In your first job as a resident doctor (Assistenzärztin or Assistenzarzt) in Germany, one of the biggest insurance questions arrives: statutory or private? The answer depends mainly on the compulsory insurance threshold (Versicherungspflichtgrenze), on the salary under your collective agreement and on your personal situation. This guide explains the 2026 rules and compares both routes.
Short answer: Employees are compulsorily insured in statutory health insurance as long as their gross salary stays below 6,450 euros a month in 2026 (77,400 euros a year). Above that you may choose between statutory and private insurance. A draft sets a higher threshold of 7,012.50 euros a month for 2027. Last updated: October 2026.
The most important points at a glance
- The compulsory insurance threshold for 2026 is 77,400 euros a year, so 6,450 euros a month (§ 6 SGB V).
- Below the threshold, statutory cover is compulsory, and employer and employee share the contribution.
- Above the threshold you may move to private insurance. The employer subsidy follows the GKV contribution (§ 257 SGB V).
- The decision affects you for years, so consider family plans, tariff terms and expected salary growth.
- Before deciding, compare your payslip, your collective agreement and the benefits that matter to you.
Which threshold applies to resident doctors?
The compulsory insurance threshold, also called the annual earnings limit, sets the salary up to which employees stay in compulsory statutory insurance. It is set again each year. For 2027 a draft regulation exists, which is not yet in force.
| Year | Annual value | Monthly value | Status |
|---|---|---|---|
| 2026 | 77,400 euros | 6,450 euros | official |
| 2027 | 84,150 euros | 7,012.50 euros | draft (cabinet 7 October 2026, Bundesrat consent pending) |
What applies below the threshold?
If your gross salary is below it, you are compulsorily insured in statutory insurance. The contribution depends on income up to the contribution assessment ceiling, which is 5,812.50 euros a month in 2026. The general rate is 14.6 percent (§ 241 SGB V), plus the additional contribution of your fund. Employer and employee share the contribution equally.
- Assumption: 6,000 euros gross a month, 30 years old, no children, additional contribution 2.9 percent.
- Only income up to the ceiling counts: 5,812.50 euros instead of 6,000 euros.
- Health insurance, employee share: 8.75 percent. 5,812.50 euros times 8.75 percent gives 508.59 euros.
- Long-term care, employee share: 1.8 percent plus the childless surcharge of 0.6 percent, together 2.4 percent. 5,812.50 euros times 2.4 percent gives 139.50 euros.
- Total employee share: 508.59 euros plus 139.50 euros gives 648.09 euros a month.
What applies above the threshold?
If your salary is above 6,450 euros a month, you are no longer compulsorily insured. You can then choose private insurance or stay voluntarily in statutory insurance. The employer subsidy matters here: it is capped at the amount your employer would pay for statutory insurance (§ 257 SGB V). You pay the rest of the private premium yourself. A return to GKV is also subject to conditions.
Statutory or private: when does which fit?
| Aspect | Statutory health insurance | Private health insurance |
|---|---|---|
| Contribution | Depends on income, employer pays half | Depends on tariff, age and health are factored in, subsidy capped |
| Benefits | Uniform statutory catalogue | Depends on the chosen tariff |
| Family | Family cover for a partner without own income and for children | Each insured person needs their own contract |
| Return | Tied to income and duration | Switch possible with conditions, tariff rules apply |
For many people statutory insurance fits well when a family is planned. Private insurance can be an option at higher income with clear wishes for benefits. A personal assessment makes sense when tariff, plans and salary have to fit together: how a consultation with Academycon works (in German).
Frequently asked questions
Can I move to private insurance as a resident doctor and go back to statutory later?
The route back depends on conditions that relate to income and duration. Do not count on a simple switch. Check the specifics with your fund or an adviser before you take the step.
Which income counts for the insurance decision?
The decisive figure is your regular annual earnings. Whether allowances, night-shift or standby supplements are included is something your human resources department can confirm. Ask them for the calculation basis before you decide.
What is the employer subsidy for private insurance?
With private insurance, the employer pays a subsidy based on the statutory contribution it would pay (§ 257 SGB V). The full private premium is not covered by the subsidy, so you carry the rest.
Does the threshold also apply to part-time work?
The threshold refers to annual earnings. With part-time work the regular salary can be below the threshold even if a full-time salary would be above it. Check your contract and the actual salary calculation.
What to do now
- Read your employment contract and the collective agreement that applies, and work out your regular annual earnings.
- Compare the result with 77,400 euros for 2026 and with the draft for 2027.
- Set the statutory contribution up to the ceiling against the private premium with employer subsidy.
- Clarify your family plans and the benefits that matter to you, such as dental care, senior physician treatment or cover abroad.
- Get a personal assessment before you terminate anything or apply for private cover.
Pension scheme and planning
Many doctors in Germany are compulsorily insured not in the statutory pension insurance but in the pension scheme (Versorgungswerk) of their state medical chamber. This mainly concerns old-age provision and not health insurance. It still pays to plan both together, because health insurance, occupational disability cover and retirement provision work together in the overall picture. Which scheme applies depends on the federal state where you work.
What to check in a private tariff
- Premium development: ask how premium adjustments are handled, not only about the starting premium.
- Hospital benefits: whether senior physician treatment and two-bed rooms are included makes a clear difference between tariffs.
- Dental benefits: reimbursement depends strongly on the tariff. Statutory insurance uses fixed subsidies for dentures instead.
- Waiting periods and health screening: some tariffs apply waiting periods or exclusions that matter at the start.
- Switching conditions: get in writing how a later return to statutory insurance works.
A tariff comparison only tells you something when you place the benefit descriptions side by side. A low monthly premium can become expensive through exclusions or deductibles elsewhere.
Related reading
- Health Insurance Income Limit 2026: What It Means
- Private Health Insurance for Working Students in Germany
- Medical student insurance: electives, practical year and cover
- Assistenzarzt Gehalt: Tarif, Stufen und Nachtdienst
Sources:
- § 6 SGB V, compulsory insurance threshold (statute)
- § 241 SGB V, contribution rate (statute)
- § 257 SGB V, employer subsidy (statute)
- GKV-Spitzenverband, fact sheet on contribution figures (1.1.2026)
- Federal Ministry of Labour, 2027 social insurance figures (draft, October 2026)
Last updated: October 2026. This guide is general information, not individual advice.
