Private Health Insurance in Germany (PKV)
Choosing private health insurance affects not only your premium, but your medical care, your flexibility and your financial planning in old age – whether you’ve lived in Germany all your life or have just arrived.
Before you switch, we clarify step by step – in English:
- Whether you should switch at all.
- How insurers assess your health.
- Which tariff structure is sustainable in the long term.
What is private health insurance (PKV)?
Private health insurance in Germany (PKV – private Krankenversicherung) is individual, comprehensive health cover: instead of an income-based contribution as in the statutory health insurance system (GKV), you pay a premium based on your age at entry, your health and the level of benefits you choose. The benefits guaranteed in your contract cannot be cut by political decisions.
…and what private health insurance is not: it is not a pure money-saving model and not a short-term change of tariff. It is a change of system with a long-term commitment – returning to statutory health insurance is heavily restricted from the age of 55. If you only look at the starting price, you make the wrong decision.
New to Germany?
Health insurance is compulsory in Germany – and for many residence permits, including the EU Blue Card, you need proof of adequate cover. Whether private health insurance makes sense for you depends on your income, your employment status and how long you plan to stay.
We explain the German system to you in English, check your options with several insurers and support you all the way – from the first question to your policy.
About private health insurance
The strategic decision about premiums, benefits, switching and your financial risk
If you are looking into private health insurance, you are facing a decision that doesn’t just affect you for one year.
But for decades.
Private health insurance is not a change of tariff. It is a change of system.
You leave the statutory health insurance system and commit to an individual contract with a health insurer that determines your benefits, your premium and your care in the event of illness for the long term.
The question is not: “Is private health insurance cheaper?”
The question is: Does it make strategic sense for your situation – or is it a mistake with long-term consequences?
If you want clarity on this, you’ll get it.
What private health insurance really is – and what it isn’t
Private health insurance is individual, comprehensive health cover.
This means:
Your premium does not depend on your income
Your level of benefits is fixed in your contract
Your age at entry permanently influences your costs
Your state of health is assessed
Unlike statutory health insurance, private health insurance is not a solidarity-based system but calculated risk cover.
That brings advantages. And responsibility.
Who can switch to private health insurance
Not everyone can switch.
Employees
Only if your income is above the annual income threshold (Jahresarbeitsentgeltgrenze) does your obligation to be insured in the statutory system end.
Civil servants & trainee civil servants
Civil servants and others entitled to allowances receive an allowance (Beihilfe) from their employer. For them, private health insurance is often the more economical choice.
Self-employed & freelancers
Self-employed people can choose freely.
Children
Your child needs their own tariff in private health insurance. If you register your child within two months of birth, there is no health assessment at all.
Doctors
Employed hospital doctors above the annual income threshold as well as doctors in private practice can choose freely. For medical professionals in particular, a detailed comparison of benefits pays off.
If you’re unsure which group you belong to, we’ll clarify it with you step by step.
Top 3 reasons why people switch to private health insurance
Not because of advertising. Because of how the system works.
Individual scope of benefits
You decide on:
- Hospital care (single room, senior consultant)
- Dental benefits
- Alternative medicine
- Premium refunds
- Daily sickness allowance
- Long-term care insurance
Contractually guaranteed benefits
What is in your contract cannot be reduced by political decisions.
Premium independent of income
Your premium is based on:
- Age at entry
- State of health
- Tariff
- Deductible
- Chosen scope of cover
Not on your salary.
The reality of premiums
The most important question is not: “What does private health insurance cost today?”
But: “How will my premium develop over 20–30 years?”
Premiums are influenced by:
- Age
- Medical inflation
- Use of benefits
- The insurer’s calculation
Yes, premiums rise. In the statutory system too.
The difference lies in the structure of your private health insurance.
What does private health insurance really cost?
There is no one-size-fits-all figure – the premium depends on age at entry, state of health, tariff and deductible. But realistic ranges do exist. The following ranges are guide values, not offers; we calculate your actual premium individually.
Example 1
Employee · 35 years · healthy
€250–350 / month
Your share after the employer’s contribution (up to 50%)
- Total premium: approx. €450–650 / month (depending on level of benefits)
- Your share after the employer’s contribution (up to 50%): approx. €250–350 / month
- Requirement: income permanently above the annual income threshold (2026: €77,400 gross / year or €6,450 / month)
Guide value · not an offer
Example 2
Civil servant with 50% allowance
€250–400 / month
Premium, often lower at a young age of entry
- Private health insurance only covers the remaining share of costs (e.g. 50%) – which makes it considerably cheaper
- Premium: approx. €250–400 / month, often lower at a young age of entry
- For many civil servants, private health insurance is structurally clearly more economical than voluntary statutory insurance
Guide value · not an offer
Private vs. statutory health insurance (GKV)
| Private (PKV) | Statutory (GKV) |
|---|---|
| Individual contract | Solidarity principle |
| Premium depends on tariff & age | Contribution depends on income |
| Health assessment | No health assessment |
| Contractual guarantees | Can be changed politically |
| Premium refunds possible | No refunds |
The biggest source of error: the health assessment
Before accepting you, every insurer checks:
- Pre-existing conditions
- Treatments
- Diagnoses
- Psychological history
- Chronic illnesses
A rejected application can limit your options.
Many people apply directly. That is risky.
Finding the right private health insurance with dein onlinemakler
We have a solution for high premiums in old age
In conversations with our clients, we are very often confronted with the fear that premiums will rise immeasurably in old age and become unaffordable.
Private health insurers take the higher risk of illness in old age into account when calculating premiums.
We offer you a solution for this too!
We’ll show you how to build up reserves at a younger age and thereby avoid high premiums later. You voluntarily pay higher contributions while you are still working and relieve yourself for retirement.
The health assessment is no longer a hurdle
The health assessment is an essential step when applying for private health insurance. From the insurer’s perspective, it serves to assess the applicant’s individual risk and adjust the terms accordingly.
You fill in a detailed questionnaire about your health, covering current and previous illnesses, operations, medication, hospital stays and other relevant medical information.
In some cases, the insurer may request additional medical examinations or reports.
Rejected? Not with us!
After reading through offers, comparing tariffs and filling in health questionnaires, the insurer may still reject you.
Reasons can include serious pre-existing conditions, chronic illnesses or certain risk factors that make the insurer consider your risk too high.
You would then be back at the very start of your search. That’s exactly the process we’ve simplified for you.
We negotiate with the insurers in the background and only present you with offers from insurers who are happy to cover you.
Our expertise for the right decision
As independent insurance brokers, we know the market and have access to almost all offers from German insurers.
We sit down with you – in English – and find exactly the offer that suits you.
We do the comparison for you
There are more than 40 private health insurers on the German market, each with its own strengths and special features. We take care of the time-consuming comparison and only select offers that match your wishes.
Long-term support
We are and remain your contact person – even after you have signed your contract. Has something changed in your personal or professional situation?
Then we review your insurance together and check whether it is still the best choice.
The truth: most mistakes happen before you apply
In practice, we see the same pattern again and again:
- People compare tariffs.
- They fill in health questionnaires.
- They submit an application.
And only then do they realise:
- The insurer rejects them
- There are risk surcharges
- Benefits are excluded
- The tariff structure doesn’t fit in the long run
We estimate that 80–90% of all problematic private health insurance decisions don’t arise in the contract. They arise before the application.
Not out of bad intent. But from a lack of structure.
And that’s exactly where we come in.
Before an application is submitted, we check anonymously with several insurers:
- How is your state of health assessed?
- With a surcharge?
- With an exclusion?
- Or on standard terms?
That is the difference between “trying” and “being in control”.
Decide with clarity – not with risk.
Private health insurance commits you for the long term.
First check anonymously and without obligation whether you would be accepted at all.
When private health insurance probably makes sense for you
The key question is:
When does the system structurally favour private health insurance?
If several of the following points apply to you, private health insurance often makes strategic sense:
1. Your income is permanently well above the annual income threshold
Not just barely. Not just temporarily.
But consistently.
The clearer your career perspective – and your plans to stay in Germany – the more sense a change of system makes.
2. You value individually tailored benefits
If the following matter to you:
- Free choice of doctor
- High-quality hospital care
- Treatment by senior consultants
- Extended dental benefits
- Contractually guaranteed benefits
then private health insurance structurally offers more flexibility than statutory health insurance.
3. You plan for the long term, not just the short term
Private health insurance rewards strategic thinking:
- Early entry
- Accurate health information
- A well-considered choice of tariff
- Realistic planning for old age
Those who think long-term make better use of the system.
4. Your health is good or predictable
Stable health improves:
- Chances of acceptance
- Premium conditions
- Tariff options
That’s why we check anonymously before you apply how insurers would assess your case.
5. You want control instead of the solidarity principle
In the statutory system, the system decides.
In private health insurance, you decide:
- Level of benefits
- Deductible
- Tariff structure
- Premium design
If individual control matters more to you than collective redistribution, private health insurance is often the better fit.
Decision check
If at least three of these points apply to you, a structured review is worthwhile.
Not to switch immediately.
But to clarify whether private health insurance makes strategic sense for your situation.
Find out now whether private health insurance suits you.
Three typical situations – and what they mean
Theory is one thing. In practice, your individual situation always decides.
Here are three typical situations that show how differently the same question can be answered.
Case 1: 34 years old, employee, €82,000 gross, single
Starting point:
- At €82,000, income is above the annual income threshold of €77,400
- No children planned
- Good health
- Stable career perspective
Question:
Stay in the statutory system or switch to private health insurance?
Analysis:
- Switching is legally possible
- The employer contributes to the premium
- Early entry secures a favourable age at entry
- Good basis for high ageing reserves
- Better benefits in hospital and with specialists possible
Our conclusion: Structurally very good conditions for private health insurance – provided the tariff is chosen with the long term in mind and not just the starting price.
Case 2: 41 years old, self-employed, €110,000 profit, married, 1 child
Current premium situation:
- Statutory: approx. €1,226 per month (own contribution as self-employed)
- Private: approx. €550–750 (depending on tariff, paid in full by yourself)
Question:
Does private health insurance make economic sense – with a family too?
Analysis:
- Private premium independent of income
- Statutory contribution rises with profit up to the contribution ceiling
- Children need their own premium in private insurance
- Daily sickness allowance can be tailored individually
- Retirement provision and liquidity planning are decisive
Our conclusion: Private health insurance can make sense – but only with a thorough overall view of income, family and retirement strategy.
Case 3: 29 years old, civil servant on probation
Starting point:
- Entitled to an allowance (e.g. 50%)
- Very good health
- Still at the start of her career
Question:
Statutory insurance, or private insurance topping up the allowance?
Analysis:
- Statutory: the allowance covers part of the costs, statutory insurance the rest
- Private insurance only covers the remaining share
- Very affordable entry possible
- Level of benefits can be chosen freely
- The employer indirectly covers part of the healthcare costs
Risks:
- Choice of tariff is decisive
- Prepare the health assessment carefully
Our conclusion: For many civil servants, private health insurance is structurally clearly more economical than voluntary statutory insurance.
The best providers in Germany – why the name isn’t what matters
– to name just a few examples. All of them are well-known health insurers.
But what really matters is:
The specific tariff
How premiums develop
The tariff structure
The options for switching
The name of your insurer is no substitute for a proper analysis.
What happens to private health insurance in old age?
A common objection is: “Won’t my premiums explode later on?”
The honest answer: your premiums can rise. But they don’t rise arbitrarily.
What matters is how the system is structured.
Ageing reserves – why they exist
In private health insurance, part of your premium is not used for current benefits.
It is saved.
These so-called ageing reserves (Alterungsrückstellungen) serve to:
- cushion rising healthcare costs in later life
- smooth out premium increases
- make the long-term calculation of your insurance more stable
The system assumes that medical costs rise with age and takes this into account from a young age.
Important: the earlier you join, the stronger the effect of these reserves.
Why premiums can still rise
Premium adjustments are not “arbitrary” – they result from:
- Medical progress (new, more expensive treatments)
- Longer life expectancy
- Greater use of benefits
- Statutory rules on recalculation
Contributions also rise in the statutory system – just through different mechanisms such as additional contributions or rising assessment ceilings.
So the decisive question is not: “Will premiums rise?”
But: “How controllable is the development?”
Internal tariff change – an often underestimated tool
Within the same insurer, you have the right to change your tariff.
This means:
- Switching to a cheaper tariff
- Adjusting your scope of benefits
- Reducing or increasing your deductible
The ageing reserves you have already built up are retained.
This tool is often underestimated or used incorrectly.
Strategic support with a full overview is decisive here.
Premium relief tariffs – predictable relief in retirement
Many insurers offer so-called premium relief tariffs (Beitragsentlastungstarife).
You pay an additional premium during your working life, which later reduces your private health insurance premiums.
It’s not a must – but an option to:
- increase planning security
- stabilise liquidity in retirement
The real core: planning instead of speculation
Private health insurance is not a short-term saving measure.
It is a long-term decision that takes into account:
- Your age at entry
- Your career development
- Your family situation (children etc.)
- Your retirement planning
Those who only look at the starting price think short-term. Those who understand the system think strategically.
Conclusion: private health insurance is not a budget solution.
It is a calculated, long-term strategy. If you plan it properly, you make use of:
- Ageing reserves
- Tariff change options
- Premium relief models
If you get it wrong, you pay unnecessarily later.
If you want to know how your premiums could realistically develop, we’ll review it with you step by step before you decide.
Frequently asked questions about private health insurance
Can I take out private health insurance as an expat or EU Blue Card holder?
Yes – if you are not compulsorily insured in the statutory system. As an employee, that is the case if your income is above the annual income threshold; as a self-employed person or freelancer, you can choose freely. Many residence permits, including the EU Blue Card, require proof of adequate health insurance.
Important for expats: think about how long you plan to stay in Germany and what happens to your cover if you move abroad. We explain your options in English and check them with several insurers before you apply.
Will private health insurance become unaffordable in old age?
No, not automatically. Part of your premium goes into ageing reserves that cushion later premium increases. Internal tariff changes (Section 204 VVG) and premium relief tariffs also help. The earlier you join, the stronger the effect of these reserves. What matters is sustainable long-term planning, not the lowest starting price.
What happens if I become unemployed or am ill for a long time?
If you receive unemployment benefit I (Arbeitslosengeld I), returning to statutory health insurance may be possible under certain conditions.
If you receive citizen’s income (Bürgergeld), you are generally required to be insured in the statutory system.
If you fall ill, your private health insurance pays the contractually agreed benefits. Your income is secured – if agreed – by a daily sickness allowance insurance (Krankentagegeld).
The right tariff structure is decisive here.
Can I return to statutory health insurance at 55 or later?
From the age of 55, returning to statutory health insurance is heavily restricted.
That’s why switching to private health insurance should not be a short-term or speculative decision, but based on a long-term strategy.
If you switch at a young age, you should take a realistic view of your career and family plans.
What happens with part-time work, parental leave or changes in income?
In private health insurance, the premium does not depend on your income.
This means:
- If your income falls, your premium does not fall automatically.
- However, there are options to change tariffs or adjust your deductible and scope of benefits.
Especially when planning a family or career changes, this phase should be taken into account in advance.
What is the difference between private and statutory health insurance?
In statutory health insurance (GKV), contributions depend on your income (solidarity principle) and benefits can be changed politically. In private health insurance (PKV), the premium depends on age, health and tariff – in return, benefits are contractually guaranteed and can be tailored individually. Private insurance offers more control, statutory insurance more collective protection.
What are the most common mistakes when switching to private health insurance?
Typical mistakes are:
- Only looking at the starting price
- Giving incomplete health information
- Not checking the tariff structure for the long term
- Not taking family planning into account
- Not carrying out an anonymous risk pre-check
Private health insurance is not a quick decision but a long-term contractual commitment.
What happens if I become seriously ill?
Your scope of benefits is contractually guaranteed.
Unlike statutory health insurance, benefits cannot be reduced unilaterally. What matters, however, is which tariff you chose and which benefits it includes.
Does private health insurance make sense for families with children?
There is no free family insurance in the private system.
Each child needs their own premium.
Whether private health insurance makes sense depends on:
- Income
- Entitlement to allowances (Beihilfe)
- Number of children
- Long-term financial planning
There is no one-size-fits-all answer here.
Is everyone accepted by private health insurance?
No.
Before concluding a contract, insurers check:
- Pre-existing conditions
- Ongoing treatments
- Chronic illnesses
- Psychological diagnoses
Depending on the risk, this can lead to surcharges, exclusions or rejection.
That’s why an anonymous risk pre-check before applying makes sense.
When should I not switch to private health insurance?
Switching often does not make sense if:
- your income is only just above the annual income threshold
- you are planning several children and have no entitlement to allowances
- your professional future is uncertain
- your finances depend heavily on your income
Not everyone benefits from private health insurance – and that is exactly what should be checked in advance.
What happens in the event of divorce or separation?
In private health insurance, every person is insured individually.
In the event of a divorce, the contract continues independently. There is no free co-insurance of family members as in the statutory system.
Is private health insurance a safe decision?
Security does not come from the system alone, but from:
- The right choice of tariff
- A careful health assessment
- Realistic long-term planning
- Strategic support
Private health insurance is not a short-term saving solution, but a long-term decision.
When is private health insurance worth it?
Private health insurance is particularly worthwhile if your income is permanently above the annual income threshold (2026: €77,400 gross/year), you are healthy and you plan for the long term. Civil servants with allowances and many self-employed people also benefit. What matters is not the starting price but the right structural starting position.
How much does private health insurance cost per month?
There is no one-size-fits-all figure. As a guide: a healthy employee in their mid-30s often pays €450–650 total premium (own share after the employer’s contribution approx. €250–350), a civil servant with a 50% allowance around €250–400. We calculate your actual premium individually.
Who can switch to private health insurance?
Employees whose gross income is above the annual income threshold (2026: €77,400), as well as self-employed people and freelancers regardless of income. Civil servants and those entitled to allowances can use private insurance to top up their allowance. Doctors are also a classic target group. Children need their own tariff.
What happens if my health assessment is rejected?
A rejection or risk surcharges can limit your options permanently. That’s why we carry out an anonymous risk pre-check in advance: we find out from several insurers how your health would be assessed – standard, with a surcharge or with an exclusion – without an official application being put on record. This way you avoid a documented rejection.
What does private health insurance cost for civil servants?
Civil servants receive an allowance (Beihilfe) from their employer (often 50%), and private insurance only covers the remaining share. This makes premiums of around €250–400 per month realistic, often less at a young age of entry. For many civil servants, private insurance with an allowance is considerably cheaper than voluntary statutory insurance.
Decide with clarity
Private health insurance commits you for the long term.
First check anonymously and without obligation whether you would be accepted at all.