# Public Health Insurance in Germany: TK vs AOK vs Barmer > Compare TK, AOK and Barmer in 2026: contribution rates, bonus programs, coverage and how to switch. A practical guide for expats in Germany. **URL:** https://migaku.com/blog/language-fun/public-health-insurance-in-germany-tk-vs-aok-vs-barmer **Last Updated:** 2026-05-15 **Tags:** culture, resources, comparison --- If you're moving to Germany or already working there, you'll almost certainly end up in the statutory health insurance system (Gesetzliche Krankenversicherung, GKV), and the three names you'll hear most often are Techniker Krankenkasse (TK), AOK and Barmer. They all cover the same legally mandated catalog of medical services, but they differ in price, bonus programs, English-language support and regional reach, and those differences are worth a few hundred euros a year. *Last updated: May 15, 2026* ## How German statutory health insurance works in 2026 Germany has 93 active statutory health insurers as of January 1, 2026, covering roughly 74.5 million people (about 89% of the population). All of them charge the same base contribution rate of 14.6% of gross salary, split equally between you and your employer. On top of that, each insurer sets its own supplementary contribution (Zusatzbeitrag), which is where TK, AOK and Barmer actually compete. Key 2026 figures to anchor your math: - Base GKV contribution: 14.6%, split 50/50 with employer - Average supplementary contribution set by the Federal Ministry of Health: 2.9% (up from 2.5% in 2025) - Long-term care insurance (Pflegeversicherung): 3.6%, or 4.2% if you're childless and over 23 - Contribution assessment ceiling (Beitragsbemessungsgrenze): €69,750/year or €5,812.50/month - Compulsory insurance threshold (Versicherungspflichtgrenze): €77,400/year. Only employees earning above this may opt out into private insurance. - Free family co-insurance income limit: €565/month - Maximum sick pay (Krankengeld): €135.63/day The coverage catalog is set by federal law, so doctor visits, hospital stays, prescription medication (with small co-pays), maternity care, mental health treatment and most preventive screenings are covered regardless of which Kasse you join. The differences lie in administrative quality, app and online portal usability, optional extras and bonus payments. ## TK, AOK and Barmer at a glance | Insurer | Total contribution rate 2026 | Supplementary 2026 | Insured persons | Footprint | |---|---|---|---|---| | Techniker Krankenkasse (TK) | 17.29% | 2.69% | ~12.3 million | National, strong English service | | AOK Bayern | 17.29% | 2.69% | ~4.6 million | Bavaria | | AOK Baden-Württemberg | 17.59% | 2.99% | regional | Baden-Württemberg | | AOK PLUS (Sachsen/Thüringen) | 17.70% | 3.10% | ~3.5 million | Saxony, Thuringia | | AOK Niedersachsen | 17.58% | 2.98% | ~3.1 million | Lower Saxony | | AOK Nordost | 18.10% | 3.50% | regional | Berlin, Brandenburg, Mecklenburg-Vorpommern | | AOK Rheinland-Pfalz/Saarland | 17.07% | 2.47% | regional | Cheapest AOK | | BARMER | 17.89% | 3.29% | ~8.3 million insured | National | A few things to note. AOK is not one company. It's a federation of 11 independent regional insurers, each setting its own price. Joining "the AOK" means joining your state's AOK, so if you live in Berlin you'll pay AOK Nordost's 3.50%, not Bavaria's 2.69%. TK and Barmer are single national entities with the same rate everywhere. ## Techniker Krankenkasse (TK) TK is the largest statutory insurer in Germany with about 12.3 million members and a 2026 budget of €69.2 billion. Among English-speaking expats it's the default recommendation for good reasons. What TK does well: - Genuine English-language customer service by phone, chat and email - A solid English website covering the application, sick notes and reimbursement - The TK-App handles digital sick notes (eAU), prescription receipts and the electronic patient record - Worldwide travel coverage included for trips up to six weeks - The TK Bonusprogramm pays 1,000 points (€10 cash or €20 as the TK-Gesundheitsdividende health credit) per qualifying activity, such as a dental check-up, vaccination, sports club membership or completed prevention course. Open from age 15. - Bonus payments up to €150 per insured per year are tax-free. Amounts above that need to be reported. The trade-off: at a 2.69% supplementary contribution, TK is no longer the price leader it was a few years ago. It's competitive, but not the cheapest. ## AOK AOK collectively covers around 27 million people, the largest share of the German market. Because each regional AOK is independent, the experience varies considerably depending on where you live. Strengths: - Dense network of local offices. If you prefer to walk in and speak with someone face to face, an AOK Geschäftsstelle is usually nearby. - Strong relationships with regional doctors and hospitals - Bonus programs vary by region. AOK PLUS in Saxony and Thuringia pays up to €240/year, including €90 for fitness tracking and €60 for hitting health goals in the AOK Navida app. - AOK Bayern at 2.69% is among the cheaper national options and stable for 2026 Weaknesses: - English-language service is patchy. Some regional AOKs handle expats well (Bayern, Baden-Württemberg in larger cities); others not at all. - Prices differ sharply. AOK Nordost (Berlin and surroundings) charges 3.50%, the highest among major Kassen, while AOK Rheinland-Pfalz/Saarland charges 2.47%, the cheapest of any AOK. - If you move between states, you may need to switch to a different AOK. For expats in Bavaria or rural areas where local presence matters, AOK is often the practical choice. In Berlin, the high contribution and inconsistent English support make AOK Nordost less attractive than TK. ## BARMER Barmer is Germany's second-largest single insurer with 8,286,577 insured persons (of whom 6,846,792 are paying members) as of mid-2025. At 3.29% supplementary contribution for 2026, it sits at the higher end of the price scale. Strengths: - Stable rate. Barmer's Verwaltungsrat confirmed on December 19, 2025 that the 3.29% would not change from 2025. - Strong digital tools, including the Barmer-App and teledoctor service - The Barmer Bonus program pays up to €100/year, with €15 for sports club membership, €15 for a fitness studio contract, €10 for vaccinations and €10 for dental check-ups - "Geld-zurück" (money-back) tariffs paying up to €1,350 over three years if you barely use benefits. Useful for healthy young professionals. - Wide network of regional offices similar to AOK Weaknesses: - More expensive than TK or AOK Bayern. Over a year, on a €60,000 salary, the difference between Barmer (17.89%) and AOK Bayern (17.29%) is roughly €180 out of your pocket after the employer split. - English support exists but is less consistently available than at TK ## Document checklist for signing up Whatever Kasse you pick, the paperwork is roughly the same. You'll need: - Passport or national ID - German residence registration (Anmeldebestätigung) from your local Bürgeramt - Employment contract or, for self-employed, proof of income and freelance status - Tax ID (Steuer-Identifikationsnummer), once issued - Previous insurance certificate if you're moving from another EU country or another German Kasse - German bank account details (IBAN) for direct debit - Address in Germany Family members can be added under Familienversicherung at no extra cost if their monthly income stays under €565. ## Application steps 1. Choose your Kasse. Compare total contribution rates and bonus programs. 2. Fill in the membership application (Mitgliedsantrag). TK, Barmer and most AOKs allow fully online enrollment in German; TK additionally offers English forms. 3. Submit identification and proof of residence. Many Kassen now accept video identification. 4. Receive your insurance number (Krankenversichertennummer) and electronic health card (eGK) by post within 2 to 4 weeks. A temporary certificate is usually issued immediately so you can see a doctor in the meantime. 5. Inform your employer of your Kasse choice. They'll deduct contributions automatically from your gross salary. If you're self-employed and voluntarily insured, the minimum contribution base in 2026 is €1,318.33/month, derived from the Bezugsgröße of €3,955/month. Expect to pay at least around €230/month even with low or no income, before optional Krankengeld coverage. ## Switching insurers You can switch insurers after 12 months of membership with two months' notice. A special right of termination applies whenever your current Kasse raises its supplementary contribution: you can then terminate at the end of the second month after the notice, regardless of the 12-month rule. Your new Kasse handles most of the paperwork once you sign with them. No coverage gap. ## Common pitfalls for expats - Assuming all AOKs are the same. Check your state's specific AOK rate before signing. - Picking the cheapest Kasse without checking app and customer service quality. A €10/month saving is wiped out by one bad reimbursement experience. - Missing the compulsory insurance threshold rule. Only employees earning above €77,400/year in 2026 may switch to private health insurance. Below that, GKV is mandatory. - Forgetting that long-term care insurance adds 3.6% on top of health insurance (4.2% if childless and over 23). - Not adding family members. Spouses with low income and children up to age 23 (25 if in education) can be co-insured for free under Familienversicherung. - Late employer notification. Tell HR which Kasse you joined as soon as you get your insurance number. ## FAQs Which Kasse is best for English-speaking expats? TK has the most developed English service, followed by Barmer. AOK quality varies by region. Is TK really cheaper than Barmer? Yes. In 2026, TK's total rate is 17.29% versus Barmer's 17.89%. On a €60,000 salary, the employee share difference is roughly €180/year. Can I keep my insurance if I move within Germany? With TK or Barmer, yes. With AOK, you may need to switch to the regional AOK of your new state. What about freelancers? Freelancers can choose voluntary GKV membership or private insurance. The 2026 minimum contribution base for voluntary GKV is €1,318.33/month. If you're applying for a Freiberufler permit, see our guide on the [Freelancer visa in Germany](https://migaku.com/blog/language-fun/how-to-get-a-freelancer-visa-freiberufler-in-germany). Does my visa affect my Kasse choice? Not directly, but proof of health insurance is required for almost every German residence permit, including the [Germany Chancenkarte requirements](https://migaku.com/blog/language-fun/germany-chancenkarte-opportunity-card-2026-requirements) and the [EU Blue Card salary thresholds](https://migaku.com/blog/language-fun/eu-blue-card-in-germany-salary-thresholds-and-documents-2026). What's changing in 2027? The contribution assessment ceiling is projected to rise by an extra €300/month to roughly €76,950/year, tied to planned healthcare reform. Watch for announcements from the Bundesministerium für Gesundheit. ## Bottom line For most English-speaking expats arriving in Germany in 2026, TK is the safe default: large, national, English-capable and at a mid-pack 17.29% total rate. AOK makes sense if you live in a state with a cheaper or stable regional AOK (Bayern at 2.69%, Rheinland-Pfalz/Saarland at 2.47%) and you value in-person service. Barmer is solid but costs more, and its "Geld-zurück" tariffs reward people who rarely visit the doctor. Getting health insurance sorted is one of your first real conversations with the German bureaucracy, and most of it still happens in German. If you're settling in long-term, picking up the language makes every appointment, contract and Behörde visit smoother. Migaku helps you learn German from the shows, news and YouTube videos you already watch, so the words you pick up are the ones you'll actually use at the Krankenkasse counter.