How to Register with a Krankenkasse in Germany

Once you know you'll be on public health insurance (GKV) — the default for most employees under the income threshold — you need to actually pick a Krankenkasse and register with it. There are dozens of public funds (AOK, TK, Barmer, DAK, and many smaller regional or trade-specific ones), and unlike the choice between GKV and PKV, which is often decided for you, choosing which Krankenkasse is entirely up to you.

The differences between funds are smaller than people expect: the core benefits catalog is set by law and identical everywhere, so you're mainly comparing the contribution rate add-on (Zusatzbeitrag, which varies slightly fund to fund), extra voluntary benefits (some funds offer things like additional vaccinations, alternative medicine coverage, or gym membership subsidies), customer service quality, and whether they have good English-language support if German isn't yet comfortable for you.

If you're starting a job, your new employer usually needs your Krankenkasse details before your first day, so it's worth sorting this out before you start rather than scrambling in week one. Most funds let you register online, and many now offer English-language sign-up forms specifically aimed at international hires.

Once registered, you'll get an electronic health card (elektronische Gesundheitskarte, eGK) by post within a couple of weeks — this is what you hand over at any doctor's office, pharmacy, or hospital, and until it arrives, your Krankenkasse can issue a temporary paper confirmation if you need care immediately.

If you're switching jobs, becoming self-employed, or your income changes enough to cross the PKV threshold, you're generally free to switch Krankenkassen, though there's typically a minimum membership period (usually 12 months) before you can change without a special reason like a contribution increase.

Students have their own simplified track: most Krankenkassen offer a discounted student rate up to a certain age, but you'll need to show your university enrollment confirmation (Immatrikulationsbescheinigung) to register at that rate rather than the full contribution.