23 and 24, read 20 October 2026. Verband der Privaten Krankenversicherung (the association of private health insurers, not a government body), So funktioniert die private Krankenversicherung (the private insurers' association's page on how private insurance works), read 20 October 2026. Statistisches Bundesamt (Destatis), the Federal Statistical Office, Pressemitteilung Nr. N060 vom 29. Oktober 2025, 72 000 Menschen ohne Krankenversicherungsschutz (press release N060, people without health insurance in 2023), read 20 October 2026. Statistisches Bundesamt (Destatis), the Federal Statistical Office, Zur Krankenversicherung befragte Personen für das Jahr 2023 (people asked about their health insurance, 2023, by kind of cover and sex), read 20 October 2026.

An employee earning more than 77,400 euros a year in 2026 (about $87,460) is free of compulsory statutory insurance, and may stay in it as a voluntary member or take private insurance. Civil servants and the self-employed may also insure privately.

The limit is set each year by ordinance: 77,400 euros for 2026, 6,450 euros a month (the ordinance for 2026, section 2). The health ministry's guide of July 2026 gives the same amount. For employees who were already privately insured at the end of 2002 the limit is 69,750 euros (the same section, and the guide).

In dollars, about, at the 2025 average rate of 0.884969 euros to $1 (World Bank; the Federal Reserve gives 1.1306 dollars to the euro), since 2026 has no yearly rate yet.

Sources: Bundesministerium der Justiz und für Verbraucherschutz and Bundesamt für Justiz, gesetze-im-internet.de, Sozialgesetzbuch (SGB) Fünftes Buch (V), Gesetzliche Krankenversicherung (the Social Code, Book V, statutory health insurance, as published on 20 October 2026), § 6 para. 1 no. 1, read 20 October 2026. Bundesministerium der Justiz und für Verbraucherschutz and Bundesamt für Justiz, gesetze-im-internet.de, Verordnung über maßgebende Rechengrößen der Sozialversicherung für 2026 (the ordinance setting the social insurance amounts for 2026), § 2 para. 1, read 20 October 2026. Bundesministerium für Gesundheit (Federal Ministry of Health), Ratgeber Krankenversicherung. Alles, was Sie zum Thema Krankenversicherung wissen sollten (Stand 07/2026) (the health ministry's guide to health insurance, July 2026), pages 19 and 21 of the file, read 20 October 2026. World Bank, World Development Indicators, from the International Monetary Fund, Official exchange rate (LCU per US$, period average), PA.NUS.FCRF, read 20 October 2026. Board of Governors of the Federal Reserve System, G.5A Foreign Exchange Rates (Annual), read 20 October 2026.

Current spending on health, public and private, without investment in buildings and equipment, as a share of gross domestic product (GDP), the value of everything the country produces in a year, by the count of the World Health Organization (WHO), made with each country's own data: 11.74% for Germany in 2023, rounded here to one decimal. 2023 is the newest year the WHO has for every country on the dial, so every figure it is set against is the same year and the same count.

On the dial, "typical" means between the lowest quarter and the highest quarter of the 10 countries Dooram covers: from 8.8% to 11.6% of GDP. "Less than most" is below that, "more than most" above it.

Read on 21 October 2026 in the WHO's Global Health Observatory and again in the World Bank's copy of the same series; the two give the same figure for every country.

The Federal Statistical Office's own count is 12.4% of GDP for 2024 (the next card): it includes investment in buildings and equipment, which the WHO's count leaves out, and is for a later year.

Sources: World Health Organization, Global Health Expenditure Database, through its Global Health Observatory and the World Bank's World Development Indicators, Global Health Expenditure Database, current health expenditure as a share of gross domestic product (GHED_CHEGDP_SHA2011), 2023 (the World Health Organization's health accounts, every country's share of its economy spent on health, 2023), GHED_CHEGDP_SHA2011; the World Bank's SH.XPD.CHEX.GD.ZS, read 21 October 2026. Statistisches Bundesamt (Destatis), the Federal Statistical Office, Pressemitteilung Nr. 115 vom 2. April 2026, Gesundheitsausgaben im Jahr 2024 auf 538 Milliarden Euro gestiegen (press release 115, health spending in 2024), read 20 October 2026.

$582.5 billion (538.2 billion euros) went on health in 2024: $6,975 a person (6,444 euros), 12.4% of the economy.

The statistics office's health spending accounts for 2024, in its press release of 2 April 2026 and again on its health spending page and in its table by payer (538,207 million euros). 2024 is the newest year it has counted; its 579.5 billion for 2025 is an estimate.

The office's total includes 9.7 billion euros of investment. Without it, 528.5 billion is current spending, the measure the international System of Health Accounts uses; Eurostat gives the same 528,491 million for Germany.

Dollars are converted by Dooram at the 2024 average rate of 0.923890 euros to $1 (World Bank; the Federal Reserve gives 1.0820 dollars to the euro).

Sources: Statistisches Bundesamt (Destatis), the Federal Statistical Office, Pressemitteilung Nr. 115 vom 2. April 2026, Gesundheitsausgaben im Jahr 2024 auf 538 Milliarden Euro gestiegen (press release 115, health spending in 2024), read 20 October 2026. Statistisches Bundesamt (Destatis), the Federal Statistical Office, Gesundheitsausgaben nach Ausgabenträgern und nach Einrichtungen, in Millionen Euro (health spending by who pays and by kind of place, 2021 to 2024), by payer and by facility, 2024, read 20 October 2026. Eurostat (the statistical office of the European Union), Health care expenditure by financing scheme (hlth_sha11_hf) (the System of Health Accounts for Germany, 2024), hlth_sha11_hf, all financing schemes, 2024, read 20 October 2026. World Bank, World Development Indicators, from the International Monetary Fund, Official exchange rate (LCU per US$, period average), PA.NUS.FCRF, read 20 October 2026. Board of Governors of the Federal Reserve System, G.5A Foreign Exchange Rates (Annual), read 20 October 2026.

Statutory health insurance paid 55.9%, $325.6 billion (300.8 billion euros). Households paid 12.1% themselves, long-term care insurance 12.0% and private health insurance 8.3%.

The statistics office's two tables for 2024, each the same total: who paid, and in what kind of place the money was spent. Nothing joins a band in one column to a band in the next, because the tables do not say which money paid for which care. The four largest payers and the two largest kinds of place are in the office's press release too.

The rest of the payers, 11.7% together, are Dooram's sum: public budgets, employers, and pension and accident insurance; households include non-profit bodies, as the office counts them. "Everything else" in the second column, 14.0%, is Dooram's sum too: rescue services, administration, investment, other places and care abroad. Dollars at 0.923890 euros to $1, the 2024 average.

Sources: Statistisches Bundesamt (Destatis), the Federal Statistical Office, Gesundheitsausgaben nach Ausgabenträgern und nach Einrichtungen, in Millionen Euro (health spending by who pays and by kind of place, 2021 to 2024), by payer and by facility, 2024, read 20 October 2026. Statistisches Bundesamt (Destatis), the Federal Statistical Office, Pressemitteilung Nr. 115 vom 2. April 2026, Gesundheitsausgaben im Jahr 2024 auf 538 Milliarden Euro gestiegen (press release 115, health spending in 2024), read 20 October 2026. World Bank, World Development Indicators, from the International Monetary Fund, Official exchange rate (LCU per US$, period average), PA.NUS.FCRF, read 20 October 2026.

The contribution is 14.6% of pay, set by law, plus an additional rate each insurer sets for itself, 2.9% on average in 2026. Employee and employer each pay half of both. Family members insured with a member pay no contribution.

The general rate is in the Social Code V, section 241, and on the health ministry's page on contributions; the statutory insurers' association gives the same. The average additional rate for 2026, 2.9%, is the ministry's, set each autumn for the next year (section 242a), on its page and in the association's key figures. The ministry's page says that employers and pension funds pay half of the additional rate too.

Contributions are charged on pay up to 5,812.50 euros a month in 2026 (the ministry's page). They go into one health fund with the federal subsidy, and the insurers are paid from the fund.

Sources: Bundesministerium der Justiz und für Verbraucherschutz and Bundesamt für Justiz, gesetze-im-internet.de, Sozialgesetzbuch (SGB) Fünftes Buch (V), Gesetzliche Krankenversicherung (the Social Code, Book V, statutory health insurance, as published on 20 October 2026), §§ 241, 242a and 249, read 20 October 2026. Bundesministerium für Gesundheit (Federal Ministry of Health), Beiträge der gesetzlichen Krankenversicherung (GKV) (the health ministry's page on contributions, 2026), read 20 October 2026. GKV-Spitzenverband (the national association of statutory health insurers, a public body set up by law), Kennzahlen der gesetzlichen Krankenversicherung, September 2026 (key figures of statutory health insurance, September 2026), page 26, read 20 October 2026.

The federal government pays 14.5 billion euros a year (about $16.4 billion) into the health fund, by law, for what insurers pay that is not insurance in the strict sense. It has paid that much every year since 2017.

The Social Code V, section 221; the health ministry's key figures give 14.50 billion a year from 2017 to 2024, and the statutory insurers' association 14.5 billion each year to 2026. The Federal Social Security Office has run the health fund since 1 January 2009, holding the contributions and the federal subsidy and paying the insurers; the ministry's guide also dates the fund to 2009.

In dollars, about, at the 2025 average rate of 0.884969 euros to $1.

Sources: Bundesministerium der Justiz und für Verbraucherschutz and Bundesamt für Justiz, gesetze-im-internet.de, Sozialgesetzbuch (SGB) Fünftes Buch (V), Gesetzliche Krankenversicherung (the Social Code, Book V, statutory health insurance, as published on 20 October 2026), § 221 para. 1, read 20 October 2026. GKV-Spitzenverband (the national association of statutory health insurers, a public body set up by law), Kennzahlen der gesetzlichen Krankenversicherung, September 2026 (key figures of statutory health insurance, September 2026), page 27, read 20 October 2026. Bundesamt für Soziale Sicherung (Federal Social Security Office), Gesundheitsfonds, Überblick (the Federal Social Security Office's page on the health fund), read 20 October 2026. Bundesministerium für Gesundheit (Federal Ministry of Health), Ratgeber Krankenversicherung. Alles, was Sie zum Thema Krankenversicherung wissen sollten (Stand 07/2026) (the health ministry's guide to health insurance, July 2026), page 192 of the file, read 20 October 2026. World Bank, World Development Indicators, from the International Monetary Fund, Official exchange rate (LCU per US$, period average), PA.NUS.FCRF, read 20 October 2026.

Of the $380.1 billion (336.4 billion euros) statutory health insurance paid for care in 2025, hospital treatment took 33.2%, medicines 17.3% and doctors 16.1%.

The health ministry's final accounts of statutory health insurance for 2025 (KJ1), and again in the statutory insurers' association's key figures from the same statistics: benefits 336.41 billion euros; hospital 111.53, medicines 58.30, doctors 54.00, sick pay 21.63, dentists 14.85 and dentures 4.28, therapies 14.83, medical aids 12.24, travel 10.39 billion. The shares are Dooram's and the association's; they agree.

"Everything else" is Dooram's sum: nursing care at home, rehabilitation, vaccination, screening, dialysis, pregnancy and other benefits. Running the insurers is not in these figures. Dollars at the 2025 average rate of 0.884969 euros to $1 (World Bank; the Federal Reserve 1.1306 dollars to the euro).

Sources: Bundesministerium für Gesundheit (Federal Ministry of Health), Gesetzliche Krankenversicherung. Endgültige Rechnungsergebnisse 2025 (KJ1), Stand 29. Juli 2026 (statutory health insurance, final accounts for 2025), sums of the benefit accounts and account 05999, 2025, read 20 October 2026. GKV-Spitzenverband (the national association of statutory health insurers, a public body set up by law), Kennzahlen der gesetzlichen Krankenversicherung, September 2026 (key figures of statutory health insurance, September 2026), pages 4 to 22, read 20 October 2026. World Bank, World Development Indicators, from the International Monetary Fund, Official exchange rate (LCU per US$, period average), PA.NUS.FCRF, read 20 October 2026. Board of Governors of the Federal Reserve System, G.5A Foreign Exchange Rates (Annual), read 20 October 2026.

An adult in statutory insurance pays 10 euros a day in hospital (about $11.30), for at most 28 days a year. For a prescribed medicine you pay a tenth of the price, at least 5 euros and at most 10, and never more than the medicine costs. Children and young people under 18 pay none of these.

The Social Code V: section 61 sets the amounts, section 31 the medicines and section 39 the 28 days in hospital, for insured people aged 18 and over. The health ministry's guide of July 2026 gives the same rules and examples: a medicine costing 75 euros, 7.50 euros; one costing 15 euros, 5 euros.

In dollars, about, at the 2025 average rate of 0.884969 euros to $1. People with private insurance pay what their own contract says.

Sources: Bundesministerium der Justiz und für Verbraucherschutz and Bundesamt für Justiz, gesetze-im-internet.de, Sozialgesetzbuch (SGB) Fünftes Buch (V), Gesetzliche Krankenversicherung (the Social Code, Book V, statutory health insurance, as published on 20 October 2026), §§ 31 para. 3, 39 para. 4 and 61, read 20 October 2026. Bundesministerium für Gesundheit (Federal Ministry of Health), Ratgeber Krankenversicherung. Alles, was Sie zum Thema Krankenversicherung wissen sollten (Stand 07/2026) (the health ministry's guide to health insurance, July 2026), pages 136, 159 and 180 of the file, read 20 October 2026. World Bank, World Development Indicators, from the International Monetary Fund, Official exchange rate (LCU per US$, period average), PA.NUS.FCRF, read 20 October 2026.

In a calendar year a person pays co-payments only up to 2% of the household's gross yearly income; for someone in long-term treatment for one serious chronic illness, 1%. After that the insurer certifies that nothing more is due that year.

The Social Code V, section 62, and the health ministry's guide of July 2026. The income of the people living in one household is added together, less set amounts for each family member and child. Chronically ill people born after 1 April 1972 who skipped the check-ups the law names pay up to 2%, unless they are in a structured treatment programme.

Sources: Bundesministerium der Justiz und für Verbraucherschutz and Bundesamt für Justiz, gesetze-im-internet.de, Sozialgesetzbuch (SGB) Fünftes Buch (V), Gesetzliche Krankenversicherung (the Social Code, Book V, statutory health insurance, as published on 20 October 2026), § 62 paras. 1 and 2, read 20 October 2026. Bundesministerium für Gesundheit (Federal Ministry of Health), Ratgeber Krankenversicherung. Alles, was Sie zum Thema Krankenversicherung wissen sollten (Stand 07/2026) (the health ministry's guide to health insurance, July 2026), pages 136, 175 and 180 of the file, read 20 October 2026.

About 72,000 people in Germany had no health insurance and no other right to care in 2023, fewer than 1 in 1,000, by the statistics office's survey. Another 198,000 had no insurance but a right to care by other means, such as asylum seekers and people on social assistance.

The statistics office's microcensus of 2023, an extra set of questions asked every four years in the survey of about 1 in 100 people, in its press release and its table: 271,000 people without insurance, 198,000 of them with another right to care and 72,000 without. 44,000 of the 72,000 were men. The figures are people's own answers. Homeless people are not in the survey, the office says.

Asylum seekers are cared for under their own law, and civil servants and soldiers have their own schemes; how many people fall behind on their contributions Dooram has not read twice.

Sources: Statistisches Bundesamt (Destatis), the Federal Statistical Office, Pressemitteilung Nr. N060 vom 29. Oktober 2025, 72 000 Menschen ohne Krankenversicherungsschutz (press release N060, people without health insurance in 2023), read 20 October 2026. Statistisches Bundesamt (Destatis), the Federal Statistical Office, Zur Krankenversicherung befragte Personen für das Jahr 2023 (people asked about their health insurance, 2023, by kind of cover and sex), 2023, read 20 October 2026.