For US citizens, the shift from a US employer-plan model to Germany's dual system is the single most confusing part of relocating. Here's the practical translation.
The mental map: how German insurance compares
GKV is closest to a Medicare-style universal system, funded by payroll. PHI is closer to a US private plan — but tightly regulated, with lifetime coverage guarantees and no annual re-underwriting. There is no US-style out-of-network / in-network split.
Total cost comparison
For a healthy 35-year-old, all-in monthly cost in Germany (PHI ~€500 or GKV ~€400 employee share) is dramatically below a comparable US bronze/silver plan plus deductible. Dental and vision are similarly cheaper.
FATCA and reporting
German insurers don't report to the IRS in the way banks do — but if you hold pension-style products or premium relief tariffs, get US-tax advice early. For plain PHI, no US filing implications.
Green Card holders returning to the US
Consider Anwartschaft if you might come back to Germany within a decade. It's the cheapest form of German insurance-optionality you can buy.
Based on 11 Google reviews
As an international student, navigating the health insurance requirements can be confusing, but their team made the entire process smooth and stress-free. They were always responsive, professional, and willing to answer my questions.
I have been working with Ms. Fröhlich for several years and I am extremely satisfied. As an outstanding insurance broker, she finds excellent tariffs, and communicating with her makes dealing with insurance genuinely pleasant. Her expertise across all insurance topics makes her an incredibly reliable specialist. I consider myself lucky to have such a competent insurance broker by my side and can recommend her to anyone without reservation.
Nobody enjoys dealing with the topic of insurance. With Ms. Fröhlich by my side that has changed: perfect advice tailored individually to me, always reliable — without ever building any pressure. On top of that, Ms. Fröhlich works in an extremely service-oriented way. Compared to online services, she offers real added value. In short: I'm thrilled. Thank you so much!
Some client reviews have been translated from German into English for better readability. The original reviews are available on our Google Business Profile.
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Editorial Review
Reviewed by our advisory team
This article was prepared with editorial support and professionally reviewed for accuracy, relevance and clarity before publication.
Tina Fröhlich
Founder & Managing Director
Independent German Health Insurance Broker (§ 34d GewO)
Tina is the founder of Happy Expats and a licensed independent broker under § 34d GewO. She specialises in independent PKV strategy for internationals and is legally bound to act in the client's interest.
Joachim Wiedmann
International Health Insurance Advisor
Joachim advises expats, freelancers and employees on German private health insurance. He focuses on making the German system understandable in plain English and matching each client with a tariff that fits their life in Germany.
Happy Expats provides independent guidance on private health insurance in Germany for internationals. Every article is reviewed before publication and updated regularly to help ensure that the information remains accurate and relevant.