Healthcare in Berlin: public vs private insurance, finding a Hausarzt and booking a Termin

Health insurance in Germany isn't optional, and that's mostly good news. Once you're in the system, a doctor's visit doesn't come with the surprise bill you might dread back home. The big decision is whether you end up in the public system or a private plan.

The short version

• Almost everyone living in Germany must have health insurance. Most people are in the statutory system (gesetzliche Krankenversicherung, GKV). A minority, mostly higher earners, the self-employed and civil servants, have private cover (private Krankenversicherung, PKV).
• In 2026, employees earning over EUR 77,400 a year (about USD 86,400) can leave the GKV for private cover [1][2]. Below that, an employee is generally in the public system.
• GKV contributions are 14.6% of salary plus a fund-specific add-on that averages 2.9% in 2026, split with your employer, on income up to EUR 69,750 (about USD 77,900) a year [1].
• Find a family doctor (Hausarzt) early. For urgent but non-emergency care when offices are closed, call 116117. For emergencies, call 112 [4].
• Medicare doesn't cover you in Germany, and US health plans rarely work here [6][7].

USD conversions in this guide use the Federal Reserve H.10 rate of October 30, 2026: USD 1.1163 per euro.

Public (GKV) vs private (PKV): who goes where

There are no networks to pick and no deductibles to track in the public system. You join a statutory fund (a Krankenkasse), such as AOK, TK, Barmer or DAK, and you get the same legally defined core benefits at all of them. Funds compete on service, apps, English support and the size of their add-on contribution.

The 2026 numbers

The federal regulation for 2026 sets the compulsory insurance threshold (Jahresarbeitsentgeltgrenze) at EUR 77,400 a year, or EUR 6,450 a month (about USD 7,200) [2]. That's up from EUR 73,800 in 2025 [1]. A lower threshold of EUR 69,750 applies to people who were already privately insured on December 31, 2002 [2].

GKV contributions in 2026 [1]:

• General rate: 14.6% of gross pay, split roughly half and half with your employer.
• Add-on (Zusatzbeitrag): set by each fund. The official average for 2026 is 2.9%, and the association of substitute funds expects many funds to charge more than 3%.
• Contribution cap: income above EUR 69,750 a year (EUR 5,812.50 a month) isn't counted, so contributions top out there.
• Long-term care insurance (Pflegeversicherung) is collected on top.

The self-employed pay both halves themselves. Ballpark: it's a real monthly bill, so price it before you sign a freelance contract.

The PKV trade-off

Private plans can look cheap when you're young and healthy, and they often mean faster specialist appointments and a private hospital room. The fine print: premiums rise with age, each family member needs a plan, and once you're in, getting back into the public system is restricted. Think long and hard if you might stay in Germany for decades or have kids. An independent insurance adviser can compare plans for you; we don't recommend specific ones.

Health insurance for visa and residence applicants

US citizens can enter Germany without a visa and apply for a residence permit at Berlin's immigration office (the Landesamt für Einwanderung) after arrival. Either way, you have to prove health cover.

The German Foreign Office is blunt about it: for long-stay national visas you need insurance at least comparable to the statutory minimum, and travel insurance is not enough [5]. In practice:

• Employees are usually in the GKV from their first day of work, and the employer registers them. Your contract and the employer's declaration show it [5].
• Family members joining someone in the GKV are generally covered by family insurance [5].
• Freelancers and self-employed applicants need either voluntary GKV membership or a private plan that meets German standards. The immigration office will check the policy.
• The visa start date can't be earlier than the first day you can prove German-standard cover [5].

Short-term "incoming" or expat plans can bridge the first weeks, but check what the immigration office accepts before you buy one.

Finding a Hausarzt in Berlin

In Germany the family doctor (Hausarzt, often listed as Allgemeinmedizin or Innere Medizin) is your first stop. You don't legally need a referral for most specialists, but a referral (Überweisung) speeds things up and is needed for the appointment service below [3].

How Americans in Berlin usually find one:

1. Ask your Krankenkasse. Most funds have doctor search tools, some with language filters.
2. Use the Kassenärztliche Vereinigung (KV) doctor search for Berlin, which lists GKV-accepting practices.
3. Try online booking platforms, such as Doctolib, which many Berlin practices use. You can often filter for English.
4. Ask neighbors and coworkers. In Berlin, word of mouth still works.

English is widely spoken by doctors in central districts like Mitte, Prenzlauer Berg and Charlottenburg, but don't count on it at the front desk. Bring your insurance card (elektronische Gesundheitskarte) to every visit, every quarter.

Booking a Termin

"Termin" means appointment, and you'll need one for almost everything. Many practices are booked solid for new patients. If you're in the GKV and a doctor has marked your case as urgent, the appointment service (Terminservicestelle) reached through 116117 can find you an appointment [3]:

• No referral needed for family doctors, eye doctors, gynecologists, pediatricians and a first consultation with a psychotherapist [3].
• Most other specialists need a referral plus an urgency code (Vermittlungscode) from your doctor [3].
• You can book online at 116117.de or in the 116117 app, or by phone [3].

After hours, emergencies and hospitals

Germany splits urgent care differently than the US, where you might head to an urgent care clinic or the ER:

The 116117 line works 24/7 but is in German only, so have a German speaker help if you need to [4]. Berlin's big hospitals include the Charité, one of Europe's largest university hospitals, and Vivantes, the city-owned hospital group. Germany's medical care is generally high quality, and ambulance services are widely available [6].

The US side: Medicare, US plans and taxes

• Medicare generally doesn't pay for care outside the US. The exceptions are narrow and mostly involve emergencies near the US border [7]. If you're 65 or close to it, read up before deciding whether to keep Part B.
• US insurance rarely works in Germany. The State Department notes that most hospitals and doctors don't accept US plans and non-residents may be asked to pay upfront [6].
• Your US return: how German health and care contributions show up on your 1040 depends on your situation. A US expat tax preparer can check it, especially if you're self-employed.
• STEP: enroll in the State Department's Smart Traveler Enrollment Program so the US Embassy in Berlin can reach you in an emergency.

Your health checklist

1. Pick a fund or plan before your first workday or residence appointment.
2. Get your insurance card and carry it.
3. Find a Hausarzt while you're healthy.
4. Save 112 and 116117 in your cell phone.
5. Bring US records: prescriptions (by generic name), vaccination records and recent test results.
6. Ask about prescriptions. Some US medications are sold under different names or need a German prescription.

Got a good English-speaking doctor in Friedrichshain or a tip on the TK app? Share it in our community group for Americans in Germany.

Sources

1. vdek: Neuerungen im Gesundheitswesen 2026
2. Sozialversicherungs-Rechengrößenverordnung 2026, § 2 (gesetze-im-internet.de)
3. KBV: Patientenservice 116117
4. 116117: Information in English
5. German Embassy London (Federal Foreign Office): Health insurance requirements
6. US Department of State: Germany international travel information
7. Medicare.gov: Travel outside the US

Keep reading

• Germany's freelance visa for Americans in Berlin
• Moving to Berlin as an American: visa routes
• Medicare when you live abroad
• Health insurance between countries