Private Health Insurance in Germany

Employees can switch to private health insurance (PKV) once their gross salary exceeds the compulsory insurance threshold, which is 77,400 EUR per year (6,450 EUR per month) in 2026, and stays above it for a full year (Versicherungspflichtgrenze, set by the federal government). Self-employed people, freelancers and civil servants can choose PKV regardless of income. Students can opt out of statutory cover at the start of their studies. For everyone else, statutory health insurance (GKV) remains compulsory.

There is no single price: the premium depends on your entry age, health status, the tariff you choose and any deductible. Younger, healthy applicants pay less; older applicants or those with pre-existing conditions pay more. Unlike GKV, the premium does not depend on your income. Because the exact figure is only fixed after the individual health assessment, you should always work with a personalised quote rather than a headline number. A comparison shows what is realistic for your profile.

In statutory health insurance (GKV) the contribution is income-dependent - 14.6% of gross income plus an average supplementary contribution of around 2.9% in 2026 - and children and non-working spouses can be insured free of charge. In private health insurance (PKV) the premium is based on age, health and the chosen tariff, every family member needs their own contract, and benefits are fixed by contract and often more extensive. PKV can offer better cover, but GKV is usually more economical for families and people with health risks.

Below 55 you return to statutory health insurance as soon as you become compulsorily insured again, typically by taking a job paying less than the compulsory insurance threshold. From 55 onwards Section 6 (3a) SGB V applies, and it is a two-part test rather than a blanket ban: you stay outside the statutory system only if you held no statutory cover during the previous five years and were versicherungsfrei or formally exempt for at least half of that period. If either test fails, statutory membership can still begin. Because the outcome turns on your own insurance record, check it before you assume the door is closed.

You stay in PKV for life, and premiums can rise. Section 146 (1) no. 2 VAG obliges insurers to build ageing reserves that are meant to cushion those increases, and the reserves start accumulating from your first contribution, which is why joining young matters. There is also a legal ceiling: under Section 152 (3) VAG the Basistarif may never cost more than the maximum statutory contribution, which works out at 1,017.18 EUR a month in 2026 according to the PKV-Verband. If you are in need under SGB II or SGB XII, Section 152 (4) VAG halves that to 508.59 EUR for as long as the need lasts.

Unlike GKV, there is no free family insurance in PKV. Each child needs its own contract. The premium per child is typically lower than for an adult because children have no ageing reserves to build, but the cost still has to be planned for - especially for larger families, where statutory cover with free family insurance is often the more economical route.

For a normal tariff, yes. Private insurers ask detailed questions about illnesses, treatments and medication over the past five to ten years and may request medical records. Pre-existing conditions can lead to risk surcharges, benefit exclusions or rejection. Answer fully and accurately, because incorrect statements can let the insurer void the contract later. The Basistarif is the exception: Section 152 (2) VAG obliges insurers to accept applicants from the listed groups, and there the health assessment cannot produce a surcharge or an exclusion.

It depends on your situation. Expats who are self-employed, earn above the threshold or work as researchers often find PKV attractive for faster appointments and broader cover, and several insurers offer English-language service. The same long-term rules still apply: family members are not covered for free, and after 55 the two-part test in Section 6 (3a) SGB V governs any return to statutory cover. If you may leave Germany within a few years, weigh that against a contract designed to run for life.

The general compulsory insurance threshold for 2026 is 77,400 EUR a year, or 6,450 EUR a month. An employee whose regular gross salary exceeds it becomes versicherungsfrei under Section 6 (1) no. 1 SGB V and may move to private cover. Two other figures are often confused with it: the special threshold of 69,750 EUR, which applies only to people already privately insured on 31 December 2002, and the contribution assessment ceiling, also 69,750 EUR in 2026, which caps the income used to calculate statutory contributions and has nothing to do with eligibility.

Yes, for employees. Section 257 SGB V entitles an employee who is versicherungsfrei purely because their income exceeds the threshold to a subsidy from the employer towards the private premium. The subsidy is calculated on the same basis as the employer share in the statutory system and is capped at half of what you actually pay. Self-employed people and freelancers have no such entitlement and carry the full premium themselves.