Is Your Existing Private Health Insurance Still Suitable? 3 Checks

A low premium does not automatically mean that an existing private health insurance contract is unsuitable. Price is only one part of the review. The contractual benefits, deductible, Krankentagegeld, family situation and long-term fit matter as well.

Eligible employees can receive an employer contribution toward qualifying private health insurance under §257 SGB V. The contribution is limited by statutory rules and by the amount actually paid for qualifying cover, so annual maximum amounts can change. Paying a lower premium does not by itself prove that money is being wasted or that cover is inadequate. The following three checks are more useful when reviewing an existing contract.

1. Sick pay

Check whether the agreed Krankentagegeld still matches the income that would be lost during a longer period of incapacity for work. The appropriate amount depends on earnings, continued salary entitlement, the benefit start date, ongoing insurance premiums and other regular obligations.

Avoid applying one universal daily amount. Review the insured amount using your actual figures and the policy conditions, including any limits on increasing Krankentagegeld later.

2. Deductible and long-term suitability

Review the deductible, premium development and how the contract may fit changing employment, family and retirement circumstances. An optional premium-relief component can be relevant for some people, but its cost, employer contribution, tax treatment and portability need individual review. It is not automatically the right solution for every contract.

3. Benefits and existing tariff options

Compare the benefits actually promised by the contract with the benefits you need. Premium refunds are conditional and should not replace a review of core cover. Under §204 VVG, policyholders can request a switch to another tariff with comparable cover within the same insurer while retaining acquired rights and ageing reserves. If the new tariff adds benefits, the insurer may apply conditions to those additional benefits. A tariff change, a contract adjustment, staying with the current tariff or changing insurer should be assessed separately rather than assuming one outcome is always preferable.

For the broader decision framework, see our Private Health Insurance Guide for Expats.