Health Insurance After Graduation: From Exams to Your First Job

Short answer

Health insurance after graduation is usually straightforward. With your first employment contract you are generally compulsorily insured again in statutory health insurance, as long as your salary stays below the compulsory insurance threshold. Student health insurance ends with your de-registration. To avoid a gap, clarify early when your cover ends, choose a health insurer and tell your employer its name.

Health insurance after graduation: when does compulsory cover begin?

Compulsory insurance generally begins on the day you take up employment subject to compulsory insurance. As long as your earnings stay below the compulsory insurance threshold, you remain in statutory health insurance. The critical phase lies before that: between the end of your exams, your de-registration and the start of work, your old cover ends while the new cover is not yet running.

What does health insurance cost as an employee?

As an employee, you pay half of the general contribution rate and half of the additional contribution, while your employer pays the other half. In long-term care insurance, you pay the childless surcharge alone. The following calculation shows the employee shares for a gross salary of 3,500 euros per month, with the average additional contribution of 2.9 percent.

1. Health insurance: (14.6 percent + 2.9 percent) divided by 2 gives 8.75 percent. Of this, 3,500 euros × 8.75 percent = 306.25 euros.
2. Long-term care insurance without children from age 23: 3.6 percent divided by 2 gives 1.8 percent, plus the surcharge of 0.6 percentage points, together 2.4 percent. Of this, 3,500 euros × 2.4 percent = 84.00 euros.
3. Total health and long-term care insurance: 306.25 euros + 84.00 euros = 390.25 euros per month.
4. For comparison: pension insurance adds 18.6 percent in total, and your share is 9.3 percent, so 325.50 euros on the same salary. Unemployment insurance is not included in this calculation.

Without the childless surcharge, or with a child, the long-term care share is 0.6 percentage points lower. The actual additional contribution depends on your insurer and may differ from the average.

How do you bridge the gap between exams and the start of work?

You avoid a gap by using the follow-on insurance under § 188 para. 4 SGB V. Afterwards, your membership continues after the end of compulsory insurance as voluntary membership, unless you declare your exit within two weeks of the insurer’s notice and prove other cover. Voluntary insurance is expensive: the minimum contribution in 2026 was around 270 euros per month without the childless surcharge, calculated from the minimum assessment base of 1,318.33 euros. For the phase without work, it is worth looking at Health insurance after studies without a job (in German).

Which health insurer may you choose?

Compulsorily insured persons may choose their health insurer. The options include the local AOK (Ortskrankenkasse) of your workplace or residence, any substitute fund (Ersatzkasse), and the insurer where you were last insured. You make this choice with your employer, who handles the registration. Compare the additional contribution before you decide, because it differs from insurer to insurer, while the general contribution rate is the same for everyone.

When is private insurance an option?

Private health insurance is usually possible for employees only once regular annual earnings exceed the compulsory insurance threshold, or if you are exempt from compulsory insurance for another reason. In 2026, this threshold was 77,400 euros per year. The decision is long-term and has consequences for contributions and for any later return. The considerations are set out in Private health insurance at the start of your career (in German).

How to proceed

1. Note your de-registration date in your calendar and ask your current health insurer when your membership ends.
2. Check whether the follow-on insurance applies, and whether you want to declare your exit within two weeks of the insurer’s notice.
3. Compare two to three health insurers before you start work, based on the additional contribution and the benefits that matter to you.
4. Tell your employer the chosen insurer in good time before your first working day.
5. If you were previously covered by family insurance, clarify it and report the end of your co-insurance.
6. Calculate your contributions with the calculator for students and career starters, and keep the proof of your insurance.

Frequently asked questions

Do I have to register myself with a health insurer after my exams?

Usually your employer registers you with the health insurer you name. If you are without employment between your exams and the start of work, you must arrange cover yourself.

Does my family insurance continue after my studies?

Family insurance depends on training and your own income. With a salary above 565 euros per month, it generally ends. For children, the age limit of 25 applies only during school or vocational training, and until 23 without employment.

What happens if I miss the deadline for leaving?

You then remain in voluntary membership and pay the corresponding contributions. You can declare your exit only within the two weeks after the insurer’s notice, together with proof of other cover.

Can I switch to private insurance after starting work?

A switch is possible if you meet the requirements, above all the compulsory insurance threshold. The way back into statutory insurance is later restricted, so you should know the consequences in advance.

Related articles

• Starting your career after studies: how to get off to a good start (in German)
• Health insurance after studies without a job (in German)
• Health insurance between exams and a legal traineeship (in German)
• Glossary: health insurance during studies (in German)

Sources and review

• § 5 SGB V (compulsory insurance), statutory text, accessed 20 October 2026, version not separately checked.
• § 173 para. 2 SGB V (right to choose), gesetze-im-internet.de, accessed 20 October 2026.
• § 188 para. 4 SGB V (follow-on insurance), gesetze-im-internet.de, accessed 20 October 2026.
• § 10 SGB V (family insurance) and 2026 calculation figures, GKV-Spitzenverband fact sheet, as of 1 January 2026.
• Additional contribution 2026, Federal Ministry of Health, as of 3 September 2026.
• Minimum assessment base for voluntary members from the 2026 reference earnings (3,955 euros divided by 3), own calculation, not officially published.

This guide is general information, not individual advice. The German version is authoritative.
Editorial team: Academycon · Last updated: October 2026

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Last updated: October 2026. This article is general information, not individual advice. The German version is authoritative.