Private health insurance

What is it?
‍Private health insurance (PKV - Private Krankenversicherung) is an alternative to Germany's public health insurance system that covers about 13% of the population. It operates as a complete substitute for public insurance, not a supplement. The German healthcare system requires everyone to have health insurance, and you can choose between two main options: public insurance (GKV - Gesetzliche Krankenversicherung) or private insurance (PKV).

There are many significant differences between Public and Private health insurance systems, which we will touch upon on this page but we go much more in depth in a dedicated blog post series here. For this guide, we'll focus specifically on how private health insurance works, who can get it, and what it covers.

How much does Private Health Insurance cost?

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Unlike public insurance, your income doesn't determine your premium. Instead, it depends on:

Your age when you join: Younger people pay less because insurance companies set aside money for your future healthcare needs. Join at 25, and you'll pay less when you're 65 than someone who joins at 45.
Coverage level: You can choose from basic to premium coverage. Compared to public health insurance, this allows you to have the choice to invest in your health insurance how you prefer to do it.
Deductible: Choose a higher deductible and your monthly premium drops significantly.
Your health status: When you apply, you'll answer detailed health questions or get a medical exam. Pre-existing conditions can lead to higher premiums, exclusions, or even rejection.

Did you know?
‍Over the past 20 years, private insurance premiums have increased by an average of 3.1% per year, while public insurance premiums rose 3.8% annually.

Money-Saving Features

No-claims bonuses are common in private insurance. If you only use preventive care (like annual checkups) and avoid filing claims for treatments, many insurers provide annual refunds. The amounts typically increase over time.

Some plans also include monthly chasback features - usually around €100 per month that isn't tied to claims usage.

What Private Insurance covers?
‍‍Private insurance offers more flexibility in coverage options. While public insurance covers "economic, sufficient, necessary and appropriate" healthcare (essentially standardized, cost-effective treatments), private insurance allows you to customize your plan with additional services and coverage levels.

Standard Coverage (All Plans)

Outpatient care: Doctor visits, specialist consultations
Inpatient care: Hospital stays and treatments
Prescription medications: Usually 100% coverage, including non-generic drugs
Emergency care: Including abroad within the EU

Customizable Options

Hospital accommodation: Choose between shared rooms, double rooms, or private single rooms
Physician choice: Treatment by senior doctors or department heads
Vision care: Glasses, contact lenses, laser surgery (€150-500 every 2-3 years)
Alternative medicine: Acupuncture, osteopathy, homeopathy
Psychotherapy: Often unlimited sessions with higher reimbursement rates
Dental care: 70-100% coverage for treatments, 75-90% for dentures

Who can get Private Health insurance?
Private health insurance isn't available to everyone. You must fit into one of these categories

High-Income Employees: If you're employed and earn more than €73,800 per year (before taxes), you can choose private insurance instead of public. This threshold is called the "Jahresarbeitsentgeltgrenze" and gets adjusted annually. Your employer still has to contribute up to half of your premium, just like with public insurance.
Self-Employed and Freelancers: If you work for yourself, you can generally opt for private insurance regardless of income. This can be also a more economical option for freelancers as you don't have an employer to cover half of the insurance costs (Unless you are a freelance artist, in which case you might consider KSK)
Civil Servants (Beamte): Civil servants get a special deal. The government covers 50% of their healthcare costs through "Beihilfe," and private insurance can cover the remaining 50%. This makes private insurance particularly attractive for this group.
Students: Students over 30 or those attending non-state-accredited universities must get private insurance, as they can't access public student rates. Student private insurance plans are typically much cheaper than regular adult plans.

Pros and Cons analysis

Advantages

Faster appointments: Get specialist appointments in days instead of months. Doctors often reserve time slots specifically for private patients
Better treatment access: Access to latest treatments and medications, treatment by senior physicians and department heads and private hospital rooms
Customizable coverage: Choose your deductible, add dental/vision coverage, alternative medicine, Psychotherapy and more. Pay only for what you actually want
Potential savings: Often 50%+ cheaper than public insurance for younger and healthier people since premiums aren't income-based
No-claims bonuses: Annual refunds (€300-1,200+) if you only use preventive care. Some plans offer monthly cashback regardless of usage
More provider choice: Access to private clinics and doctors who don't accept public insurance. No GP referral needed for specialists

Disadvantages

Upfront payments: You must pay medical bills yourself first, then submit for reimbursement.
Harder to switch back: Very difficult to return to public insurance after age 55. Switching between private insurers can also be expensive
Individual family costs: Unlike public insurance's free family coverage, each spouse and child needs their own plan with separate premiums
Health-based pricing: Pre-existing conditions (mental health, chronic illness, diabetes) can lead to rejection or significantly higher premiums

When Private makes sense?
For a more comprehensive on eligibility, you can read in this blog post

Private health insurance is typically ideal if you:

Are under 40 and in good health
Employed and earn a high income (above the €73,800 threshold)
Are self-employed or a civil servant
Students over 30
Value faster access to healthcare
Want control over your coverage
Rarely visit doctors and want to benefit from no-claims bonuses

Public insurance is usually better if you:

Have pre-existing health conditions
Are over 45 and switching for the first time
Students under 30
Have a large family (more than 2 children)
Want simple, card-based healthcare access

To learn more about Public health insurance, you can find more information here :)

The Bottom Line:
There's a lot to consider when choosing between public and private health insurance, and the right choice depends on your individual situation, health, income, and long-term plans. We're here to help you navigate these options and find the best solution for you!

Contact our health insurance expert!

Daniel Weiss

Email: daniel.weiss@versicherungsbuero-weiss.com
Telefon: +49 30 - 40 36 31 95 1
Mobil / WhatsApp : +49 178 - 140 584 0
Book a free consultation: https://calendly.com/vb-weiss_daniel/meeting

Private health insurance

Contact our health insurance expert!

Versicherungsbüro Weiss