The Idea Behind the Ageing Reserve
Private health insurance (private Krankenversicherung, PKV) in Germany is designed to be held for life, and the Alterungsrueckstellung — the ageing reserve — is what makes that sustainable. Because medical costs rise sharply with age, insurers deliberately charge younger policyholders more than their current costs require. The surplus is saved and invested for each individual, then drawn down later to keep premiums affordable in old age.
In essence: your younger self pre-funds your older self. Without the ageing reserve, premiums would climb steeply every year; with it, the age-driven part of the curve is largely flattened.
How It Is Built
Each month, part of your premium goes toward current claims and part into your ageing reserve. The reserve is invested at a regulated minimum interest rate (the Rechnungszins). Over decades this compounds into a substantial sum earmarked specifically for you. A statutory 10% surcharge (gesetzlicher Zuschlag) paid between ages 22 and 60 feeds an additional buffer used to reduce premiums from age 65.
Why Premiums Can Still Rise
The ageing reserve tackles the age component of cost, but not everything. Premiums can still increase due to:
- Medical inflation — treatments and drugs become more expensive over time
- Higher-than-expected claims in your tariff group, which trigger recalculations
- Lower investment returns, which mean the reserve grows more slowly than assumed and must be topped up from premiums
What Happens When You Switch?
This is the crucial part for anyone considering a change:
| Move | What happens to your reserve |
|---|---|
| Switch tariff within the same insurer (§204 VVG) | Full ageing reserve stays with you — no loss |
| Switch to a different insurer | Only a limited, portable portion (linked to the Basistarif) transfers; the rest is generally lost |
| Return to GKV | The reserve is generally forfeited |
This asymmetry is why advisers almost always recommend exploring an internal tariff change under §204 of the Insurance Contract Act (VVG) before moving to a new company. Internally, your entire reserve follows you to the cheaper tariff; externally, you may sacrifice years of accumulated savings.
Planning With the Reserve in Mind
Because the reserve rewards long, stable membership, two habits pay off: choose your insurer carefully at the outset (you are entering a decades-long relationship), and review your tariff internally rather than chasing a marginally cheaper competitor. If you want extra protection against later premiums, a dedicated Beitragsentlastungstarif lets you build additional provision during your working years.
Frequently Asked Questions
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