No Free Family Insurance in PKV
The single most important fact for couples considering private health insurance (private Krankenversicherung, PKV) is that, unlike statutory insurance (GKV), there is no free family insurance (Familienversicherung). In GKV, a non-earning spouse and children can be covered at no extra cost under one member's contributions. In PKV, every person is insured individually and carries their own premium based on age and health.
The consequence: for a couple where both work and earn well, two individual PKV policies can offer excellent cover and good value. For a couple with one earner and a non-working spouse, the maths needs careful thought.
Two Earners: Often Straightforward
Where both spouses are employed above the salary threshold, or self-employed, each can choose PKV on their own merits. Two healthy professionals often secure comprehensive cover at attractive premiums, each benefiting from the employer subsidy (if employed) and from premiums based on age and health rather than income. There is no penalty for being a couple — you simply hold two policies.
One Earner, One Non-Working Spouse
This is the classic decision point. In GKV, the non-working spouse could be covered free. In PKV, they need their own policy with its own premium. Considerations include:
- The non-working spouse's age and health, which set their individual premium
- Whether the earning spouse could/should be in GKV to enable free family insurance for the partner and children
- Future plans — returning to work, having children, or income changes
| Situation | Often favours |
|---|---|
| Both earning well | Two individual PKV policies |
| One earner, non-working spouse, no kids | Depends on spouse premium vs convenience |
| One earner, non-working spouse, several kids | GKV family insurance often cheaper overall |
Children Tip the Balance
Because each child in PKV also carries a separate premium, families with several children and one earner frequently find GKV's free family insurance more economical overall. A couple with two strong incomes and no plans for children, by contrast, often finds two PKV policies excellent value. The right answer is genuinely situation-specific.
How Couples Should Decide
- Price both routes — get PKV quotes for each spouse and compare with GKV family insurance
- Factor in children, current and planned
- Consider the long term — switching back from PKV to GKV is hard, especially after 55
- Take advice — a couple's optimal structure depends on income, health, age and family plans
There is no one-size-fits-all answer for couples, but understanding that PKV insures each person individually is the foundation for making the right choice together.
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