Written by
John Spencer
John Spencer is the founder of Compare Expat Plans, where he focuses on helping people compare health plans for life abroad. He emphasizes clear information, neutral analysis, and practical decision support.
Our Top Picks
German expats face unique challenges: the excellent GKV (gesetzliche Krankenversicherung) system sets high expectations, and returning to it after time abroad requires planning. Here's what we recommend:
- Cigna Global: Best overall for German expats. German-language support, strong EU network, seamless billing. Covers home visits to Germany.
- Allianz Care: German company, familiar brand. Excellent for expats who value dealing with a Versicherung they recognize.
- BDAE: German specialist in expat insurance. Designed specifically for Germans abroad. Very competitive pricing for EU residents.
- MAWISTA: Budget-friendly German option. Good for younger expats or those on tighter budgets.
- Bupa Global: Premium option with excellent coverage, though no German-language support.
Important for GKV Members
If you're leaving Germany but plan to return, consider Anwartschaftsversicherung before you go. This preserves your right to rejoin the GKV without medical underwriting.
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Leaving the German Health System
Germany's dual system (GKV public and PKV private) creates specific considerations when moving abroad. Your situation depends on which system you're in and whether you're employed or selbstständig.
If You're in the GKV (Public Insurance)
When you deregister from Germany (Abmeldung), your GKV membership ends. This matters because returning to the GKV later has rules: you need to be employed with income below the Versicherungspflichtgrenze (€69,300 in 2026), or you might be forced into PKV.
Key points:
- Your EHIC card stops working when you deregister
- GKV membership can be maintained with Anwartschaft (see below)
- Returning after age 55 without Anwartschaft may force you into PKV
- Freelancers returning can choose GKV if they were GKV members before leaving
If You're in the PKV (Private Insurance)
PKV members have more flexibility abroad. Many PKV policies offer limited coverage outside Germany (typically 1-3 months per year), but you'll need international coverage for longer stays. Consider:
- Some PKV companies offer Auslandskrankenversicherung add-ons
- You can often pause your PKV and maintain Anwartschaft
- PKV age-based premiums continue accumulating even while paused
- Returning to PKV is generally straightforward with Anwartschaft
Anwartschaft Options
Anwartschaftsversicherung is a German concept that doesn't exist in most other countries. It's essentially paying a small premium to maintain your "reservation" in your insurance system while abroad. This protects you from:
- Having to undergo medical underwriting when you return
- Being denied coverage for conditions you developed abroad
- Age-based premium increases (for PKV)
- Being locked out of the GKV due to age or income rules
GKV Anwartschaft
Most GKV insurers (TK, AOK, BARMER, etc.) offer Anwartschaft for expats. Typical cost is €50-100/month. This maintains your membership rights but provides no actual coverage—you still need international health insurance.
PKV Anwartschaft
PKV Anwartschaft is more expensive (often 20-40% of your regular premium) but maintains your Alterungsrückstellungen (age reserves) and prevents new medical underwriting on return.
Should You Get Anwartschaft?
If you might return to Germany within 10 years: probably yes. The cost of Anwartschaft is usually far less than the cost of being denied favorable GKV rates or facing PKV underwriting with new health conditions. If you're leaving permanently, skip it.
Quick Comparison
| Provider | German Support | EU Coverage | Repatriation | Starting Price |
|---|---|---|---|---|
| Cigna Global | German hotline | Full | Included | €180/mo |
| Allianz Care | German branch | Full | Included | €200/mo |
| Bupa Global | English only | Full | Included | €220/mo |
| BDAE | German company | Full | Included | €150/mo |
| MAWISTA | German company | Full | Included | €120/mo |
Detailed Reviews
Cigna Global
Cigna Global is our top recommendation for German expats because it combines international coverage quality with German-language support. You can call a German hotline, receive documents in German, and access a strong network of doctors across the EU.
The Global Health Plan offers three tiers (Silver, Gold, Platinum) with coverage from €1 million to unlimited. All tiers include inpatient, outpatient, and mental health coverage. You can add home country coverage for visits to Germany.
Best for: German expats who want a reliable international insurer with German-language support and strong EU coverage.
Allianz Care
Allianz is a name every German knows. Allianz Care is their international health insurance arm, and they understand German expat needs well. The claims process is straightforward, and you'll deal with a company whose reputation matters in your home country.
Plans range from Essential to Platinum, with comprehensive coverage including maternity (after waiting period), mental health, and chronic condition management. Direct billing is available at most major hospitals in popular expat destinations.
Best for: Expats who prefer the familiarity of a German insurance brand and value comprehensive coverage.
BDAE (Bund der Auslands-Erwerbstätigen)
BDAE specializes exclusively in insurance for Germans living abroad. They understand Anwartschaft, tax implications, and the specific needs of German freelancers and employees overseas. Documentation is in German, support is in German, and they know the German system inside out.
Their Expat Private plan offers solid coverage at competitive prices, especially for EU destinations. Coverage includes repatriation to Germany if needed for specialized treatment.
Best for: German expats who want a specialist German provider and prefer dealing entirely in German.
MAWISTA
MAWISTA offers budget-friendly options specifically designed for German expats, students, and working holiday travelers. While coverage limits are lower than Cigna or Allianz, they're adequate for many situations and the price is right.
Plans include Expat (comprehensive), Student (for studying abroad), and Visum (visa-compliant basic coverage). All plans include German-language support and claims processing.
Best for: Budget-conscious German expats, students, or those just starting their expat journey.
Get Multiple Quotes
German expat insurance pricing varies significantly based on age, destination, and coverage level. Compare quotes from multiple providers to find the best value.
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Returning to Germany
Planning your return is as important as planning your departure. Here's what to expect:
Returning to the GKV
You can return to the GKV if:
- You're employed with income below the Versicherungspflichtgrenze
- You're under 55 and were GKV-insured in the 5 years before leaving (if freelancing)
- You maintained Anwartschaft with your previous GKV insurer
- You're receiving German unemployment benefits
Without Anwartschaft and over age 55, you may be forced into the PKV—which means medical underwriting and potentially much higher premiums based on any conditions you developed abroad.
Returning to the PKV
PKV return is generally straightforward with Anwartschaft. Without it, you'll face full medical underwriting. Any conditions you developed abroad will either be excluded or result in risk surcharges (Risikozuschläge).
Tax Implications
Germany requires proof of health insurance to register (Anmeldung). You cannot register without coverage, so plan your return timing carefully. Many expats maintain their international policy for the first month while sorting out German coverage.
Common Questions
Can I use my TK/AOK abroad?
Within the EU, your EHIC provides emergency coverage only—not routine care. Outside the EU, GKV provides no coverage. You need international insurance for expat living.
Is Anwartschaft worth the cost?
If you're under 50 and might return within 10 years, yes. The €50-100/month is far less than potential costs of being locked out of favorable GKV rates or facing PKV underwriting.
Will international insurance count for Anmeldung?
Yes, international health insurance is accepted for German registration. Bring your policy documents showing German coverage when you visit the Bürgeramt.
Can I see German doctors abroad?
International insurers cover care wherever you receive it. If there's a German-speaking doctor in your destination, you can use them. Many expat hubs have German medical clinics.
What about German medications abroad?
Most international plans cover equivalent medications. For German-specific medications, you may need to order from Germany or find local alternatives. Discuss with your insurer.
Is BDAE or MAWISTA accepted for visas?
Both are accepted for most visa applications, including German freelancer visas and EU residency permits. Check specific requirements for your destination.
Final Verdict
German expats have excellent options for international health insurance. Cigna Global is our top recommendation for its combination of quality coverage and German-language support. Allianz Care is ideal if you prefer a familiar German brand. BDAE offers the best specialist knowledge for Germans abroad, while MAWISTA provides budget-friendly coverage for those just starting out.
Whatever you choose, don't forget Anwartschaft if you might return to Germany. The small monthly cost can save you significant headaches and expenses when reintegrating into the German health system.
