Health insurance for international students in Germany: public vs private
Short answer: health insurance is compulsory for enrolment. Until the end of the semester in which you turn 30, you can join a public insurer at the student rate: about €141–146 a month in 2026 at TK, one of the largest insurers (the exact amount depends on the insurer's extra contribution and your age). You can instead choose private insurance, but the exemption you sign for that cannot be reversed for the rest of your studies.
What public student insurance costs in 2026
Every public insurer charges the same base rate for students; what differs is each insurer's extra contribution (Zusatzbeitrag). Example: TK, from 1 January 2026.
| Part | Under 23, no children | 23 or older, no children |
|---|---|---|
| Health insurance base rate | €87.38 | €87.38 |
| TK extra contribution | €23.00 | €23.00 |
| Long-term care insurance | €30.78 | €35.91 |
| Total per month | €141.16 | €146.29 |
Source: TK, contributions for students from 1 January 2026. Other insurers' extra contributions are different, so their totals are a few euros higher or lower. Students with children pay a lower care-insurance rate.
Who can use the student rate
- Age limit: student insurance applies until the end of the semester in which you turn 30. Since 2020 the number of semesters no longer matters. Extensions beyond 30 are possible only in exceptional cases (Verbraucherzentrale).
- Over 30: you can usually continue as a voluntary member of a public insurer, but contributions are based on income and are noticeably higher than the student rate; private or special expat plans are the other route. Plan for this before your 30th birthday.
- EU students can often use their European Health Insurance Card (EHIC) instead; ask the insurer you contact.
Public or private: the decision that locks you in
If you want private insurance instead, you apply to a public insurer for an exemption from compulsory insurance (Befreiung von der Versicherungspflicht) within three months of the start of your studies. According to the Verbraucherzentrale, this exemption normally applies for the entire study period and cannot be revoked. Returning to public insurance is then usually only possible through a job with compulsory insurance after you graduate.
| Public (student rate) | Private (after exemption) | |
|---|---|---|
| Monthly cost | Fixed student rate (≈ €141–146 at TK in 2026) | Depends on plan, age and health; cheap plans often cover less |
| Can you switch later? | Yes, between public insurers | Not back to public during your studies |
| After age 30 | Voluntary public membership, higher cost | Stays private; price depends on the contract |
| Pre-existing conditions | Covered | May be excluded or cost more |
| Paying the doctor | Insurance card, insurer pays | Often you pay first and claim the money back |
Private cheap plans can look attractive at the start, but read what they exclude, and remember you cannot go back to public insurance until after your degree.
Visa insurance vs enrolment insurance
The visa application usually needs insurance that covers you from arrival until enrolment (often called travel or incoming insurance). Your university then needs proof of public student insurance, or of an exemption. Several blocked-account providers bundle both; compare them in our blocked account comparison.
Step by step
- Before the visa: arrange insurance that covers you from arrival until enrolment.
- Choose a public insurer (or decide on private and apply for the exemption within three months).
- The insurer reports your insurance status to the university electronically; you will be asked for your insurer's sender number or similar details at enrolment.
- Bring proof of insurance to the residence permit appointment.
- Note your 30th birthday: plan the switch before your student rate ends.
Next step in order: the first 90 days checklist.
Sources
- TK: student contributions from 1 January 2026
- Verbraucherzentrale: student health insurance options, age limit, exemption
General information, not insurance advice. Insurance rules for your individual case: ask the insurer directly.