Before you start

An employment contract or proof of self-employed income
Meldebescheinigung from your Anmeldung
Steuer-ID and, once issued, your social security number
A German bank account for contributions

Step-by-step

1
Establish which system you are eligible for
Employees below the compulsory insurance threshold — around EUR 77,400 gross for 2026 — must be in the statutory system. Above it, and for freelancers, private cover becomes available. Nuremberg salaries mean plenty of people sit close to the line rather than clearly over it, so check rather than assume.
OnlineWho: YouFirst month
2
Default to a statutory fund if you are at all unsure
Statutory funds differ modestly in supplementary rate and extras, and switching between them is easy. Starting statutory keeps every option open; starting private closes most of them, permanently after a certain age.
OnlineWho: You
3
Let payroll run the contributions
Once your employer has the fund's details, health, pension, unemployment and long-term care contributions come off gross pay and are split roughly evenly with the employer. There is no separate invoice — people from countries where cover is bought individually spend weeks looking for a bill that does not exist.
Via employerWho: Employer and you
4
Get the membership confirmation for your residence permit
The Ausländerbehörde requires proof of valid cover before issuing or activating a permit. Your insurer issues a Mitgliedsbescheinigung on request within days. Have it in the file before the appointment.
OnlineWho: You
5
Register with a Hausarzt in your first month
Your GP is the gateway to specialists and to the sick note German employers require from the third day of absence, or from the first under some contracts. Practices here are less uniformly closed than Munich's, but the good ones still fill. Call rather than email and ask colleagues for a recommendation.
In personWho: You
6
Learn 116117 and know where the hospitals are
For urgent problems outside surgery hours that are not emergencies, 116117 routes you to whatever is open. Klinikum Nürnberg is one of Europe's largest municipal hospitals and the Erlangen university hospital is twenty minutes up the S-Bahn — between them the region's specialist coverage is much better than a city of this size would normally have.
Mobile appWho: You

Documents you’ll need

Employment contract or proof of income
Meldebescheinigung
Steuer-ID and social security number
Passport and residence permit
Bank details for contributions

Things most newcomers don’t know

Private cover is close to a one-way door, and Nuremberg salaries put many people right on the boundary.

Because pay here is below Munich's, a lot of newcomers sit just around the compulsory insurance threshold rather than comfortably above it — which is precisely where insurance brokers concentrate. Private premiums rise with age rather than falling, every family member is separately underwritten where statutory covers non-earning dependants free, and returning is effectively impossible after 55. Decide on the thirty-year path, not the first premium.

Source: Bundesministerium für Gesundheit

Six weeks of full pay during illness is a statutory right, and newcomers routinely do not know it.

Under the Entgeltfortzahlungsgesetz an employee off sick continues to receive full salary from the employer for up to six weeks per illness, after which the statutory insurer pays Krankengeld at a reduced rate. People arriving from countries with minimal sick pay treat illness as a financial emergency and work through it. Know the rule, and know your contract's notification deadline, which is often the first hour of the working day.

Source: Entgeltfortzahlungsgesetz

The region's hospital coverage is better than a city of this size normally gets.

Klinikum Nürnberg is among the largest municipal hospitals in Europe, and the Universitätsklinikum Erlangen twenty minutes north is a full university hospital attached to one of Germany's biggest medical faculties and to the Siemens Healthineers cluster. For anything specialist you are unusually well served here, without the waiting lists or the rents that come with a bigger city.

Source: community-reported

116117 is the number that keeps you out of an emergency department queue.

The national medical on-call service handles urgent but non-life-threatening problems outside surgery hours and routes you to what is actually open. Newcomers default to the hospital, where a non-emergency is triaged accordingly and waits for hours. Save the number before you need it, because you will be looking for it at a moment when looking anything up is hard.

Source: Kassenärztliche Bundesvereinigung

Common mistakes to avoid

Being sold private cover on a first-year premium comparison while sitting right on the eligibility threshold.
Not realising statutory cover includes non-earning dependants free while private prices each of them.
Not knowing that six weeks of full salary during illness is a statutory right.
Turning up at the Ausländerbehörde without a membership confirmation from your insurer.
Leaving the GP search until you are ill, even in a city where it is easier than Munich.

Some of this may be out of date. Spotted something inaccurate? Help us keep it right for the next newcomer.