Contents (8 sections)
- National visa health insurance in Germany: the rule in one sentence
- Which cover for which visa? An overview
- Work visa and EU Blue Card: the gap before your first day
- Student visa: enrolment needs proof of insurance
- Family reunification: when proof is needed
- Freelance and self-employed visa: private cover from day one
- Schengen visa or national visa? Do not mix them up
- Checklist: health insurance for your national visa
- For a national visa (D visa), your livelihood including adequate health insurance must be secured (§ 2 (3) and § 5 (1) (1) AufenthG); whether your cover is sufficient is decided by the German mission or the immigration office.
- German missions accept either future public insurance plus a bridging policy for the validity of the visa – usually three months for family reunification and one year for study and work – or a sufficient, permanent private health insurance taken out before entry (German Embassy Nairobi, information sheet).
- Travel health insurance is not sufficient proof for a national visa; an incoming policy must cover you until your long-term stay and final health insurance are established.
- A Schengen visa (C visa, up to 90 days) is different: it needs travel medical insurance with at least €30,000 cover (Art. 15 EU Visa Code).
- After arrival your job decides: below €77,400 (2026) or €84,150 (2027, draft) you are publicly insured by law; above it, and as a freelancer, a full private policy is an option – often the only one for non-EU newcomers who are self-employed.
For a German national visa (D visa) you need adequate health insurance: either future public insurance – through your job, enrolment or family insurance – plus a bridging policy for the validity of the visa, or a sufficient, permanent private health insurance taken out before entry. Travel health insurance is not accepted for a national visa; incoming policies are, if they cover you until your long-term stay begins (German Embassy Nairobi, information sheet; § 2 (3) AufenthG). Whether your cover is sufficient is decided by the German mission or the immigration office (as of October 2026).
This is not immigration or legal advice.Whether your health insurance is sufficient for a visa or residence permit is decided by the German mission abroad or your local immigration office (Ausländerbehörde). Requirements can differ between missions. Official information: Federal Foreign Office, BAMF and Make it in Germany.
National visa health insurance in Germany: the rule in one sentence
A residence title requires that your livelihood is secured, and German law counts health insurance as part of it: your livelihood is secured if you can pay for it “including adequate health insurance” without public funds (§ 2 (3) and § 5 (1) (1) AufenthG). For the visa this means two possible routes, as the German Embassy in Nairobi explains in its information sheet:
Route A: public insurance later, bridge now
You will be covered by public insurance in Germany – from the start of your job, from enrolment as a student or from the start of family insurance – and you take out sufficient cover of another type for the validity of the visa: usually three months for family reunification and one year for study and work visas.
Route B: permanent private insurance
You take out a sufficient and permanent private health insurance in Germany before entering the country. This is the usual route if public insurance will not be open to you, for example as a self-employed newcomer.
The missions add a clear warning: travel health insurance is not sufficient proof. Incoming policies are accepted for the bridging period, but many contain a clause that excludes the country of long-term residence. That is only acceptable if it cannot be read as excluding your first months in Germany – the policy must cover you until your long-term stay is established and a final health insurance is in place.
Which cover for which visa? An overview
| Purpose of stay | For the visa | After arrival |
|---|---|---|
| Employment, incl. EU Blue Card (§§ 18a, 18b, 18g AufenthG) | bridging policy until the job starts, or permanent private insurance | public insurance from the first working day below the income threshold; above it, choice between public and private |
| Job search with the Opportunity Card (§ 20a) | usually incoming policy valid in all Schengen states, at least €30,000, for the whole stay | public insurance only through a job above mini-job level |
| Study at a state-recognised university (§ 16b) | bridging policy until enrolment (usually one year visa validity) | student public insurance up to age 30, or exemption and private insurance |
| Language course or other preparatory stay | adequate private or incoming cover for the whole stay | student public insurance usually does not apply |
| Family reunification (§§ 27 ff.) | bridging policy, usually three months, if livelihood must be secured | family insurance if the family member is publicly insured and you have no or low income; otherwise own insurance |
| Self-employed or freelance work (§ 21) | usually permanent private health insurance | private insurance; public insurance is often not open to non-EU newcomers |
Details for the two most frequent cases are in our guides on health insurance with the EU Blue Card and health insurance with the Opportunity Card.
Work visa and EU Blue Card: the gap before your first day
Public insurance through your job does not start when the visa is issued. It starts with your employment contract or your first working day. The embassy in San José points out that if you enter before that, you need private cover for the time in between, and that travel or incoming policies may exclude long stays. Plan the bridge so that there is no gap – and keep the policy until your health insurance fund has confirmed your membership.
What happens next depends on your salary. Below the income threshold – €77,400 a year in 2026, €84,150 in 2027 (draft: Federal Cabinet decision of 7 October 2026, Bundesrat approval pending) – you are publicly insured by law. Above it you may choose. Private health insurance then has clear advantages: the premium does not depend on your income, your benefits are fixed by contract and cannot be cut by law, and your employer pays half of the premium, up to €613.22 a month in 2026. Our income threshold checker shows on which side of the line you are.
Student visa: enrolment needs proof of insurance
Students at a state-recognised university are usually compulsorily insured in public health insurance from enrolment, as a rule until the age of 30 (§ 5 (1) no. 9 SGB V). There is a catch: the university only enrols you if you show proof of health insurance. For the visa you therefore usually need a bridging policy until enrolment.
Students can apply for an exemption from student public insurance and take out private cover instead. The decision is binding for the whole degree, so think about it carefully – especially if you plan to stay and work in Germany afterwards. Language courses and other preparatory stays are usually not covered by student public insurance; here you need adequate private or incoming cover for the whole stay. The German rules on exemptions are explained by KV-Student.de on the exemption from student insurance (in German).
Family reunification: when proof is needed
For family reunification the missions ask for proof of health insurance only if the livelihood of the family must be secured. If your family member in Germany is publicly insured, a spouse or child without own income can often be covered free of charge through family insurance once it starts – until then a bridging policy for the first months is needed. When family members join a German spouse, a minor German child or a German parent with custody, proof of health insurance is usually not required in the visa process (German Embassy Nairobi).
If the family member in Germany is privately insured, there is no free family insurance: each person needs an own policy. Children can be added to a parent's private policy without health questions if they are registered within two months of birth (§ 198 VVG). How private cover works for families is explained in private health insurance for families.
Freelance and self-employed visa: private cover from day one
For a residence permit as a self-employed person or freelancer, adequate health insurance must also be secured. Many non-EU newcomers have no route into public insurance, because voluntary public membership usually requires previous public insurance. In practice the missions therefore expect a permanent private health insurance from the start. A full German private policy has advantages here: your premium does not depend on your profits, and benefits such as hospital treatment by a senior doctor or a single or double room can be chosen. Read more in health insurance for freelancers in Germany.
Schengen visa or national visa? Do not mix them up
A Schengen visa (C visa) is for short stays of up to 90 days in 180 days – visits, business trips, conferences. It needs travel medical insurance with at least €30,000 cover, valid in all Schengen states (Art. 15 EU Visa Code). A national visa (D visa) is for longer stays and needs adequate health insurance as described above. Travel insurance that is fine for a Schengen visa is not enough for a national visa. Visiting parents of expats usually need the Schengen type – see short stays in Germany.
Checklist: health insurance for your national visa
- Check the information sheet of your German mission – requirements can differ.
- Bridge the whole time until public insurance or your private policy starts – no gap.
- Read the exclusions of incoming policies: is Germany as the country of long-term stay excluded from the start?
- Bring the insurance certificate in the form your mission asks for – language, original or copy.
- Plan the long-term solution now: public through a job, family insurance or a full private policy.
Which long-term option fits you – public or private, including your family and the costs for 2027 – is shown by the free 60-second decider. A specialised expert from our partner network explains private health insurance in English and helps you find a policy that the immigration office can check – the decision on your visa stays with the authorities.
Frequently asked questions
What health insurance do I need for a German national visa?
You need adequate health insurance for your stay. German missions accept either future public insurance (for example through your job) plus a bridging policy for the validity of the visa, or a sufficient and permanent private health insurance taken out before entry (German Embassy Nairobi). Travel health insurance is not enough. The mission or immigration office decides in each case; this is not immigration advice.
Is travel insurance enough for a D visa?
No. The German missions state that travel health insurance is not sufficient proof for a national visa. Incoming policies can be accepted for the bridging period, as long as they cover you until your long-term stay is established and a final health insurance is in place – check that the policy does not exclude your planned country of residence from the start.
When does public health insurance start for a work visa?
With the start of your employment contract or the day you start work (German Embassy Nairobi). Until then you need a bridging policy. Below the income threshold of €77,400 (2026) public insurance through the job is compulsory; above it you may choose a full private policy.
Which health insurance do students need for the visa?
Students at a state-recognised university are usually publicly insured from enrolment until the age of 30 (§ 5 (1) no. 9 SGB V) – but the university only enrols you with proof of health insurance. For the visa you therefore usually need a bridging policy until enrolment. Students can also apply for an exemption and go private; the decision is binding for the whole degree.
Do family members need their own health insurance for the visa?
Usually yes, if their livelihood must be secured. If the family member in Germany is publicly insured, a spouse or child without own income is often covered free of charge through family insurance once it starts; a bridging policy is then needed for the first months. Joining a German spouse or a German child usually does not require proof of health insurance in the visa process (German Embassy Nairobi).
Sources
- German Embassy Nairobi: Health insurance for national visas (information sheet) – retrieved 22 October 2026
- § 2 AufenthG – secured livelihood incl. health insurance (para. 3) – retrieved 22 October 2026
- § 5 AufenthG – general conditions for residence titles – retrieved 22 October 2026
- Regulation (EC) No 810/2009 (EU Visa Code), Art. 15 – travel medical insurance – consolidated
- German Embassy San José: information sheet national visa EU Blue Card – December 2025
- German Embassy Cairo: information sheet national visa “Chancenkarte” – April 2026
- § 5 SGB V – compulsory insurance (employees, students) – retrieved 22 October 2026
- § 9 SGB V – voluntary insurance, first job in Germany – retrieved 22 October 2026
- Federal Foreign Office: visa and residence
This article provides general information on health insurance in Germany (as of 22 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.