📘 PKV Guide

Pflegepflichtversicherung: The Mandatory Care Insurance Beside Your PKV

Private health insurance never comes alone: compulsory long-term care insurance (PPV) is bundled with every PKV policy. What it covers, what it costs — and why children are free.

The Insurance You Get Whether You Ask or Not

When you take out private health insurance in Germany, a second policy arrives with it automatically: private compulsory long-term care insurance (private Pflegepflichtversicherung, PPV). Care insurance has been mandatory for everyone in Germany since 1995 — GKV members pay it through the social care system, and PKV members must insure the same risk privately, always with the same insurer as their health cover.

Good to know: PPV benefits are identical to those of the statutory care system by law. Unlike PKV health premiums, PPV premiums are capped at the maximum contribution of the social care insurance — and children are covered without any premium at all.

What Long-Term Care Insurance Covers

PPV pays benefits when you need help with daily living due to illness, disability or age. Benefits depend on your assessed care grade (Pflegegrad 1–5) and include:

Assessments for privately insured members are carried out by Medicproof rather than the statutory medical service, but the criteria and care grades are the same.

What It Costs

PPV premiums are risk-rated by entry age but with important social caps:

FeatureRule
Premium ceilingCapped at the maximum social care contribution
ChildrenCovered premium-free
Civil servants (Beihilfe)Pay a reduced share (beihilfekonforme PPV)
Employer subsidyEmployees receive a contribution, as with health premiums
Health questionsAcceptance is compulsory for the insurer — no rejection

The Coverage Gap Nobody Should Ignore

Whether statutory or private, compulsory care insurance is deliberately only partial cover. Residential care routinely costs far more than the insurance pays; the difference comes from your pension, savings — or your children. That is why many advisers recommend supplementary care insurance (Pflegezusatzversicherung), such as a Pflegetagegeld policy paying a fixed daily amount per care grade. Taken out young and healthy, it is inexpensive; taken out late, it is costly or unavailable.

The Bottom Line

PPV is the quiet companion of every PKV policy: identical benefits to the statutory system, capped premiums, free cover for children and guaranteed acceptance. Budget for it alongside your health premium — and think early about whether a supplementary care policy should close the substantial gap that compulsory care insurance leaves open by design.

Frequently Asked Questions

Is long-term care insurance mandatory with PKV in Germany?
Yes. Everyone in Germany must hold care insurance. PKV members take out private Pflegepflichtversicherung (PPV) with the same insurer as their health policy, with benefits identical by law to the statutory care system.
How much does private compulsory care insurance cost?
Premiums depend on entry age but are capped at the maximum contribution of the statutory care system. Children are covered premium-free, employees receive an employer contribution, and Beihilfe-entitled civil servants pay a reduced share.
Does compulsory care insurance cover the full cost of a care home?
No — by design it covers only part of care costs. The gap between real residential care costs and insurance benefits must be met privately, which is why supplementary care policies (Pflegezusatzversicherung) are worth considering while young and healthy.

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