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 the age of 55 a return to statutory health insurance is possible if you become compulsorily insured again, for example by taking a job with a salary below the compulsory insurance threshold. From the age of 55 the return is practically excluded by law, even in the event of unemployment or part-time work. This one-way nature is one of the most important factors to weigh before choosing PKV.

You stay in PKV for life. Premiums can rise over time, but German law requires insurers to build ageing reserves (Alterungsrueckstellungen) that are meant to cushion increases in old age. If a premium ever becomes unaffordable, the standard and basic tariffs (Standardtarif and Basistarif) provide a fallback at a level comparable to GKV. Starting early helps because ageing reserves build from day one.

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.

Yes. Private insurers ask detailed health 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, in some cases, rejection. Answer the questionnaire fully and accurately - incorrect statements can allow the insurer to void the contract later.

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. However, the same long-term rules apply: the return to GKV is hard from the age of 55, and family members are not covered for free. Compare carefully and factor in how long you plan to stay in Germany before deciding.