Nomadsurance

Destination

Healthcare in Germany, and what it costs without cover

Berlin is a magnet for freelancers, but Germany doesn't hand out a nomad visa. The freelance residence permit does the job instead, and it demands real German health insurance, not the travel policy you arrived on.

Insurance required?

Required · The freelance permit needs German statutory (GKV) or comparable private (PKV) cover; foreign or nomad insurance is not sufficient

Recommended coverage

PKV for a freelancer runs €230 to €900 per month depending on age and tariff

Emergency number

112 (ambulance/fire), 110 (police), 116 117 (on-call)

Healthcare quality

One of Europe's strongest systems; the Charité in Berlin is top-ranked with English-speaking care

  • Best for Long-term nomads
  • Best for Slowmads
  • Best for Freelancers
  • Best for Perpetual travelers

The 30-second read

  • Germany has no nomad visa; the freelance Freiberufler residence permit requires German statutory (GKV) or comparable private (PKV) insurance, and foreign cover is explicitly not enough.
  • The system is one of Europe's strongest, with the top-ranked Charité in Berlin and the country's largest pool of English-speaking doctors.
  • PKV is a one-way door: premiums climb with age and switching back to public insurance after 55 is close to impossible.
  • US, UK, Canadian and Australian visitors enter visa-free for 90 days in any 180; from late 2026 they will also need an ETIAS authorisation (around €20).

The system

Healthcare system in Germany

Germany runs one of the strongest healthcare systems in Europe, built on two tracks: statutory public insurance (gesetzliche Krankenversicherung, GKV) and private insurance (private Krankenversicherung, PKV).

GKV and PKV

Most residents are in GKV, where contributions are income-based and treatment is almost entirely covered. Self-employed people and freelancers usually have a choice between the two, and many nomads end up in PKV because GKV's voluntary contributions for the self-employed can be steep. Whichever you hold, the standard of care is high and hospitals are well equipped. What you don't get on the public side is much choice of doctor or a private room; PKV buys faster specialist access and better amenities.

English-speaking doctors in Berlin

Berlin has the highest concentration of English-speaking doctors in the country, clustered around Mitte, Prenzlauer Berg, Charlottenburg and Schöneberg, so day-to-day care rarely gets lost in translation. For serious cases, the Charité in Berlin is Germany's top-ranked hospital and runs a dedicated international patient service; major university hospitals in Munich, Heidelberg, Frankfurt and Hamburg also have English-capable staff and international departments. The emergency number is 112 for ambulance and fire; police is 110; and the non-emergency medical on-call service (for when you need a doctor after hours but it isn't life-threatening) is 116 117. Pharmacies (Apotheken) are everywhere, pharmacists are clinically trained, and an on-call rota keeps one open overnight in every area.

What you'd pay

Typical costs

Private or self-pay GP consultation€40 to €70 (~$45–80)
Specialist consultation (self-pay)€80 to €150+ (~$90–170+)
Ambulance call-outroughly €300 to €600 (~$340–690)
Private health insurance (PKV) for a freelancer€230 to €900 (~$260–1,000) per month depending on age and tariff
ETIAS travel authorisation (from late 2026)€20 (~$25), valid up to 3 years

These are indicative figures in euros, with the dollar equivalents as rough conversions for comparison, and move with your age, health, the specific clinic, and whether you walk in as a cash patient or bill through an insurer. PKV is the number to think hardest about: premiums look cheap when you're young and climb sharply with age, and after 55 switching back to public insurance is close to impossible. Treat the choice between GKV and PKV as a long-term decision, not a price comparison for this year.

Interactive

Verified prices

What would it cost in Germany without insurance?

The rare one that changes your finances rather than your week. Intensive care, then an air ambulance.

Itemised bill in Germany: Something serious, and you fly home
Emergency room, on arrival$65–$400
Three nights in intensive care$5,124–$10,248
Air ambulance home$20,000–$200,000
You pay, out of pocket$25,189–$210,648

Priced as one lump instead of itemised, a serious admission in Germany runs $5,000 to $15,000.

That is the bill you carry alone. Insurance exists for exactly this.

See what cover costs

Typical private-care estimates for illustration, not a quote. Actual bills vary by hospital, city and severity.

Entry & stay

Visa, residency & insurance

For short visits, US, British, Canadian and Australian passport holders enter Germany visa-free for up to 90 days in any 180-day period across the Schengen area.

No travel insurance is legally required to enter visa-free, though it's sensible to carry it. From the last quarter of 2026, these travellers will also need an ETIAS authorisation (around €20, valid up to three years), which is a quick online form, not a visa, and does not itself require insurance. Nationalities that do need a Schengen tourist visa must show travel medical cover of at least €30,000 valid across the whole Schengen area.

The freelance residence permit

Germany has no formal digital nomad visa. The route long-stay remote workers actually use is the freelance residence permit (Aufenthaltserlaubnis for self-employment under the Residence Act), often called the Freiberufler visa, issued for up to three years and renewable. There is no single published income figure: you must show your freelance work is financially viable and that you can support yourself without public funds. In Berlin the working rule of thumb is that your net income should exceed your rent plus your health insurance plus €563 a month, and since 1 July 2025 applicants over 45 must additionally prove pension entitlement of €1,612.53 a month for at least 12 years or assets of €232,204 (a handful of nationalities are exempt). The insurance rule is the part that catches nomads out: for the permit you need German health insurance, statutory or comparable private, and the immigration office states plainly that foreign health insurance is not sufficient. Basic expat or "nomad" policies are sometimes accepted for a first application but routinely rejected on renewal. We break down the requirements on the Germany freelance visa page.

Who these rules apply to: Rules are written for non-EU/EEA/Swiss foreign nationals; EU/EEA/Swiss citizens enjoy free movement and need no visa. Many visa-exempt nationals (e.g. US, UK, Canada, Australia) can still enter for short stays without a visa. ETIAS travel authorisation is expected to launch around Q4 2026 (and only become mandatory after a transition period, likely in 2027), so it is not yet required as of mid-2026; verify before travel.

  • Tourist

    Short-Stay Schengen Visa (Type C): Tourism & Visits

    Up to 90 days within any 180-day period across the Schengen area.

    Insurance
    Requiredtravel medical insurance with minimum €30,000 coverage valid across all Schengen states, including emergency treatment and repatriation.
    Good for
    Visa-required nationals visiting for tourism, family/friends or short visits (visa-exempt nationals enter without a visa; ETIAS authorisation expected to be required once it launches, around Q4 2026).
    Requirement
    Valid passport, proof of funds, accommodation and return travel, plus a clear purpose of visit; €90 fee (reduced to €45 for children aged 6–12).
  • Business

    Short-Stay Schengen Visa (Type C): Business

    Up to 90 days within any 180-day period; not for taking up employment.

    Insurance
    Required€30,000 minimum Schengen travel medical insurance covering the full stay.
    Good for
    Visa-required nationals attending meetings, conferences, negotiations or short training/internships (no local employment).
    Requirement
    Invitation/letter from the German business partner, proof of funds and ties; €90 fee.
  • Work

    EU Blue Card (National Visa, Type D)

    Tied to the employment contract; renewable, with a fast track to a settlement permit (21 months with B1 German, or 27 months with A1).

    Insurance
    RequiredGerman statutory or fully comprehensive private health insurance from the start date; foreign/travel insurance is not accepted.
    Good for
    Highly qualified non-EU professionals with a recognised university degree and a qualifying German job offer.
    Requirement
    Recognised degree plus a job offer meeting the 2026 salary threshold of €50,700 gross/year (or €45,934.20 for shortage occupations such as IT, engineering, science and healthcare, recent graduates, and IT specialists without a degree).
  • Work

    Skilled Worker Visa (§18a/§18b, National Visa Type D)

    Linked to the employment contract; renewable, with a path to a settlement permit.

    Insurance
    RequiredGerman statutory or comprehensive private health insurance valid in Germany; travel insurance is not accepted.
    Good for
    Non-EU workers with recognised vocational training (§18a) or a university degree (§18b) and a German job offer who do not meet Blue Card terms.
    Requirement
    Recognised qualification (at least ~2 years' vocational training, or a recognised/comparable degree) plus a job offer for qualified work; no general salary minimum, though pay must be appropriate (first-time applicants over 45 must earn at least €55,770 gross/year in 2026, or prove adequate pension provision). Verify recognition rules.
  • Work

    Opportunity Card / Chancenkarte (Jobseeker, National Visa Type D)

    Up to 1 year to find employment (part-time work up to 20 hrs/week and trial jobs permitted).

    Insurance
    Requiredcomprehensive 'incoming'/expat health insurance covering the stay (min ~€30,000, limited deductible, no termination clause); ordinary travel insurance is generally rejected.
    Good for
    Skilled non-EU jobseekers entering Germany to look for qualified work without a prior job offer, via recognition or a points system.
    Requirement
    Either a recognised qualification or at least 6 points (qualification, language skills, experience, age, German ties), plus proof of funds of approx €13,092 (≈€1,091/month) in a blocked account or a part-time contract.
  • Work

    Freelance / Self-Employed Visa (Freiberufler / Selbständiger, National Visa Type D)

    Typically issued for up to ~3 years, renewable; tied to the freelance/self-employed activity.

    Insurance
    Requiredcomprehensive private expat or German public/private health insurance; the Ausländerbehörde routinely rejects basic travel or 'digital nomad' policies.
    Good for
    Non-EU freelancers and self-employed professionals (Germany has NO dedicated digital-nomad visa; this §21 route is the closest option for remote/independent workers settling in Germany).
    Requirement
    Recognised skills, a viable business plan and client letters showing local demand, plus proof of financial means (no fixed national threshold; local Ausländerbehörden often expect stable monthly income of roughly €2,500+). Verify with the local Ausländerbehörde.
  • Study

    Student Visa (National Visa Type D)

    Length of the study programme; converted to a study residence permit after arrival.

    Insurance
    Requiredan incoming/travel policy (min €30,000) to bridge before enrolment, then mandatory statutory student health insurance (e.g. TK, AOK, Barmer) once studies begin.
    Good for
    Non-EU students with a university admission (or applicant/preparatory study) in Germany.
    Requirement
    University admission letter and proof of funds, currently €11,904 for 12 months (€992/month) in a blocked account.
  • Residence

    Family Reunion Visa (National Visa Type D)

    Tied to the sponsor's residence status; renewable, leading to an independent residence permit over time.

    Insurance
    Requiredhealth insurance covering the stay (travel/incoming cover often accepted for the visa); permanent German statutory or comprehensive private health insurance needed for the residence permit.
    Good for
    Spouses, registered partners and minor children joining a German citizen or a foreign national lawfully resident in Germany.
    Requirement
    Proof of relationship, the sponsor's secure residence and adequate income/housing, and usually basic German (A1) for spouses unless exempt (e.g. Blue Card families); €75 fee (€37.50 for minors).
  • Transit

    Airport Transit Visa (Type A)

    International transit zone only; no entry into German/Schengen territory.

    Insurance
    OptionalNot required: no Schengen entry, though travel cover is advisable for the journey.
    Good for
    Nationals of a defined list of countries connecting through a German international airport without entering the Schengen area.
    Requirement
    Onward flight booking and valid travel documents for the final destination; required only for the listed nationalities.

General guidance only, not legal or immigration advice. Rules, fees and thresholds change frequently; always confirm with an official German mission or the Make it in Germany / BAMF portals before applying.

Compare visasHow Germany compares: insurance rules for every nomad visa, side by side

Passing through and settling in are two different insurance problems. If Germany is where you plan to live for a while, health insurance for Germany is the page that goes through what a plan has to include.

Local risk notes

What to watch out for in Germany

  • Your travel policy won't pass for the visa. The Ausländerbehörde wants German statutory or comparable private cover, and explicitly says foreign insurance is not enough; budget for real German health insurance from day one.
  • PKV is a one-way door. Private premiums rise steeply with age and you generally cannot move back to public insurance after 55, so choose deliberately.
  • Processing is slow. Freelance permit decisions can take anywhere from about 8 weeks to 7 months, so apply early and keep valid insurance running the whole time.
  • The over-45 rule changed in mid-2025. Older applicants now face pension or asset thresholds that didn't exist before; check the current Berlin requirements rather than old guides.
  • Bureaucracy is in German and unforgiving. Appointments, forms and the registration (Anmeldung) you need before almost anything else are notoriously hard to get; build in time and consider professional help.
  • Watch the 90/180 Schengen clock. Days spent elsewhere in Schengen count too, and overstaying while a permit is pending can derail your application.

Common questions

Germany insurance FAQ

No. There is no dedicated nomad visa. Self-employed remote workers use the freelance residence permit (Freiberufler), issued for up to three years and renewable, which requires proof that your work supports you and that you hold German health insurance.

Not reliably. The immigration office states that foreign health insurance is not sufficient; you need German statutory (GKV) or comparable private (PKV) cover. Expat policies are occasionally accepted for a first application but usually rejected on renewal.

No, if you hold a US, UK, Canadian or Australian passport you can stay visa-free for 90 days in any 180. From late 2026 you'll also need an ETIAS authorisation, a quick online step that costs about €20.

There's no official fixed figure. You must show your freelancing is viable and self-supporting. Berlin's practical benchmark is net income above your rent plus health insurance plus €563 a month, with extra requirements for applicants over 45.

Yes on both counts. The system is high quality, and Berlin has the largest pool of English-speaking doctors, with international patient services at the Charité and other major university hospitals.

Dial 112 for ambulance or fire and 110 for police. For non-life-threatening medical help after hours, call the on-call service on 116 117.

Keep exploring

Nearby destinations

Ready for Germany?

Three minutes of honest questions, then only the insurance options that actually fit your situation in Germany. No spam, no markup.

Find my plan
See your matched plans for Germany