What is it about?
Eligibility for German private health insurance depends on your insurance and employment status. Benefits and reimbursement follow the chosen policy.
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How does private health insurance work?
PKV is based on an individual insurance contract. The premium and cover depend particularly on your entry age, health when applying and chosen tariff. You submit medical invoices for reimbursement under the policy, potentially subject to an excess. We review outpatient, hospital and dental benefits, income protection during illness and compulsory long-term care cover.
Who can switch to private health insurance?
Typical candidates include civil servants, primarily self-employed people outside compulsory GKV membership and employees above the applicable annual earnings threshold. The general threshold is €77,400 in 2026; exceptions and the date compulsory membership ends require individual checks. Health assessment and family plans also matter. Returning to GKV requires specific legal conditions and is often particularly restricted from age 55.
What advantages can PKV offer?
You can choose benefits reflecting your preferences, for example for dental replacement, hospital treatment or medical aids. Actual policy terms matter: a low premium does not automatically mean comprehensive cover. Benefits are defined contractually. Health assessment, personal contributions and separate premiums for family members must also be considered. We assess both benefits and long-term affordability.
Differences between PKV and GKV
PKV and GKV use different funding and benefit rules. Neither system is universally better for everyone. Compare family costs, income changes, desired benefits and retirement. GKV offers contribution-free family cover only when eligibility requirements are met; PKV generally requires a separate contract for each person. The table sets out the main differences.
| Topic | PKV | GKV |
|---|---|---|
| Premium / contribution | Tariff, entry age and health assessment | Assessable income up to the contribution ceiling |
| Benefits | Defined in the contract | Statutory benefits plus health-fund extras |
| Family | Generally separate premiums per person | Free family cover if eligibility conditions are met |
| Billing | Usually invoice followed by reimbursement | Usually through the health insurance card |
| Retirement | Income-independent premium; relief mechanisms | Contribution depends on status and assessable income |
PKV premiums in retirement: what matters?
Ageing reserves help cushion higher healthcare costs, but do not guarantee unchanged premiums. Retirement does not automatically reduce the premium. Sick-pay cover may end, and statutory pension recipients may apply for a limited contribution subsidy. Premium-relief arrangements or an internal tariff switch may be options. We examine benefits, personal contributions and reserves rather than the monthly premium alone.
Who is it for?
For eligible people considering a switch or reviewing an existing private health insurance policy.
What we look at together
- Eligibility and desired benefits
- Excess, family needs and long-term premiums
- Sick pay and compulsory long-term care cover
What helps for our first conversation?
- Insurance and employment status
- Existing policy or quotes
- Benefit preferences and questions
Your topic is enough for a first message. We agree on a suitable way to exchange personal documents or medical details later.