Learn about the key benefits and coverage options of private health insurance in Germany. Discover for whom private health insurance makes sense. Uncover the factors to consider when evaluating if private insurance is worth it for you.

Key takeaways

• Comprehensive private health insurance is expensive.
• Private insurance premiums increase as you grow older. It has grown 3% annually during the savings phase and 2.3% after retirement.
• Switching from private to public health insurance is tough.
• Changing your private health insurance plan or company is expensive.

This is how you do it

• Consider the criteria in this guide to decide if private health insurance is the right choice.
• Consult a fee-based advisor before choosing between private or public health insurance.
• You can compare private health insurance tariffs on the comparison portal Check24*.
• If you are looking for service in English, check out the private health insurance plan from Feather*. Feather offers services and consultation in German.

Table of contents

What is private health insurance (Private Krankenversicherung) in Germany?

Every resident in Germany must have health insurance.

The German health insurance system is divided into two groups: private health insurance and public health insurance.

As the name suggests, private companies offer private health insurance.

The German government regulates private insurers. However, they don’t have as much control as they do on public health insurance.

88% of the employed and 59% of the self-employed people living in Germany are insured under public health insurance (Statutory health insurance).

As the number suggests, most Germans prefer statutory health insurance over private. You’ll learn why in this guide.

Who can take private health insurance in Germany?

Civil Servants

Civil servants can choose between private and public health insurance. But, private insurance is more lucrative for civil servants.

It’s because the employer covers 50% to 70% of the medical costs. But the aid is only for the employees insured with private health insurance (PKV).

Self-employed

Full-time self-employed people can also choose between private and public health insurance. Unlike employees, how much you earn doesn’t matter.

Only the freelancers pursuing artistic or journalistic work are the exception. They are subject to compulsory statutory health insurance under the Artists’ Social Insurance Fund (Künstlersozialkasse (KSK) in German).

Check out our guide on private health insurance for self-employed to learn more.

Employee

Employees earning below the annual limit are insured under compulsory public health insurance. The annual limit is 66,600 € as of 2023, and it’ll be 69,300 € in 2024.

Employees earning above the annual limit can choose between private or public health insurance. The annual salary limit is called Beitragsbemessungsgrenze in German. The German government sets the annual limit, which is revised every year.

The annual limit includes

• your gross salary,
• vacation bonus (Urlaubsgeld),
• and Christmas bonus (Weihnachtsgeld).

The annual limit doesn’t include special payments such as profit distributions.

Students

Students must decide on their health insurance at the start of their university studies.

You can choose private health insurance or public health insurance. But, if you choose private insurance, you cannot change it during the study period. 

You can switch from private to public health insurance in the following situation. It’s when you get full-time employment for the first time after graduation.

If you become self-employed immediately after graduating, you must remain privately insured, regardless of how much you earn. 

Private health insurance is worth it for students whose parents are civil servants. This is because children of civil servants who have private health insurance receive up to 80% of medical aid. 

But you receive civil servant aid till you are 25 or till your parents get child support.

For whom private health insurance makes sense?

Private health insurers offer more comprehensive medical services than state insurers. However, it comes at a price that is not affordable for everyone. 

Moreover, the private health insurance premium increases as you age, regardless of your income.

Lastly, switching from private to public health insurance is almost impossible.

Thus, you must carefully decide which health insurance best fits your long-term needs. Here are a few criteria you must consider before you opt for private health insurance.

Do you plan to settle in Germany?

Are you planning to stay in Germany permanently? If yes, a statutory health insurance scheme is the right choice.

You can compare and pick a statutory health insurance provider on Feather*. 

However, private insurance might be better if you are in Germany for only a few years.

Are you under 40?

As private health insurance gets expensive with time, part of the contributions at a young age go into so-called retirement provisions. The retirement provisions ensure that the insurance premium doesn’t get too high in old age. 

However, you must contribute to the retirement provision long enough for it to make a difference. Thus, enrolling in private insurance when you are young is critical. 

You should only consider private health insurance in old age if you can afford a high monthly premium after retirement.

Are you self-employed with a high income?

Employers pay 50% of the health insurance contribution for employees. However, the self-employed must pay the whole contribution themselves. 

Thus, self-employed people end up paying approximately 50% more in insurance premiums than employees with the same income. Hence, self-employed people with a private health insurance policy can save a couple hundred euros monthly.

But again, consider other factors, such as your family status, health condition, and age, before choosing private health insurance.

Do you have health problems?

Private insurers have the right to choose their customers. Hence, they either reject the applicants with prior health problems or charge a high premium.

It’ll be difficult to get a cheap private health insurance if you have one or more of the following illnesses:

• High blood pressure,
• Cardiovascular problems,
• Diabetes,
• Asthma,
• allergies,
• back problems,
• spinal diseases,
• physical or mental disabilities.

Are you a civil servant?

Employers cover 50% of the medical bills of civil servants in Germany. Hence, private insurance might be a good idea if you are one.

Are you planning to have a family in the future?

Private health insurance doesn’t cover your family, i.e., spouse and children, for free. You have to take their health insurance separately. 

On the other hand, public health insurance covers your family for free.

Moreover, you must continue to pay the private health insurance premium during parental leave. In the public system, however,

• your partner’s insurance will cover you during the parental leave,
• or the insurance premium will decrease during the parental leave.

Thus, private health insurance makes sense if you don’t plan on marrying or having children in the future.

Conclusion

• Private health insurance is not everyone. But it’s a good option for young single high-earners who are temporarily living in Germany. Otherwise, opt for statutory health insurance.
• Choosing private health insurance is a lifetime decision. This is because moving back from private to public health insurance is difficult. You can learn more about it in our guide on switching from private to public health insurance.
• Good private insurance tariffs are not cheap. They can cost you anywhere from 500 € to 600 € per month. Additionally, the cost of each family member’s health insurance. You can compare private health insurance plans on the comparison portal Check24*.
• The cost of private health insurance increases with your age. In the past, private insurance premiums increased 3% per annum during the savings phase and 2.3% after retirement. So, a 35-year-old whose insurance premium starts at 500 € per month will pay 1290 € per month by the time they are 67. The premium will continue to increase and will be around 1949 € per month by the time you are 85.
• Reduce private health insurance costs. If you can no longer afford your private health insurance premiums, you can switch to a cheaper tariff offered by your insurer. Read our guide on how to reduce private health insurance costs to learn more.

Advantages of private health insurance

• Civil servants aid. The state covers at least half of the healthcare costs for civil servants with private health insurance, even after retirement. You need private health insurance to cover the remaining costs. It is also called residual cost insurance. 
• Top medicine and treatment: Good private insurance tariffs cover the cost of top medicine and treatment by a specialist in a private clinic or abroad. 
• Early appointment: Privately insured patients receive appointments earlier than state-insured patients. This is because doctors often receive more money for the same treatment from a private patient than from a statutory health insurance patient.
• Fixed medical coverage: You agree on the services your private health insurance policy will provide initially. Health insurance companies cannot change the services agreed upon later. However, public health insurers can reduce the coverage, as seen in the past with dental care. 
• Better dental coverage: Private insurance tariffs usually offer better dental care than public insurance. However, you can get supplementary dental insurance on top of public insurance to cover the gap.

Disadvantages of private health insurance

• Premium of private insurance depends on age and health. Yes, private insurance is cheaper when you are young and healthy. But the private premium increases as you get older. 
• Private health insurers reject unhealthy applicants. Private insurers perform a health check before accepting a new customer.
• It’s difficult to change the private health insurance plan. Suppose you want to change the services offered by your private insurance plan. You may have to go through a complete health check again.  If the health check shows any existing diseases, you’ll end up paying a high premium.
• Premiums in the private healthcare system increased by 2.8% per annum on average between 2013 and 2023.
• Private insurance premiums don’t change if you are unemployed or have a low pension. Low income may mean you cannot afford high private insurance contributions. It may force you to switch to the basic plan that offers fewer services.
• Divorce from a civil servant spouse may prove expensive. The state stops providing subsidies to the divorced spouse of a civil servant. It leads to high private premiums.
• Private healthcare insurance doesn’t cover your family for free. You must take private health insurance for every individual. It doesn’t matter if they earn or not. However, the statutory health insurance system covers non-earning family members for free.
• Private insurance is not significantly better than public insurance. Yes, high-performance private insurance offers access to the latest medicine. However, there are many services that private insurers do not cover but are part of public insurance. Moreover, you can take supplementary health insurance on top of public insurance. Check our guide on private vs public health insurance to learn more.
• Stuck to a private insurance company for life. It’s not economically worthwhile to switch to another private insurer. It’s because only part of the saved retirement provisions can be taken to the new insurer. Moreover, the insurance premium will be higher at the new insurer. The reason is your age. You’ll be older than when you took the insurance from the previous insurer. 
• Patients with private health insurance pay the medical bills themselves. Later, the private insurer reimburses the costs. However, you don’t pay the bills for inpatient treatments. Hospitals bill them via a health insurance card, similar to statutory health insurance.

Services good private health insurance must cover

We have created a checklist that you can use while finding private insurance. You can also use this checklist when you contact an insurance broker for advice.

As taking private health insurance is a lifelong decision, you must not compromise on services to reduce the insurance cost.

You can read our guide on private health insurance services in Germany to learn more.

Cost of private health insurance in Germany

The cost of private health insurance depends on your age and health. The private insurance costs for people in different age groups and professions.

• Children insured by their parents: between 90 € to 120 € per month
• Young employee: from 160 € per month
• 30-year-old employee: between 301 € and 355 € per month 
• Self-employed: between 466 € and 683 € for their tariffs
• Civil servant (Beamter in German) with 50% subsidy: between 288 € and 400 €
• Civil servant (Beamter in German) with 70% subsidy: from 225 €
• Not working: from 350 € per month

You can learn more about the costs in our guide on private health insurance costs in Germany.

Can you cancel private health insurance anytime?

Yes, you can cancel your private health insurance policy by sending a written cancellation request to your insurance provider within the notice period.

The notice period for most health insurers is three months before the end of the “insurance year.”

You can use our sample private health insurance cancellation letter to cancel your policy. You can download it here for free.

NOTE: German law requires everyone in Germany to have a health insurance policy. Thus, to cancel your health insurance policy, you must prove the following to your current insurer. You have a new German health insurance policy. You’ll remain insured without interruption.  You cannot cancel the old policy without proof of a valid new policy.

In special situations like an increase in insurance premium, you can cancel the contract within two months after receiving the letter. Moreover, you can cancel the contract immediately if you leave Germany permanently.

Private health insurance companies can also terminate your contract if you breach the contract terms or provide misleading information when applying.

Where can you get advice on the German health insurance system?

As you know, purchasing private health insurance is a lifetime decision. So, before making a decision, you should consult with a fee-based advisor (Versicherungsberater in German) or a health insurance broker (Versicherungsmarkler in German). 

We recommend consulting with fee-based advisors rather than health insurance brokers. It’s because of how they get paid.

Fee-based advisors get paid by you on an hourly basis. Insurance brokers get a commission from the insurance company.

The commission is paid after a successful contract conclusion. Thus, a broker might not give you unbiased advice.

The consultation fee of a fee-based insurance advisor is between 150 and 200 € per hour. 

Use what you learned in this guide during the consultation. Reserve at least 6 hours for the consultation. It should be enough to clarify doubts and explore different health insurance options.

Best private health insurance companies in Germany

As you are stuck with a private health insurance company for life, choose one carefully. The most important thing to consider is the financial stability of the insurer. 

Top five private health insurance companies based on financial health as per Finanztip.

• LVM
• Universa
• Signal Iduna
• Alte Oldenburger
• R+V

You can compare private health insurance plans on the comparison portal Check24*. You can also compare private health insurance plans offered by Feather*.

Filing a complaint against your private health insurer

The top two complaints against private insurers by patients are

• Was the treatment medically necessary?
• The medical bills are too high.

Your first point of contact when filing a complaint is the private insurance ombudsman. The ombudsman acts as an arbitration board for disputes with private health insurance. 

Unfortunately, many disputes related to private health insurance end up in court. The ombudsman is able to resolve only one out of every 5 cases. Thus, taking legal protection insurance is critical.

References

• https://www.finanztip.de/pkv/
• https://www.pkv.de/wissen/private-krankenversicherung/leistungen-und-erstattung/
• https://www.test.de/Private-Krankenversicherung-Alles-was-Sie-wissen-muessen-5353750-0/
• https://www.pkv.de/wissen/private-krankenversicherung/
• https://www.bundesgesundheitsministerium.de/private-krankenversicherung