You need to move from Expat health insurance to Public health insurance (GKV) or Private health insurance (PKV) when certain changes happen, such as earning above the minijob threshold, going over the student working-hour limits, or starting longer-term employment. You can upgrade through your account with no gap in coverage. Freelancers and artists use the same process to join Public health insurance through the KSK or SMART. The best time to switch depends on which product you’re moving to. If you’re not eligible or your application is rejected, your Expat health insurance stays active.
When do I need to upgrade from Expat health insurance to Public health insurance (GKV) or Private health insurance (PKV) in Germany?
Certain life changes require you to move from Expat health insurance to Public health insurance (GKV) or Private health insurance (PKV). You’re required to upgrade if any of the following apply:
Your employment earnings exceed the minijob threshold of €603 per month (2026). This applies whether you were previously unemployed, a student, or working a minijob, unless you qualify for an exemption such as working student status or short-term employment rules.
You’re a student working 20 or more hours per week during the semester, and your earnings also exceed the minijob threshold of €603 per month (2026). Both conditions together generally put you beyond working student status.
You’re in short-term or seasonal employment that exceeds 3 months or 70 working days within a calendar year, which means you’re no longer exempt from social contributions.
These rules apply to employment. Freelancing and self-employment follow different rules, which are covered in our article on health insurance options for freelancers and self-employed people in Germany.
How can I check whether I’m eligible for Public health insurance (GKV) or Private health insurance (PKV) in Germany?
You can check your eligibility for Public health insurance (GKV) or Private health insurance (PKV) with our recommendation tool. The tool reviews your situation against the requirements for each product. You can find more detail in our online guide to health insurance in Germany.
What are the income requirements to switch to Private health insurance (PKV) in Germany?
Private health insurance (PKV) in Germany has minimum annual income thresholds that depend on your employment status, your age, and your residency status in Germany:
Employees must earn at least €77,400 gross per year (2026).
Freelancers and self-employed people can qualify from €25,000 gross per year (2026), depending on their situation.
To find out which threshold applies to you, you can get a quote or read our article on the income threshold for Private health insurance.
When is the best time to upgrade to Public health insurance (GKV) or Private health insurance (PKV) in Germany?
The best time to upgrade depends on which product you’re switching to:
For Public health insurance (GKV), we recommend upgrading before you start a new job, because processing can take up to 7 business days. Upgrading within 2 weeks of starting employment is also acceptable.
For Private health insurance (PKV), processing usually takes 2–5 business days. If you haven’t been insured in the last 12 months, you need medical and dental check-ups, which can extend the processing time.
How do I upgrade from Expat health insurance to Public health insurance (GKV) or Private health insurance (PKV)?
You can upgrade from Expat health insurance to Public health insurance (GKV) or Private health insurance (PKV) through your account, with no gap in coverage between the 2 policies. To upgrade:
Sign in to your account.
Open your Expat health insurance policy.
Choose the option to switch your health insurance.
Select Public health insurance (GKV) or Private health insurance (PKV).
If you choose Public health insurance, select your provider: TK, AOK, BARMER, or DAK.
Complete the sign-up questionnaire.
How do I join Public health insurance (GKV) through the KSK or SMART as a freelancer or artist?
Freelancers and artists can join Public health insurance (GKV) using the same upgrade process. They can join through the KSK (Künstlersozialkasse, the Artists’ Social Insurance Fund) or through SMART, a cooperative that acts as an employer for freelancers who don’t qualify for the KSK.
To join through the KSK, select BARMER as your Public health insurance provider. In the sign-up questionnaire, say that you’re employed, enter “KSK membership application” as your employer, and set your employment start date 6 months in the future to allow for processing time.
To join through SMART, contact SMART directly to confirm your eligibility, then complete the standard upgrade process through your account.
What happens if I’m not eligible to upgrade or my application is rejected?
If you’re not eligible for Public health insurance (GKV) or Private health insurance (PKV), or your application isn’t approved, your Expat health insurance stays active and you can keep using it without interruption. If you need to switch because of a visa renewal, or because you’ve reached the maximum coverage period for Expat health insurance (usually 5 years), we offer Long-term expat health insurance as an alternative.