Private Health Insurance in Germany

Key takeaways

• Private health insurance is cheaper for high earners and offers better coverage than public health insurance.
• Read our book on German healthcare to understand the German health system.
• Between 2014 and 2024, private insurance premiums increased on average by 3.2% annually during the savings phase and 2.3% after retirement.
• Switching from private to public health insurance is tough and virtually impossible after 55.

This is how you do it

• Consider the criteria in this guide to decide if private health insurance is the right choice. You can use our “Health Insurance Finder” tool to check which health insurance (Public or Private) makes sense and when.
• Consult a fee-based advisor or an insurance broker before choosing between private or public health insurance.
• In our comparison and test, we found Haellesche and Signal Iduna’s private health insurance plans to be the best.
• If you are looking for English customer service, check out the private health insurance plan from Feather*. Feather is an insurance agent and sells health insurance plans from Hallesche Versicherung.

Table of contents

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

Every resident in Germany is legally required to 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.

As of 2023, 90% of the German population is insured under public health insurance. If you look further, 95% of the employed and 59% of the self-employed people living in Germany are insured under public health insurance (Statutory health insurance). [1]

Why does only 10% of the German population have private health insurance?

To qualify for private health insurance, you must earn above 69,300€ gross per annum (as of 2024). This is called the income threshold, which will increase to 73,800€ in 2025.

Around 85% of the German population earn below the income threshold. Thus, they don’t qualify for private health insurance. This is the main reason why 90% of German residents are insured under public health insurance.

Who can take private health insurance in Germany?

Civil Servants

Civil servants can choose between private and public health insurance. However, private health insurance is more lucrative for civil servants as their employer covers 50% to 70% of the medical costs.

Thus, civil servants need supplementary private insurance instead of full private insurance. This makes private insurance very cheap for them.

On the other hand, the state doesn’t offer any aid if the civil servant is insured by public health insurance. Only a few federal states contribute 50% of the public insurance premium.

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 69,300 € as of 2023, and it’ll be 73,800 € in 2025.

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 at the start of your study. However, you cannot change it during your study period. 

You can change your health insurance again when you get full-time employment for the first time after graduation.

Suppose you had private health insurance during your studies and became self-employed immediately after graduating. In this case, 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 statutory health insurers. However, one must be aware of a few things before taking private health insurance.

• Unlike public health insurance, private health insurance premiums don’t depend on your income. So, even if your income decreases, the insurance premium will continue to rise. The private health insurance premium has increased on average by 3.2% per annum between 2014 and 2024.
• Switching from private to public health insurance is tough.
• Switching private health insurance providers is expensive.

You can use our “Health Insurance Finder” tool to check which health insurance (Public or Private) makes sense and when. We recommend getting advice from a fee-based advisor or health insurance broker before deciding.

Here are some criteria that can help you decide between private and public health insurance.

Both you and your partner are high-earners

If your partner and you earn a high income, private health insurance is a better choice. You get better services and pay less than public health insurance.

Are you under 40?

Private health insurance premium depends on your age and health at the time of taking the insurance. Thus, experts recommend getting private health insurance when you are young and healthy.

Retirement provisions

To keep the private health insurance premiums stable, part of your contributions 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 employees’ health insurance contributions. 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?

The state covers 50% to 70% of the medical bills of privately insured civil servants in Germany. Hence, civil servants need only supplementary health insurance to cover the rest.

This is why civil servants can save hundreds of euros every month with private health insurance.

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, public health insurance makes sense if you are the sole earner in the family.

Conclusion

• Private health insurance is not everyone. But it’s the only option if you seek the best medical coverage in Germany.
• Choosing private health insurance is a lifetime decision. This is because moving back from private to public health insurance is difficult.
• Good private insurance tariffs are not cheap. They can cost you anywhere from 500 € to 600 € per month. Additionally, you pay for each family member’s health insurance.
• The cost of private health insurance increases with time. The private insurance premiums increased 3.2% per annum during the savings phase and 2.3% after retirement between 2014 and 2024. So, a 35-year-old whose insurance premium starts at 650 € per month (as of 2024) will pay 1670 € per month by the time they are 65 (as of 2054). The premium will continue to increase and will be more than 2000 € per month by the time you are 85 (as of 2074). However, it’s the same with public health insurance. Moreover, you’ll pay more in the public system if you are a high earner (even after retirement). Read more about health insurance premium development here.
• 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 or cancel some of the services covered, 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.

You can learn more in our guide on services private health insurance offers that you don’t find in statutory health insurance.

Disadvantages of private health insurance

• Premium of private insurance doesn’t depend on your income. So, even if your income decreases or you become unemployed, you’ll continue to pay the same premium.  
• 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 an average of 2.8% per annum between 2004 and 2024 and 3.2% per annum between 2014 and 2024.
• Private insurance premiums don’t change if you are unemployed or have a low pension. Low income may mean you cannot afford 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. Hence, you must take out full private health insurance on your own. Thus leading to high private insurance 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.
• Stuck to a private insurance company for life. It’s not economically worthwhile to switch to another private insurer. This is because only part of the retirement provisions (approximately 70%) 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 during your consultation with an insurance broker. We recommend you make notes and have your broker sign the checklist after the consultation.

This way you can be sure that you have discussed all the important points and have understood everything correctly.

If you are unsure about private and public health insurance after your consultation with the insurance broker, you can consult a fee-based advisor.

Fee-based advisors don’t receive a commission if you take out private health insurance. You pay them instead. This ensures that you get an unbiased advice.

You pay between 150 and 200 euros per hour for a consultation with a fee-based insurance advisor. But this fee is worth it as you are making a lifelong decision.

You can find insurance advisors here. Ensure that the advisor specializes in private health insurance.

NOTE: You must not compromise on private health insurance coverage 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 at the time of taking the policy. The private insurance costs for people in different age groups and professions if they take it in 2024.

• 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 (after deducting the employer’s contribution)
• Self-employed: between 466 € and 683 € per month
• Civil servant (Beamter in German) with 50% subsidy: between 288 € and 400 € per month
• Civil servant (Beamter in German) with 70% subsidy: from 225 € per month
• Not working: from 350 € per month

NOTE: The cost of private health insurance doesn’t increase if you get sick after taking the insurance.

You can learn more about the costs in our guide on 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.

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. 

In short, you cannot cancel the old health insurance 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). 

You pay fee-based advisors on an hourly basis. Insurance brokers get a commission from the insurance company.

Both insurance brokers and fee-based advisors are liable for their advice. This means that if you asked for a particular coverage and the insurance policy recommended by the broker or the advisor didn’t cover it, they are liable to pay you the damages.

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

You should never get insurance advice from insurance agents. They represent an insurance company, and their goal is to sell as many insurance policies of that company as possible. Moreover, they are not liable for their advice.

You can book a free call with the insurance broker we recommend or find a fee-based insurance advisor here.

Advantages of consulting an insurance broker or fee-based advisor

• If you inquire about private health insurance yourself and get rejected, the insurer may enter you in the “information and advice system (Hinweis- und Informationssystem (HIS))” of the German insurance industry. This will make it difficult for you to get insurance from other providers.
• Insurance brokers or advisors can make an anonymous pre-inquiry on your behalf. This way, your personal details, such as name, address, etc., are hidden from the insurer. Thus, even if the insurer rejects your application, no entry can be made in the HIS.
• Finding good private health insurance is not easy. Insurance companies differ in their benefits and acceptance criteria. Depending on your state of health, one insurance company may reject you, but another may accept you under normal conditions. 
• An insurance broker or fee-based advisor can help you find the best private health insurance plan with good conditions.

Best private health insurance companies in Germany

In our comparison and test, we found Haellesche’s and Signal Iduna’s private health insurance plans among the best.

Private health insurance is a complicated product. So, we recommend consulting a fee-based advisor or an insurance broker for personalized advice.

Best private health insurance tariffs in Germany

Here are the private health insurance plans rated the best by Handelblatt, Focus Money, and Morgen and Morgen.

Basic protection	Standard protection	Top protection
Hallesche “NK.select S Bonus, NK.select Flex URZ”	Gothaer „MediCompactPlus“	Hallesche “NK.select XL Bonus, URZ”
AXA “EL Bonus-U, Komfort Zahn-U, KUR-U/100”	AXA “ActiveMe-U, Komfort Zahn-U, KUR-U/100”	Arag “MedBest”
HanseMerkur „KVS1,EKV2, KUT/100“	Hallesche “NK.select L Bonus, URZ”	DKV “BMK0, BMZ1, BMKD”
Debeka „NW“	R+V „Agil comfort U“	HanseMerkur “AZP, EGO, PS3, PSV”
		Continentale „Premium, SP1“

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 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. In 2023, the ombudsman was able to resolve only one out of every 5 cases. Thus, taking legal protection insurance is critical here.

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