Public vs Private Health Insurance for Students in 2026: The Real Difference

Health insurance is the first real financial decision you make in Germany, and it is the one students most often get wrong by optimising for the monthly figure. Public student cover works out at EUR 146.29 a month at a typical fund. A private expat policy can be quoted at EUR 30-80. The gap is real, and so is the reason for it.

The public price is not a quote, it is arithmetic

Statutory student cover is not priced on your income, your age or your risk. It is calculated from a fixed base written into law, which is why shopping between funds saves almost nothing. Here is the whole calculation:

• Section 236 of SGB V sets the contribution base as the monthly BAfoeG need rate for a student living away from home: EUR 855.
• Section 245 sets the student rate at seven tenths of the general contribution rate of 14.6 percent, so 10.22 percent. That is EUR 87.38.
• Your fund adds its own additional contribution on the same base. TK's is 2.69 percent from 1 January 2026, so EUR 23.00. The average across all funds is 2.9 percent.
• Long-term care insurance is 3.6 percent, plus 0.6 points for members without children from the month after they turn 23, so 4.20 percent, or EUR 35.91.

Total: EUR 146.29. Under 23, or with a child, the care portion falls to EUR 30.78 and the monthly bill to EUR 141.16. The only number that varies between funds is the additional contribution, so the entire competitive spread is a couple of euros a month. Anyone quoting you a dramatically different public figure is quoting a different product.

What that buys

Doctor visits, hospital treatment, prescriptions and standard care, with no argument about what is included and no surprises when you actually need it. It satisfies both the visa officer and the university registration desk without anyone having to check anything. For most international students that is the end of the decision, and how student health insurance enrolment works covers the sign-up.

Why the private quote is lower

Many of the cheap student policies are expat or travel-style plans with caps, exclusions and conditions attached. They are not lying about the premium. They are quoting a smaller product. The saving evaporates the first time you need a specialist referral, an emergency procedure or an interruption to your studies for medical reasons, and by then you are holding the policy you chose in your first week in Germany.

The exit is the real decision, and the law is blunt about it

This is the part worth reading twice, because it is not a matter of provider policy or goodwill. It is statute.

Under section 8 of SGB V, a student who wants a private policy applies to be exempted from compulsory insurance. The application has to be made within three months of the insurance obligation starting, and the law then says, in one sentence: the exemption cannot be revoked. Not "is difficult to revoke". Cannot.

The consequence bites at the other end. Because you were never a compulsory member, you never accumulate the insurance history that section 9 requires to join voluntarily: 24 months of cover in the last five years, or 12 uninterrupted months immediately before. A student who opted out in October of their first semester has neither, so the public door stays shut for the rest of the degree even if the private policy turns out to be inadequate.

Nor does graduating fix it automatically. An employee can only stay private if their salary exceeds the annual threshold, which for 2026 is EUR 77,400. Below that, employment makes you a compulsory member again, which is the usual route back in, but it depends on landing a job rather than on your own choice. The full comparison of student insurance options goes through which private policies are actually recognised.

Turning 30 roughly doubles the bill

Section 5 of SGB V makes students compulsorily insured at most until they complete their thirtieth year. Exceptions exist where the type of education or family and personal circumstances justify it, but they are exceptions, not a default.

After that you insure voluntarily, and voluntary members are priced from a minimum base rather than from a student base. Section 240 sets that floor at one ninetieth of the monthly reference figure per calendar day, which works out at a third of the monthly Bezugsgroesse. For 2026 the Bezugsgroesse is EUR 3,955 a month, so the minimum base is EUR 1,318.33. Apply the reduced contribution rate of 14.0 percent for members with no sick-pay entitlement and you get EUR 184.57, plus TK's additional contribution of 2.69 percent at EUR 35.46, plus care insurance at 4.20 percent, EUR 55.37.

That is about EUR 275 a month, close to double the student rate, and it lands on the birthday rather than at the end of the degree. If you will cross 30 during your programme, budget the later semesters at the higher number now. A three-year master's that starts at 29 costs far more than the same programme starting at 26.

The visa and enrolment link

Proof of recognised health insurance is required for the student visa and again for university enrolment. A policy German authorities do not recognise fails you at one step or the other, and fixing it at the counter is not an option. Check that your provider is accepted before you pay for anything, which the visa file, blocked account and insurance guide sets out in order.

Price the whole degree, not the first month

Run the numbers over the real length of the programme. Two years of public cover at EUR 146.29 is EUR 3,510.96. Two years of a EUR 60 private policy is EUR 1,440, a saving of about EUR 2,071 across the degree, or roughly EUR 86 a month.

Now price the downside. A single hospital stay that the policy caps or excludes wipes out that saving several times over, and section 8 means you cannot repair the decision afterwards. For a first degree in a country whose medical system you do not yet know, EUR 86 a month is a cheap price for not having to read the small print under pressure. Fold the number into your blocked account budget from the start, because it is a fixed monthly cost, not an optional one.

If you already hold a policy

Confirm before you fly that it counts as German student cover. Travel insurance from home almost never does, however comprehensive it looks, and an expat plan that worked for a previous stay may not be accepted for enrolment. Ask the university directly and get the answer in writing. The requirements for the rest of the file are in the German student visa guide.

Sources

• Section 236 SGB V, contribution base for students
• Section 245 SGB V, student contribution rate
• Section 8 SGB V, exemption cannot be revoked
• Section 9 SGB V, voluntary membership conditions
• Social insurance reference figures for 2026
• GKV-Spitzenverband, care insurance rate

Not sure your policy will be accepted? Get post-arrival support and have it checked before you enrol.