Contents (8 sections)
- Health insurance for international employees: the rules in one minute
- Public or private? What it means for your company
- Your duties as an employer – step by step
- The employer contribution 2026 and 2027
- Posted workers and short assignments
- Benefits: corporate health insurance for international teams
- What to tell new hires – without giving advice
- Checklist for HR
- International employees follow the same rules as German staff: below the income threshold of €77,400 (2026) – €84,150 in 2027 (draft: Federal Cabinet decision of 7 October 2026, Bundesrat approval pending) – they are compulsorily insured in public health insurance; nationality does not matter.
- Above the threshold they may choose private health insurance, and you pay half of the premium, up to €613.22 a month in 2026 and about €672.56 in 2027 (scenario), with health and care parts capped separately (§ 257 SGB V, § 61 SGB XI).
- If a new employee does not name a health insurance fund within two weeks of starting, you must register them with a fund yourself (§ 175 (3) SGB V).
- Since 1 January 2026, private insurers transmit their policyholders' premiums to the Federal Central Tax Office, and you retrieve them electronically for payroll tax, unless the employee objects (§ 39 (4) no. 4 and (4a) EStG).
- A corporate health insurance plan (betriebliche Krankenversicherung) is a popular benefit: up to €50 a month per employee it stays free of tax and social security contributions (§ 8 (2) sentence 11 EStG).
Health insurance for international employees in Germany follows the same rules as for German staff: below the income threshold of €77,400 (2026) – €84,150 in 2027 (draft) – they are compulsorily insured in public health insurance and you pay about half; above it they may choose private health insurance, and you pay half of the premium, up to €613.22 a month in 2026 (§ 257 SGB V). Your duties as employer: register the employee with the fund they choose – or one you choose if they have not decided within two weeks (§ 175 (3) SGB V) – and, for privately insured staff, pay the employer contribution and use the premiums transmitted electronically for payroll tax since 2026 (as of October 2026).
General information for HR: This page explains the legal framework as of October 2026. It is not legal, tax or immigration advice. Whether an employee's insurance is sufficient for a visa or residence permit is decided by the German mission abroad or the local immigration office (Ausländerbehörde).
Health insurance for international employees: the rules in one minute
Germany has two systems: public health insurance (gesetzliche Krankenversicherung, GKV), run by health insurance funds (Krankenkassen), and private health insurance (private Krankenversicherung, PKV). Which one applies to an employee depends on the salary – not on nationality, visa type or how long someone plans to stay.
Two details matter for new arrivals. First, someone who starts a new job with a regular salary above the threshold is exempt from public insurance from day one. Second, in their first job in Germany they can still join public insurance voluntarily within three months, even above the threshold (§ 9 (1) no. 3 SGB V). After that window, the choice is usually private. The EU Blue Card does not change any of this: its 2026 minimum salary of €50,700 (€45,934.20 in shortage occupations) is far below the threshold, so many Blue Card holders start in public insurance. More on the visa side: health insurance with an EU Blue Card.
Public or private? What it means for your company
| Salary of the employee | Health insurance | What you do as employer |
|---|---|---|
| Below €77,400 (2026) / €84,150 (2027, draft) | Public insurance is compulsory | Register with the chosen fund, deduct and pay contributions – you pay about half |
| Above the threshold, first job in Germany | Free choice; voluntary public insurance possible within three months | Give the employee time to decide; register with the fund or process the private certificate |
| Above the threshold, privately insured | Private health and long-term care insurance | Pay half of the premium up to the cap, keep the insurer's certificate, use the electronic premium data for payroll tax |
| Posted to Germany by a foreign employer | Often stays in the home system | Check A1 certificate or social security agreement before the start |
For your budget, the good news: the maximum employer contribution to private insurance equals what you would pay for a publicly insured employee at the contribution ceiling with the average additional contribution. A privately insured employee above the threshold therefore costs you at most that amount – and less if half of their premium stays below the cap.
Your duties as an employer – step by step
Before arrival
Public insurance through the job only starts with residence in Germany and the start of work. German missions point out that anyone entering earlier needs private cover until the job begins (German Embassy San José, Blue Card information sheet, December 2025). Mention this in your offer letter.
First two weeks
The employee tells you which health insurance fund they choose. If they have not done so within two weeks of compulsory insurance starting, you must register them yourself – with the last fund, or with any fund they could have chosen – and inform them in writing (§ 175 (3) SGB V).
Privately insured staff
Ask for the insurer's certificate that the policy meets the legal requirements; the employee renews it every three years (§ 257 (2a) SGB V). Then pay the employer contribution with the salary.
Payroll tax
Since 1 January 2026, private insurers transmit the premiums to the Federal Central Tax Office, and you retrieve them as an electronic payroll tax feature (ELStAM) – unless the employee objects to the transmission (§ 39 (4) no. 4 and (4a) EStG; § 52 (36) EStG).
A practical point for HR: international health plans from abroad do not automatically qualify. The employer contribution is only payable if the insurer meets the German requirements, and a policy that does not may not satisfy the legal obligation to have health insurance in Germany either. Details: employer contribution to private health insurance.
The employer contribution 2026 and 2027
For privately insured employees you pay half of the health and long-term care premium, each part capped separately. The cap rises in 2027 with the contribution ceiling.
| Per month | 2026 | 2027 (scenario) |
|---|---|---|
| Health insurance part (§ 257 SGB V) | €508.59 | €557.81 |
| Long-term care part (§ 61 SGB XI) | €104.63 | €114.75 |
| Maximum employer contribution | €613.22 | €672.56 |
The contribution also covers family members who would be family-insured in public insurance – but only within the same maximum. Self-employed people get no employer contribution. Worked examples for employees: private health insurance for employees.
Posted workers and short assignments
Not everyone who works in Germany is insured in Germany. If a foreign employer sends someone to Germany for a limited time, German rules on compulsory insurance can be excluded (§ 5 SGB IV, Einstrahlung). Within the EU/EEA and Switzerland, a posted employee usually stays in the home system for up to 24 months with an A1 certificate (Art. 12 Regulation 883/2004). For other countries, social security agreements may apply. If you hire someone on a German employment contract, however, German rules apply from day one. Because these cases depend on the details, clarify them with the competent authority or a specialist before the start.
Benefits: corporate health insurance for international teams
Many companies add a corporate health insurance plan (betriebliche Krankenversicherung, bKV) as a benefit. You take out a group contract; your employees get private extras such as dental cover, single or double rooms in hospital or a yearly health budget – on top of their public or private insurance. At the end of 2025, 60,600 companies offered such a plan, 16% more than a year earlier, covering over 2.8 million people (PKV-Verband).
- Tax-free up to €50: If the company is the policyholder and the employee can only claim insurance cover, the premium counts as a benefit in kind and stays free of tax and social security contributions up to €50 a month, together with other benefits in kind (§ 8 (2) sentence 11 EStG).
- Often no health questions: Many group contracts waive health checks and waiting periods; one insurer offers its plan from five employees and for publicly and privately insured staff (Allianz, accessed 18 October 2026).
- Valued by staff: In a Civey survey in January 2026, 45% said a corporate health plan matters more to them than other company extras (PKV-Verband).
For international hires who are new to the German system, such a plan can be an easy first step into private-level benefits. It does not replace their full health insurance.
What to tell new hires – without giving advice
New colleagues will ask you: “Public or private – what should I do?” HR is not an insurance adviser, and staying neutral protects both sides. Give your new hires the facts that apply to everyone – the threshold, the three-month window in the first job, the employer contribution – and point them to neutral information outside HR. Our free 60-second decider sorts their situation in English, without health questions, and the public vs private cost calculator shows their own share for 2027. If they want, a specialised expert from our partner network compares both systems with them in English, including what happens if they leave Germany later.
In German, for your payroll team: Arbeitgeberzuschuss 2027 (in German). A German version of this page is available: Krankenversicherung für ausländische Mitarbeiter.
Checklist for HR
- Mention in the offer letter that public insurance starts with the job – earlier arrival needs private bridging cover.
- Ask for the choice of health insurance fund on day one; register within the deadline (§ 175 (3) SGB V).
- Check the expected regular annual salary against €77,400 (2026) and €84,150 (2027, draft).
- For privately insured staff: certificate under § 257 (2a) SGB V, employer contribution, electronic premium data for payroll tax.
- For posted workers: A1 certificate or social security agreement before the first working day.
- Consider a corporate health plan as a tax-free benefit up to €50 a month.
Frequently asked questions
Do international employees have to join public health insurance in Germany?
Only if their regular gross annual salary is below the income threshold – €77,400 in 2026 and €84,150 in 2027 (draft). Then public insurance through the job is compulsory, whatever the nationality. Above the threshold they may choose between public and private insurance; in their first job in Germany they can still join public insurance voluntarily within three months (§ 9 (1) no. 3 SGB V).
Does the employer pay for private health insurance of international employees?
Yes, for employees who are exempt from public insurance and have a qualifying private policy: you pay half of the premium, up to €613.22 a month in 2026 and about €672.56 in 2027 (scenario). The health and long-term care parts are capped separately (§ 257 SGB V, § 61 SGB XI). The employee gives you a certificate from the insurer and renews it every three years.
Which health insurance does an EU Blue Card holder need?
The Blue Card does not decide that – the salary does. The minimum Blue Card salary in 2026 is €50,700 (€45,934.20 in shortage occupations), well below the health insurance threshold, so many Blue Card holders are compulsorily insured in public insurance. Above the threshold, private insurance is an option. Whether insurance is sufficient for the visa is decided by the German mission or the immigration office.
What if a new employee arrives before the job starts?
Public insurance through employment only begins with residence in Germany and the start of the job. German missions point out that anyone entering earlier needs private cover until the employment begins, and that travel or incoming policies can exclude long stays. Plan this gap with your new colleague before arrival – it is not something HR has to insure.
Can we offer group health insurance to international staff?
Yes. A corporate health insurance plan (betriebliche Krankenversicherung, bKV) adds private benefits such as dental, hospital or a health budget on top of public or private insurance. Many group contracts waive health questions; one insurer offers its plan from five employees and for both publicly and privately insured staff (Allianz). Up to €50 a month per employee it is a tax-free benefit in kind.
Are employees posted to Germany insured in Germany?
Not always. Employees sent to Germany temporarily by a foreign employer can stay in their home system: within the EU usually for up to 24 months with an A1 certificate (Art. 12 Regulation 883/2004), from other countries under the German rules on temporary assignments (§ 5 SGB IV) or a social security agreement. Check the individual case with the competent authority – this is not legal advice.
Sources
- § 6 SGB V – exemption from compulsory insurance (income threshold)
- § 9 SGB V – voluntary insurance (first employment in Germany)
- § 175 SGB V – choice of health insurance fund (para. 3: registration by the employer after two weeks) – accessed 18 October 2026
- § 257 SGB V – contribution subsidies for employees (para. 2a: insurer requirements, certificate every three years) – accessed 18 October 2026
- § 61 SGB XI – contribution subsidies for long-term care insurance
- § 39 EStG – payroll tax deduction features (para. 4 no. 4 and para. 4a: private health insurance premiums) – accessed 18 October 2026
- § 52 EStG – application rules (para. 36: § 39 as amended applies from 1 January 2026) – accessed 18 October 2026
- § 8 EStG – income in kind (para. 2 sentence 11: €50 monthly exemption limit) – accessed 18 October 2026
- § 5 SGB IV – temporary assignment to Germany (Einstrahlung) – accessed 18 October 2026
- Regulation (EC) No 883/2004 – coordination of social security systems (Art. 12: posted workers)
- Federal Ministry of the Interior: minimum salaries for the EU Blue Card 2026 (BAnz AT 18.12.2025 B3)
- German Embassy San José: information sheet national visa EU Blue Card (health insurance before the job starts) – December 2025
- Federal Government: contribution ceilings and thresholds 2027 (Cabinet decision) – 7 October 2026, Bundesrat approval pending
- PKV-Verband (Association of German Private Health Insurers): corporate health insurance – 60,600 companies, 2.8 million insured – as of 31 December 2025, accessed 18 October 2026
- Allianz: corporate health insurance for companies (insurer's information: no health questions, from 5 employees, for publicly and privately insured staff) – accessed 18 October 2026
This article provides general information on health insurance in Germany (as of 18 October 2026). It does not replace individual advice. Which solution suits you depends on your personal situation, e.g. age, health, income, family and length of stay. Despite careful review we cannot guarantee completeness and accuracy; laws and tariffs change. It is not immigration advice: whether your insurance is sufficient for a visa or residence permit is decided by the German mission abroad or your immigration office. Publisher: German-PKV.de. German-PKV.de is not an insurance broker and does not provide insurance, legal or tax advice; individual advice is provided exclusively by specialised cooperation partners licensed under § 34d GewO.