Private health insurance (PKV) in Germany

Employees may generally choose PKV when their regular annual income exceeds the applicable JAEG and the statutory conditions for leaving compulsory GKV are met; for 2026, the general JAEG is €77,400 per year (€6,450 per month). Self-employed people, civil servants and students follow separate rules. See the TK 2026 income threshold.

For employees, the general 2026 income threshold (Jahresarbeitsentgeltgrenze, JAEG) is €77,400 per year (€6,450 per month). The separate GKV contribution assessment ceiling is €69,750 per year (€5,812.50 per month); it limits the income used to calculate GKV contributions and does not determine PKV eligibility.

The JAEG and the contribution ceiling have different purposes. Eligibility and the timing of a change must be checked against your individual employment situation. Sources: TK: 2026 JAEG and TK: 2026 contribution ceiling.

There is no single answer. PKV can be attractive for some higher-earning employees, self-employed professionals and people who value broader or individually defined benefits. GKV can be particularly attractive for families because eligible spouses and children may be covered without an additional contribution.

The better choice depends on your income, age, health, family situation and long-term plans in Germany.

There is no fixed PKV price. Your premium depends on factors including your age when you join, health, chosen benefits, deductible and insurer.

That is why comparing only the cheapest monthly premium can be misleading. The benefits and long-term suitability of the plan matter too.

GKV contributions are mainly based on income up to the contribution assessment ceiling (Beitragsbemessungsgrenze). In PKV, premiums are calculated individually based on factors such as age at entry, health and the selected benefits.

This means two people earning the same salary can pay different PKV premiums.

For employees, the employer contribution is limited to eligible premium components and the applicable statutory maximum. It is not necessarily half of the combined amount shown in a quote.

Calculate the contribution from an itemised offer and the current limits; do not halve a total that may include ineligible components. See § 257 SGB V for private health insurance and § 61 SGB XI for private long-term care insurance.

Yes, if the child meets the statutory conditions. In a married or registered-partner GKV/PKV family, free cover is excluded when the privately insured parent’s regular total income exceeds one-twelfth of the applicable JAEG and is regularly higher than the GKV-insured parent’s income. See § 10 SGB V.

In PKV, each insured family member generally needs their own cover and premium. A spouse’s insurance status must also be assessed separately.

PKV insurers assess your health when you apply. Depending on your medical history and the insurer, a pre-existing condition can affect the terms offered to you and may result in a risk surcharge, exclusion or other underwriting decision.

Health questions should therefore be answered completely and accurately. Where appropriate, we can first explore how insurers may assess your situation before proceeding with a formal application.

The deductible (Selbstbehalt) is the amount of eligible healthcare costs you pay yourself according to your plan before or alongside reimbursement.

A higher deductible can reduce the monthly premium, but it also increases the amount you may have to pay yourself. The right balance depends on your health, finances and employment situation.

If you are employed, your employer normally continues paying your salary for a limited period when you are unable to work due to illness. After that, privately insured employees may need Krankentagegeld to protect their ongoing income.

The appropriate amount and start date depend on your employment and income situation, so Krankentagegeld should be considered together with your PKV plan.

PKV premiums can change over time, for example when healthcare costs or the underlying calculations change. Private insurers also build ageing reserves (Alterungsrückstellungen) to help finance higher healthcare costs later in life.

It is therefore misleading to assume either that your premium will stay unchanged forever or that it automatically increases simply because you have another birthday.

Sometimes, but not by personal choice alone: a statutory route such as compulsory GKV membership must apply. A qualifying change in employment or income may be relevant; insurance history and age also matter.

Additional restrictions can apply from age 55 under § 6 SGB V. Check your circumstances before changing or ending cover.

Private patients may experience differences in access to doctors and available services, but faster appointments should not be treated as guaranteed.

A better way to compare GKV and PKV is to look at the actual contractual benefits, such as outpatient treatment, hospital accommodation, dental benefits and reimbursement rules.

A permanent move to India does not automatically preserve German PKV cover under unchanged terms. Continuation depends on your tariff’s territorial scope, residence rules and contract; confirm the effect with your insurer before moving.

Check trips and longer stays separately. If you expect to return to Germany later, ask whether an Anwartschaft is appropriate before cancelling cover.

Do not compare PKV plans on price alone. Look at the benefits and conditions you may rely on for many years.

Important areas include outpatient treatment, hospital treatment, dental benefits, deductibles, reimbursement limits, Krankentagegeld, benefits abroad and how the plan fits your family and long-term plans.