Medical student insurance usually stays in place during electives (Famulatur) and the practical year (PJ), as long as you remain enrolled and have not yet reached the end of the semester in which you turn 30. In 2026, this costs about €118 to €123 per month including long-term care insurance, plus your fund’s additional contribution. With your first employment contract as a doctor, you move into employee status, and then health insurance becomes a choice or a duty again.
Key points in brief
- The electives add up to four months in four blocks of one month each. The practical year lasts 48 weeks in three blocks of 16 weeks each.
- As long as you are enrolled, compulsory student insurance applies. The contribution is €87.38 base contribution plus additional contribution plus long-term care insurance.
- Pay during the practical year may not exceed the BAföG requirement. Clarify in advance how it affects your insurance and BAföG with your health insurer and the BAföG office.
- The exemption in favour of private insurance is possible only shortly after compulsory insurance begins, and it is irrevocable for the whole degree.
- After your studies, student insurance ends with the semester of your last enrolment. With an employment contract, you are compulsorily insured as an employee as long as your salary is below €77,400 per year.
How does medical training look from an insurance perspective?
The degree consists of a preclinical and a clinical part, with the sections of the medical licensing examination (Ärztliche Prüfung) in between and after. The practical year (PJ) starts only after the Second Section of the medical licensing examination. In terms of insurance, little changes at most stations, because you remain enrolled throughout. The timeline shows where there are still turning points.
| Stage | What happens | Health insurance |
|---|---|---|
| Preclinical and clinical | Courses, examinations, four electives of one month each | Compulsory student insurance, or family cover up to age 25 |
| Second Section of the medical licensing examination | Prerequisite for starting the practical year | Unchanged, as long as you are enrolled |
| Practical year | 48 weeks, three blocks of 16 weeks each | Enrolment continues; clarify pay with the fund in advance |
| End of studies | Final re-enrolment, licence to practise medicine | Student insurance ends with the semester of your last enrolment |
| Career entry | Employment contract as a doctor | Compulsory insurance as an employee if salary is below €77,400 per year (2026 figure) |
The details on contributions, the age limit and alternatives are in the overview Health insurance for students (in German).
Does medical student insurance apply during electives?
Yes, as a rule. The elective is part of the degree, you remain enrolled, and compulsory student insurance takes precedence. Under the Medical Licensing Regulations (§ 7 ÄApprO), electives consist of four blocks of one month each. One month is spent in a medically run facility or practice (outpatient), one in a hospital or inpatient rehabilitation facility, and one in general practice care. The fourth month takes place in a suitable facility. The provision is in the legal text.
If the facility pays you for the elective, ask your health insurer beforehand whether and how this affects your status. This applies especially to a job alongside your studies, and the rules are set out in the guide Health insurance during an internship (in German). If you are family-insured, also keep the income limit of €565 per month in view.
How am I insured during the practical year?
During the PJ you are still a student of the university, so you remain enrolled, and your existing insurance status continues. The PJ begins each year in the second half of May and November. It is split into three training blocks of 16 weeks each: internal medicine, surgery, and general practice or another clinical-practical subject (§ 3 ÄApprO). That makes 48 weeks. Part-time study at 50 or 75 percent of the weekly training time is possible, in which case the total duration is extended. Absences are credited up to 30 training days.
As a compulsory member, you pay the nationwide base contribution of €87.38 per month (10.22 percent of €855), plus your fund’s additional contribution and long-term care insurance. Childless students from age 23 pay €35.91 for long-term care.
| Component (example: age 24, childless, additional contribution 2.9 percent) | Monthly amount |
|---|---|
| Base contribution, health insurance | €87.38 |
| Additional contribution (2.9 percent of €855) | €24.80 |
| Long-term care insurance (childless from age 23) | €35.91 |
| Total | about €148 |
The additional contribution differs by fund. The age limit of 30 applies until the end of the semester in which you turn 30. Beyond age 30, compulsory insurance remains only if the type of training or family or personal reasons justify exceeding it. An overview of student health insurance is provided by the Consumer Advice Centre.
Does the PJ allowance count as income?
Whether a clinic pays anything during the PJ, and how much, is decided by each institution. The Medical Licensing Regulations only set the upper limit: cash or in-kind benefits that exceed the BAföG requirement for students are not permitted during the PJ (§ 3 para. 4 ÄApprO). There is therefore no entitlement to a particular amount. Ask your clinic and your state examination office what applies to you.
The consequences of a payment depend on the individual case. For family cover, the 2026 limit is total income of €565 per month. BAföG and child benefit do not count. Have your fund confirm in writing whether the PJ payment is included. For BAföG, ask the BAföG office before you commit to the amount with the clinic. Bring the clinic’s confirmation or contract to both offices.
What applies to electives and the practical year abroad?
Within the EU, the EEA and Switzerland, the European Health Insurance Card (EHIC) covers medically necessary care under the rules of the country you are in. You may have to pay co-payments locally, and statutory insurance does not pay for repatriation to Germany. For that, you need private travel health insurance.
In the USA and many countries outside Europe, you cannot count on benefits from statutory insurance. Take out private international health insurance and check its term and repatriation cover, because many policies apply only for a limited period, and for several months you need a long-stay policy. During a semester abroad in the EU, the EEA or Switzerland, you remain in compulsory insurance if you stay enrolled in Germany and keep your residence there. Check with your fund whether this also applies to your placement abroad. More is in the guide Travel health insurance for Erasmus, USA and work and travel (in German).
Do you need professional liability insurance as a medical student?
That cannot be answered in general terms. In electives and the PJ you work close to patients, and whether the clinic, practice or university insures students through its own liability cover varies from place to place. So ask beforehand how this is handled for you, and get the answer in writing.
Your private liability insurance is a second safety net. Many children are co-insured under their parents’ policy, as long as they are unmarried and studying. This depends on the contract. Depending on the terms, cover ends after training, on marriage or at a contractual age limit, and it can end earlier with a late master’s degree or permanent employment. The Consumer Advice Centre recommends at least €10 million in cover. Whether co-insurance includes activities with patients is set out in the terms and conditions. Whether you need your own professional liability insurance at career entry depends on your employer and the role. Clarify this before you sign your employment contract.
What changes with licensure?
Student insurance does not end with the last examination. It runs until the end of the semester in which you were last enrolled or re-enrolled, if you are de-registered by then. Afterwards, depending on your situation, the following options apply:
- You start directly in a position as a doctor: you are then compulsorily insured as an employee, as long as your salary is below the annual earnings threshold of €77,400 (2026 figure).
- There are weeks or months between the end of your studies and your employment contract: family cover (income limit €565, and age limit 23 for unemployed persons) or compulsory follow-on insurance may then apply. Follow-on insurance is voluntary membership with your previous fund, linked to compulsory membership.
After membership ends, benefit claims continue for at most one month, as long as you are not in employment and no other insurance takes precedence. So plan the transition several weeks before your final re-enrolment. If you are starting your career, the decision criteria are in the guide Private health insurance at career entry (in German).
Public or private: what should future doctors weigh up?
As a student, you can apply for an exemption from compulsory insurance and switch to private health insurance. The application must reach your health insurer within three months of the start of compulsory insurance. The exemption usually applies for the whole degree and cannot be reversed. Free family cover then ends, and a return to statutory insurance is possible only in narrow cases, for example through employment that is subject to compulsory insurance. Contributions can rise later.
If you are in the middle of your studies or the PJ and never applied for an exemption, you have usually already passed this fork. You can decide again at career entry. The advantages and disadvantages for medical students are summarised in the guide Private health insurance for medical students (in German).
A word on occupational disability: the statutory reduced earning capacity pension (Erwerbsminderungsrente) requires a waiting period of five years and three years of compulsory contributions in the last five years, which students usually do not meet. That is why taking out cover during your studies is often discussed, especially as a later application becomes harder if your health has deteriorated. Answer the health questions completely and truthfully. More is in Occupational disability insurance in medical studies (in German).
Frequently asked questions
How am I insured during the practical year?
During the PJ you remain enrolled at the university, so your existing cover continues: compulsory student insurance, family cover or, after an exemption, private health insurance. If your clinic pays an allowance, have your fund confirm in writing whether your status changes as a result.
Does student insurance apply during electives?
Yes, you remain enrolled and therefore in compulsory student insurance, provided nothing takes precedence. The electives total four months in four blocks. If you are paid, or have a job during that time, check with the fund whether limits such as the 20-hour working student rule apply.
Does the PJ allowance count as income?
It depends on what you are checking. For family cover, total income is measured against the limit of €565 per month, while BAföG is decided by the BAföG office. Legally, a payment during the PJ may not exceed the BAföG requirement. Get the relevant office’s answer in advance.
Do I need professional liability insurance as a medical student?
For electives and the PJ, first clarify whether the clinic, practice or university insures students. Your private liability insurance is an additional safety net, and whether it covers activities with patients is set out in its terms. At career entry, the answer depends on your employer. Get each answer in writing.
What changes with licensure?
Student insurance ends with the semester of your last enrolment. With an employment contract, you are compulsorily insured as an employee as long as your salary is below €77,400 per year (2026 figure). If the start is later, you need a bridge solution such as family cover or follow-on insurance.
What to do now
- Before each elective and before the PJ, ask the facility about pay and liability cover, and get both confirmed in writing.
- Ask your health insurer whether any pay affects your status or family cover, and ask the BAföG office about eligibility.
- For placements abroad, plan private travel health insurance with repatriation cover and a suitable term.
- Note the end of your final enrolment and clarify in good time how insurance passes into your career.
If you want to talk through your situation, you will find the route to advice on the Academycon homepage.
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Related articles
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Last updated: October 2026. This guide is general information, not individual advice. The German version is authoritative.
