Understand the process of changing private health insurance plans in Germany. Learn the intricacies and your rights of switching tariffs with the same insurer. Whether seeking to optimize insurance coverage or find cheaper insurance options, our resource provides step-by-step instructions and key insights.

Key takeaways

• Everyone insured with private health insurance can change their insurance policy.
• Your insurance provider is legally obliged to offer tariff change advice free of charge.
• You can find cheaper insurance plans with similar services.
• You should change your health insurance plan with the same insurer. Changing the insurer is not recommended.
• You should ask your insurer to provide the tariff change advice in writing.
• Regarding the tariff change, you can get support from fee-based advisors, consumer advice centers, and your health insurer.

This is how you do it

• Identify the medical services important to you and the goal of switching the insurance plan.
• Ask your insurer what available health insurance tariffs are available for you. You can download the free sample letter to request tariff change here.
• Never forego essential services to reduce insurance costs. It’s expensive to get back services later.
• Compare health insurance schemes offered by your insurer regularly.
• The premiums of cheaper tariffs are not fixed in stone. It can rise in the future. Hence, don’t opt for a cheaper tariff by reducing health services or increasing your deductible. There are other ways to reduce your insurance costs.

Table of contents

Who can change private health insurance plans in Germany?

Everyone insured with private health insurance in Germany can switch to a different tariff their insurer offers. You have a legal right to choose from all the insurance plans your health insurance provider offers or has offered in the past.

The law is stipulated in Section 204 of the Insurance Contract Act (VVG). 

Here are a few things you must know about changing health insurance schemes.

• You can change your health insurance schemes as often as you like.
• You can’t change from a “unisex tariff” to a “bisex tariff.” A unisex tariff is one in which both men and women pay equal private health insurance contributions. On the other hand, in the bisex tariff, men and women pay different monthly premiums.
• You can switch from “bisex” to “unisex” tariff. However, unisex tariffs are usually more expensive than bisex. More on it later.
• You do not lose the retirement provisions if you change plans with the same insurer. However, you lose much of your old-age provisions if you change the private health insurance company.
• Increasing the deductible to reduce your health insurance premiums is not recommended. The reason is reducing the deductible requires a new health checkup. Hence, it may lead to higher premiums.
• The insurer may demand a complete health check-up if you switch to a private insurance policy offering better services than the current one.

NOTE: Changing the private health insurance providers is not recommended. You lose a large part of your retirement provisions if you switch insurers.

How do you change private health insurance tariffs?

Changing the private health insurance plan is a four-step process.

1. Identify the medical services important to you and why you want to change the tariff.
2. Request all the health insurance options available for you from the health insurer.
3. Consult your health insurance provider or insurance advisors to find the right insurance cover.
4. Finally, take out the new health insurance tariff you found best. 

NOTE: Switching to a cheaper tariff doesn’t guarantee a lower premium forever. Thus, you should never give up on services important to you to reduce insurance costs. You can download the list of essential services here.

Let’s dive deep into each step.

1. Identify vital medical treatments and services

You mustn’t let go of the health insurance services that are important to you to reduce insurance costs. Getting back medical services later is tough and expensive.

Thus, it’s critical to identify the private insurance services that are important to you. Moreover, you should be clear about the purpose of the tariff change. 

When contacting your health insurer for tariff change advice, you need to provide this information.

2. Request the available health insurance options

In this step, send a written request to your private health insurance provider for advice on changing your tariff. Private health insurance companies are legally obliged to offer the advice free of charge.

Moreover, the insurer must offer advice keeping your best interests in mind.

You should consider the following while contacting your health insurance company.

• Communicate your tariff change goal and wishes to the insurance company. As the communication with the German private health insurance companies is in German, we wrote a sample letter for you. You can use it as a template and modify it per your needs. You can download the letter here.
• Always ask the health insurer to provide all the insurance options in writing. Don’t settle and pick a new insurance plan after a call with an insurance agent.
• It’s vital to have the information in writing. You’ll need it if things go to court or the insurance ombudsman. 
• 24 private health insurance providers signed a binding guideline to offer better tariff change advice to their customers. Thus, these insurers must oblige to those guidelines. You can even use these guidelines against the insurer during the ombudsman procedure. More on it later.

3. Consult your health insurance provider or insurance advisors

You should consult your health insurance provider for any doubts or clarification. Your insurer can support you in understanding the tariffs better and find the one that’s best for you.

Suppose you feel that the insurance company is not suggesting suitable tariffs. You can also get support from

• specialized insurance brokers
•  insurance advisors
•  consumer advice centers

You also have the right to file a complaint with the PKV ombudsman. An ombudsman acts as a mediator in the event of a dispute.

You should also inform the Financial Supervisory Authority Bafin. Bafin reacts quickly if customer complaints against an insurer start piling up.

4. Finally, take out the private health insurance tariff you found best. 

Once you find the new tariff, request the insurer to make the change. Mention the deadline by when the tariff change should happen.

If the insurer delays the tariff change, you can ask for the change to be done retroactively. This way, you’ll get back the extra contributions you made.

NOTE: Everything should be in writing. Verbal commitments have no legal basis.

 

When does switching private health insurance plan make sense?

There are two main reasons for changing your private health insurance policy.

1. You want to reduce the private health insurance costs.
2. You are unsatisfied with the services of your health insurance plan and want to switch to a better tariff.

Over time, private health insurance costs increase for two reasons: inflation and increasing life expectancy. Moreover, low-interest rates make it difficult for health insurers to invest their customer’s contributions profitably.

Since 2004, private health insurance premiums increased by 2.8% annually. Thus, you should regularly check your insurer’s new policies to find the one with reduced costs but the same services. 

Things to pay attention to when changing a private health insurance scheme

The private health insurance policies offered before 2013 were differentiated based on gender. Such health insurance tariffs are referred to as bisex tariffs.

Usually, tariffs for women were more expensive than those for men. The reason was statistically, women live longer than men and use more health services over time.

But since 2013, private health insurers have stopped differentiating insurance policies based on gender. Thus, everyone pay the same premium for the same health insurance plan.

That said, here are a few things you should pay attention to when switching from an old policy to a new policy.

• The insurance premium for women wanting to switch from bisex to unisex doesn’t change much. Although the unisex plans usually cover more health services.
• The insurance contributions for men increase significantly when they move from bisex to unisex tariff. But of course, it also depends on the services you choose.
• Legally, private health insurers must offer their customers free advice on tariff change. Moreover, they must document the advice in writing and provide it to the insured person.
• Ensure your private health insurance company presents all the open and closed tariffs. 
• Pay attention to the term “Tarife nur eine Auswahl” in the response from your health insurer. It means the health insurance company presented only a selection of tariffs instead of all.
• Ensure that the insurance coverage in the new policy is sufficient.
• Private insurers are not offering bisex tariffs to new customers. Thus, the probability of bisex tariffs becoming more expensive than unisex is high. 
• The unisex tariffs often have the suffix “U” in their name. But most German insurance companies reused the bisex tariff names for new. Thus, it’s difficult to tell whether a tariff is unisex or bisex. You can request the insurer to provide this information. 
• You should compare the private health insurance plans regularly to save money.
• You should communicate to your insurer when the tariff change should occur. If the private health company delays the tariff change, you can ask for the change to be done retroactively. Thus, the insurer must reimburse your extra contributions during the delayed period.

Guidelines for private health insurance companies while offering tariff change advice 

As of 2024, 24 private health insurers signed the binding guideline to provide better tariff change advice to their customers.

The guidelines state the practices a health insurer must implement to offer a transparent tariff change process.

Free advice from the insurance company

Insured persons must receive free individual advice about tariff changes from their insurance company. The guiding principle for the advice is the needs and wishes of the insured person. 

The advice must be understandable to the insured person. Moreover, the insurance company must explain the difference between the current and target tariff. For example,

• additional services part of the new tariff,
• services that you’ll lose in the new policy,
• is there a risk surcharge and why,
• how can the insured person avoid risk surcharge,
• differences in the insurance contribution amount,

Also, the advice must be documented if the customer requests it.

Ensuring transparency about the tariff world

The insurance provider must share all the tariff options with their customers. It must be clearly stated if the insurer shares part of the available insurance options.

The insurer must group the health insurance tariffs into three major categories.

• Insurance plans that offer similar services to your current policy.
• Insurance plans that offer higher services than your current policy.
• Insurance plans that offer lower services than your current policy.

Handling complaints swiftly about tariff changes

The insurance company must send a written response to the complaint within 15 working days. If there is a delay in responding, the insurer must send an interim message about the same.

Automatic advice for customers aged 55 or over

The private health insurance provider informs customers who meet the following criteria about tariff change options. 

• Customers aged 55 or over
• and paying a higher insurance premium

The advice must offer alternatives that result in a premium reduction.

List of 24 private health insurers who signed the binding guidelines

Who can support you during the private health insurance tariff change?

You can get support from 

• Your private health insurance provider
• Insurance broker with whom you have taken out private health insurance
• Flat rate fee insurance advisor
• Performance-related fee insurance advisor
• Consumer advice center

Let’s check the pros and cons of all.

Your private health insurance provider

Pros

• Legally obliged to provide advice free of charge.
• Must document the advice.
• Must present all the tariff options available.
• Must mention the differences between the current and new tariff

Cons

Switching to a cheaper tariff that offers services similar to your current policy isn’t very attractive for your health insurer. Thus, trusting your health insurer to give neutral advice is not ideal.

Insurance broker with whom you have taken out private health insurance

Your insurance broker is still responsible for guiding you even after the conclusion of the private health insurance contract. It’s because the insurance brokers in Germany get ongoing compensation every year.

So, the benefit for you is free advice. But that’s also the issue. The broker earns nothing additional from the tariff change.

Thus, you cannot rely on insurance brokers for detailed, neutral advice. 

Flat fee-based insurance advisor

Pro

• The consultant is paid irrespective of whether they find a better and cheaper tariff for you. Thus, they are more open to offering neutral advice.
• Some advisors even offer free initial assessment on whether a tariff change makes sense for you.

Cons

• You must pay the fee even if you didn’t find a cheaper tariff.

NOTE: You should ask about the expected fee range right from the start. You should also avoid paying the entire fee upfront. You should split the consultation into steps and pay for each step separately. And if at any step you find that a tariff switch is not favorable, you can conclude the consultation.

Performance-related fee insurance advisor

Pro

• You only pay if the advisor helps you get a cheaper rate.
• The insurance advisor gets part of the premium you save in the first year as a consultancy fee. If the advisor can’t find a suitable tariff for you, the advice costs nothing.

Cons

• The advisor gets paid based on how cheap the new tariff is. Thus, the incentive to offer neutral advice is not there.
• In the worst-case scenario, the advisor can tempt you to switch to a significantly cheaper but disadvantageous tariff. Dubious insurance advisors work with this model to recommend the highest possible savings. Thus securing the highest possible fee for themselves.

Things to pay attention to while getting advice.

• Mention in your fee agreement that the new tariff must have at least equivalent services to your previous one in all areas.
• Never fall into the trap of cheaper tariffs, as the contributions can rise again. Moreover, your advisor cannot guarantee the projected savings.
• You don’t pay anything if you don’t change your insurance plan. But you pay the advisor if you later switch to one of the tariffs they recommended. This rule is usually valid for 24 months after the consultation. But it may be longer. You should not accept fee agreements that tie you to a consultant for longer than two years.

Consumer advice centers

Consumer advice centers are neutral entities that offer free advice or charge a small fee. However, they are not specialized health insurance advisors. 

FAQs

Can private health insurance companies demand a new health checkup?

Yes, your insurer can ask for a new health checkup for a tariff change. But it’s not a risk for you.

Legally, your private health insurance company can only charge a risk surcharge for better services in the new tariff. So, you can decide if paying the surcharge is worth it.

It’s only valid if you change the insurance plan with your current provider. If you change the health insurance provider, the new provider can charge as they wish.

What happens to the old-age provisions after the tariff switch?

Suppose you switch the insurance plans with your current health insurer. Then, your insurer will transfer your retirement provisions to the new tariff.

You’ll lose much of your old-age provisions if you change your health insurance company.

Why do similar health insurance policies cost different?

People of the same age insured under a particular tariff share the medical costs. Thus, an insurance plan will get expensive if more sick people are part of the tariff than healthy ones. 

Thus, depending on the health of insured people in the tariff, the price of tariffs with similar services can vary.

The private health insurance providers launch cheaper tariffs to attract new healthy customers. The insurer can offer and afford a cheaper insurance plan as they accept only healthy customers.

Hence, the existing customers can take advantage of it and switch to a cheaper tariff with similar services. 

NOTE: If the health insurer calculated the new tariff’s premium too tightly, the premium may rise sharply in the future. It leads healthy customers to leave the tariff. Hence making insurance plans even more expensive.

Although both healthy and sick customers have the right to switch tariffs. But it has been seen that healthy customers are more willing to change tariffs.

Is changing private health insurance providers worthwhile?

No, switching private health insurance companies is not worth it for the following reasons.

• You lose a large part of your old age provisions.
• New health insurers require a complete health check. Hence, the new insurer may add risk surcharges or exclude some benefits based on your age and state of health.

Canceling the plan with your current health insurance provider and moving to a new one make sense in the following situation.

• You are with the current private insurer for a couple of years only.
• You don’t have any health problems.
• You are not satisfied with the service of your current insurer. 

Read our guide to learn how to cancel a private health insurance contract in Germany.

Can I return to statutory health insurance?

Switching from private to public health insurance is difficult. But yes, there are ways to return to the statutory health insurance system.

Unfortunately, moving to public insurance for people 55 years of age or over is almost impossible.

You can learn more about it in our guide on switching from private to public health insurance in Germany.

References

• https://www.verbraucherzentrale.de/wissen/gesundheit-pflege/krankenversicherung/private-krankenversicherung-so-wechseln-sie-in-einen-guenstigeren-tarif-12352
• https://www.finanztip.de/pkv/pkv-tarif-wechsel/
• https://www.pkv.de/verband/tarifwechsel-leitlinien-pkv/
• https://www.destatis.de/DE/Themen/Arbeit/Arbeitsmarkt/Qualitaet-Arbeit/Dimension-2/krankenversicherungsschutz.html