How to Switch from Private to Public Health Insurance in Germany

Why Students Want to Switch from Private to Public Insurance

Many international students in Germany start with private health insurance (PKV) because it’s often cheaper initially and easier to obtain. But as they settle in, they realize that public health insurance (GKV) offers significant advantages, especially full coverage, no claim rejections, and wide acceptance by doctors and universities.

Switching from private to public health insurance in Germany is possible, but it’s not always straightforward. This guide explains exactly how to do it, when you’re eligible, and what pitfalls to avoid.

GKV vs. PKV: A Quick Recap

Before the switching steps, here’s why many students prefer GKV:

Feature	GKV (Public)	PKV (Private)
Monthly cost	~€146/month for students	€30–€150+/month
Coverage scope	Full, standardized	Varies by plan
Pre-existing conditions	Covered	May be excluded
Accepted everywhere	Yes	Most places
Enrollment certificate	Always issued	Not always accepted

For a detailed comparison, see our GKV vs. Private Insurance guide.

Who Can Switch from PKV to GKV?

The key question: Are you eligible? Germany’s healthcare regulations are strict about who can join the GKV system.

Students Under 30

If you’re under 30 years old and enrolled at a German university, you have the right to join a GKV provider. However, there’s a critical catch:

The enrollment window matters. When you first enroll at a German university, you must choose between GKV and PKV. If you actively chose PKV (by signing a “Befreiung von der Versicherungspflicht”, exemption from mandatory insurance), switching back to GKV is very difficult during the same degree program.

Students Over 30

Students over 30 are generally not eligible for the standard student GKV rate. However, you may qualify for:

• Voluntary GKV membership (freiwillige Versicherung): more expensive at ~€200+/month
• Staying with private insurance

After Graduation

If you start working in Germany after graduation with a salary below the income threshold (Jahresarbeitsentgeltgrenze, ~€77,400 in 2026), you are automatically enrolled in GKV. This is the easiest path to public insurance.

Step-by-Step: How to Switch

Step 1: Check Your Eligibility

Ask yourself:

• Am I under 30?
• Did I sign a GKV exemption (Befreiung) when I enrolled?
• Am I starting a new degree program?

If you signed the exemption, you typically can’t switch until:

• You start a new degree program (e.g., Bachelor → Master)
• You turn 30 (though this makes you ineligible for student GKV rates)
• You start employment after graduation

Step 2: Choose a GKV Provider

All public health insurers in Germany offer essentially the same core coverage. Popular choices for students include:

• TK (Techniker Krankenkasse): Largest, excellent English service
• AOK: Regional, good in-person support
• DAK: Nationwide coverage
• Barmer: Good digital services

Step 3: Apply for Membership

Contact your chosen GKV provider and provide:

• Enrollment certificate (Immatrikulationsbescheinigung)
• Passport
• Proof of current insurance
• Residence registration (Meldebescheinigung)

Step 4: Cancel Your Private Insurance

Once accepted by the GKV, formally cancel your PKV contract. Note:

• Most PKV contracts require 3 months’ notice
• Some may require notice by a specific date
• Get written confirmation of cancellation

Step 5: Submit GKV Certificate to University

Your university needs the GKV enrollment certificate (Versicherungsbescheinigung). This is usually transmitted electronically, but check with your Studierendenkanzlei.

The “Befreiung” Trap: What You Need to Know

This is the biggest pitfall for international students in Germany.

When you first enroll at a university, you must either:

1. Join a GKV provider, OR
2. Sign a “Befreiung von der Versicherungspflicht” (exemption from mandatory public insurance)

If you sign the Befreiung to use private insurance, this decision is binding for the entire duration of your current degree program. You can’t simply change your mind.

How to Avoid the Trap

• Think carefully before signing the Befreiung. Once signed, there’s no going back easily.
• If you’re unsure, start with GKV. You can always switch to private later, but switching back is much harder.
• Read everything before signing. Some private insurers push the Befreiung form without clearly explaining the consequences.

Special Cases

Switching When Starting a Master’s Program

Starting a new degree (e.g., transitioning from Bachelor to Master) opens a new enrollment window. This is your best opportunity to switch from PKV to GKV if you previously signed the Befreiung.

EU/EEA Students with EHIC

If you have a European Health Insurance Card (EHIC), you may be able to use it temporarily. However, for long-term stays, you’ll likely need to join the German system. Your EHIC status can sometimes help with the transition to GKV.

Students with Pre-Existing Conditions

One major advantage of GKV: pre-existing conditions are always covered. If you have ongoing health needs, switching to GKV can save you significant money compared to PKV plans that may exclude or surcharge for pre-existing conditions.

Timeline: How Long Does Switching Take?

Step	Duration
Research and choose GKV	1–2 weeks
Apply to GKV	1–2 weeks for approval
Cancel PKV	3 months notice (typically)
Total process	1–4 months

Plan ahead. Don’t wait until the last minute, especially if your PKV contract has a long notice period.

Costs Comparison

Insurance Type	Monthly Cost (Students)
GKV student rate	~€146/month
Budget PKV	€30–€80/month
Mid-range PKV	€80–€150/month
Voluntary GKV (over 30)	~€200+/month

While PKV can be cheaper in the short term, GKV often provides better value considering the full coverage and lack of exclusions.

Take Action

Ready to switch to public health insurance? Start by checking your eligibility and comparing GKV providers.

👉 Compare health insurance options in Germany to find the right GKV provider for your situation. If you’re not sure whether to switch, use our comparison tool to see how GKV and PKV plans stack up for your specific needs.