Why Leaving Germany Is a Critical Moment for PKV
PKV is a private contract between you and your insurer. Unlike GKV, which is linked to your employment and residency in Germany, PKV continues regardless of where you live — unless you actively cancel it. When you leave Germany, you must decide what to do with your policy. The wrong decision can be very costly, particularly if you return to Germany later in life and find that rejoining PKV at an older age means substantially higher premiums.
Key principle: The older you are when you first take out PKV, the higher your starting premium. Every year you spend outside PKV — and then re-enter later — costs you. Protecting your entry age through an Anwartschaft (suspension) is often the smartest financial move.
Your Three Main Options
An Anwartschaft (expectancy/suspension policy) lets you pause your full PKV coverage while preserving your right to resume it at your current age-based premium when you return. You pay a small monthly holding fee — typically €20–€60/month — instead of your full premium. No claims can be made during the suspension period.
When it makes sense: If you expect to return to Germany within 2–5 years, or are uncertain about how long you'll be away. The Anwartschaft preserves your original entry age and all associated premium advantages.
- Retains your original entry age for premium calculation
- Preserves any age-related provisions (Alterungsrückstellungen)
- Low monthly cost (€20–€60)
- No coverage during suspension — you need local coverage in your destination country
You can continue your German PKV while living abroad. This makes sense if you need treatment in Germany regularly (e.g. visiting family), if your tariff includes worldwide coverage, or if you plan to return to Germany within 1–2 years. Full premiums continue to be paid, and you retain full coverage for treatment within Germany and potentially abroad depending on your tariff.
When it makes sense: Short absences (under 2 years), frequent return visits to Germany, or when you want uninterrupted German healthcare access.
- Full coverage maintained in Germany
- Full premiums still apply
- Check whether your tariff covers treatment in your destination country
- Some insurers require notification of extended stays abroad
Cancelling your PKV entirely severs the relationship with your insurer. All accumulated Alterungsrückstellungen (age-related provisions) built up in your tariff are lost — you cannot take these with you or reclaim them later. If you ever return to Germany, you will need to apply for PKV afresh at your current (older) age, with a new health declaration and higher premium.
When it makes sense: Only if you are certain you will never return to Germany, or if the cost of an Anwartschaft over many years outweighs the premium advantage of preserving your entry age (typically relevant for very long absences of 10+ years).
- Stops all premium payments immediately
- All accumulated provisions are forfeited
- Re-entry to PKV later is at current age with new health declaration
- Minimum notice period: 2 months to end of quarter (check your contract)
Comparison Table
| Option | Monthly Cost | Coverage While Away | Return to PKV | Best For |
|---|---|---|---|---|
| Anwartschaft | €20–€60 | None | At original entry age | Return within 2–7 years |
| Keep running | Full premium | Germany + tariff-dependent abroad | Continuous | Short absences <2 years |
| Cancel | €0 | None | At current age (higher premium) | Permanent relocation only |
Special Rules: Moving Within the EU
If you are relocating to another EU/EEA country, you may be required to enrol in that country's statutory health system. In some countries (e.g. France, Spain), local health insurance is mandatory for residents. Your German PKV does not automatically satisfy this obligation. You may need to hold both your German PKV (in Anwartschaft form) and local coverage in your new country.
EU freedom of movement provisions do not exempt you from a new country's health coverage requirements. Always check the rules of your destination country before departing.
Planning Your Return to Germany
If you return to Germany after an Anwartschaft, contact your insurer in advance to confirm the reactivation terms. Most insurers require at least 4–6 weeks' notice and will need updated contact and employment details. Your coverage will resume at your original entry-age premium level, adjusted only for any general premium increases that occurred during your absence.
If you return after having cancelled your policy, you will need to start the PKV application process fresh — including a new health declaration. Any conditions that developed during your time abroad will now be disclosed and may result in surcharges or exclusions that would not have applied had you maintained your original policy.
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