Number of People in Private Health Insurance in Germany [1991 to 2025]

Key takeaways

• In 1991, 6.33 million people were insured under private health insurance in Germany. The total number of privately insured individuals rose to 8.97 million in 2011 and started declining until 2023.
• The number of people insured in private health insurance increased sharply to 8.74 million in 2024.
• People are losing faith in the public healthcare system, which has contributed to the increase in the number of people enrolling in private health insurance. 
• The number of people moving between the two health insurance systems is common. For most years between 1991 and 2025, more people switched from public to private health insurance.

This is how you do it

• Use our "Health Insurance Finder" tool to check which health insurance is best for you.
• We recommend getting private health insurance via an insurance broker. They are experts and can help you find the best plan for your needs. You can book a call with an expert we recommend here.
• In our comparison and test, we found Haellesche, Allianz, and Signal Iduna’s private health insurance plans to be the best.
• Read our book on the German healthcare system to get an overview and understand both systems’ intricacies, pros, and cons.

Table of Contents

How did the number of people insured in Germany’s private health insurance change from 1991 to 2025?

Year	Total number of people insured in private health insurance (in million)	Net number of people who switched  from public to private health insurance (in thousands)
2024	8.74
2023	8.709	49.6
2022	8.705	12
2021	8.718	23
2020	8.724	20
2019	8.732	17
2018	8.736	1
2017	8.753	-4
2016	8.772	-2
2015	8.787	-20
2014	8.835	-30
2013	8.890	-37
2012	8.956	-20
2011	8.976	74
2010	8.896	75
2009	8.811	94
2008	8.639	73
2007	8.549	79
2006	8.489	141
2005	8.373	120
2004	8.259	167
2003	8.110	208
2002	7.924	232
2001	7.710	213
2000	7.494	176
1999	7.356	176
1998	7.206	173
1997	7.065	171
1996	6.977	66
1995	6.945	85
1994	6.934	92
1993	6.829	132
1992	6.686	329
1991	6.333	231

In 1991, 6.33 million individuals were insured under private health insurance (PKV) in Germany. The number of people with full private insurance increased steadily until 2011, when it peaked at 8.976 million insured individuals. Since 2011, the number of people with private insurance has been declining. 

The trend shifted in 2023 when the number of people insured in private health insurance increased from 8.805 million in 2022 to 8.709 million in 2023.

After many years, in 2024, private health insurance saw a big jump in insured members, which increased from 8.709 to 8.74 million.

Why did the number of people in private health insurance increase recently?

As per the survey of Rober Bosch Stiftung, 60% of the Germans have lost confidence in the German healthcare system. Three years ago, it was only 30% of the people. 

It’s a big and justified drop. The German healthcare system is struggling due to increased expenses and reduced income. 

The healthcare expenditure was 497.7 billion euros in 2022 and is increasing consistently each year.

The factors contributing to the rising healthcare expenditure are

• Germany’s aging population. More old people (60 and above) mean more medical expenses. 31% of the German population is 60 or above as of 2024. The situation will worsen as one-third of the German population will be 60 or above by 2050. [4]

• Inflation is increasing the cost of medical treatments, medicines, etc.
• Medical science progress: Innovations in the medical field offer patients better and more treatment options. This leads to increased medical spending.
• Longer life expectancy: Life expectancy in Germany is around 81 years [5]. Statistically, each year costs the health system about twice as much as the previous one.

To cover these healthcare costs, Germany needs more young earners to contribute to the public healthcare system. However, the population of young professionals is decreasing.

All these factors make people lose their trust in the German healthcare system. People fear that the German public healthcare system will no longer be able to offer high-quality service at an affordable price.

Moreover, experts predict that health insurance premiums will increase drastically in the future.

All this has led people to switch to private health insurance. On top of it, private health insurance is cheaper for high earners and offers better services.

Another argument favoring private health insurance is that it’s better prepared for the future with 344 billion euros as of 19 Feb 2025 in retirement provisions.

On the other hand, public health insurance companies cannot finance medical expenditures with monthly premiums alone.  The German government offers billions of euros in subsidies to keep the public healthcare system running.

We recommend getting private health insurance via an insurance broker. They are experts and can help you find the best plan for your needs. You can book a call with an expert we recommend here.

Why did the number of people insured in private health insurance decline between 2011 and 2022?

Despite the increase in the German population since 2012, the total number of people in private insurance declined between 2011 and 2022. This is because of the following factors.

• The increase in the German population is mainly due to increased immigration. Most immigrants are not eligible to get private health insurance, so they are compulsorily insured with public health insurance.
• Many immigrants eligible for private health insurance are sole earners in their families. This makes private health insurance expensive as they cannot insure their family members for free. 
• Private health insurance became unaffordable for some people. Hence, they returned to the public system. 

Understanding the move between the two health systems

There are two groups of people who have private health insurance.

• The first group is those who joined private health insurance when they started working. This group usually comprises young civil servants and the self-employed.
• The second group is those who moved from public to private health insurance during their careers. This group usually comprises employees whose income has increased and who can now enroll in private health insurance.

From 1991 to 2025, we have seen people move between the two health systems. However, the net number of people joining private health insurance remained positive for most years. This means more people moved to private health insurance than left it.

More people are moving into private health insurance for the following reasons.

• Decreasing trust in the public health system. As mentioned earlier, people fear that the public health system will be unable to offer good medical coverage at an affordable price.
• Private health insurance is cheaper for high earners.
• Better medical coverage in private health insurance.

Between 2011 and 2017, more people left private health insurance. This can be attributed to the following factors.

• Private health insurance became unaffordable for some people. Hence, they returned to the public system. These are usually the people who didn’t save for their retirement or took a private health insurance plan with high aging provisions.
• Small-level self-employed people switched to an employee relationship and thus to statutory health insurance.

Which health insurance is better: private or public?

The German healthcare system is complex. Which health insurance is right for you depends on your life situation and plans. 

In general, premium private health insurance plans provide better medical coverage than public health insurance. However, you cannot insure your non-working family members for free in private health insurance. 

Many insurance agents and brokers lure customers to buy private health insurance by selling them cheap tariffs. Run and never look back when you encounter such insurance agents or brokers. 

When taking private health insurance with an insurance broker, discussing and creating a long-term strategy is critical. You should never compromise on your medical coverage to save some euros.

Take our private health insurance benefits checklist with you to your consultation. Ask the insurance broker to fill it out and sign it. This acts as written proof of your consultation. 

Moreover, you must invest the money you save by moving to private health insurance to cover the premiums after retirement. You can start an ETF savings plan and invest a small sum every month.

You can open a free account with Scalable Capital* or Finanzen.net Zero* and start saving.

We recommend getting private health insurance via an insurance broker. They are experts and can help you find the best plan for your needs. You can book a call with an expert we recommend here.

References

• https://www.pkv.de/verband/presse/pressemitteilungen/private-krankenversicherung-auch-2024-mit-stabilem-wachstum/
• https://www-genesis.destatis.de/datenbank/online/statistic/12411/table/12411-0001