The Assumption That Trips People Up
Anyone moving from statutory to private cover carries an assumption from the old system: that a spouse and children come along on the main earner’s insurance. In GKV they do — Familienversicherung covers a non-earning spouse and children at no extra contribution. Private insurance has no equivalent. Every person is insured on their own policy with their own premium. Discovering this after the fact, rather than planning for it, is one of the most common PKV surprises.
The rule in one line: PKV insures individuals, not households. There is no free ride for family members — each spouse and each child needs their own contract, priced on their own age and health.
Why It Works This Way
The two systems are built on different principles. GKV is a solidarity system funded by income-based contributions, so it can extend cover to dependants without extra charge. PKV is a risk-based, individually funded system where each policy carries its own reserves for that person’s lifetime. Family insurance simply doesn’t fit that model — there is no shared pot to draw a spouse and children into for free. It is a feature of the design, not an oversight.
What It Means for the Family Maths
- Count every person: budget a premium for each family member, not one household figure
- Children are relatively cheap, but not free: child tariffs are modest, yet several add up
- One-income families feel it most: where GKV would cover a non-earning spouse and children free, PKV charges for each — often the single biggest factor tilting such families back toward GKV
- Mixed households need planning: if one partner is GKV and the other PKV, where the children can be insured depends on the parents’ income and status
Making It Work
None of this makes PKV wrong for families — a dual-income couple, or a household that values private benefits and can carry the premiums, may still choose it happily. The point is to go in with eyes open: model the total family premium across everyone, factor in that children’s cover is per-child, and compare that honestly against what capped GKV contributions plus free family insurance would cost. The decision is sound when the full-family maths is done up front.
The Bottom Line
Private insurance has no family insurance because it insures individuals, not households — so a spouse and every child need their own policy and premium. That is the design, not a gap. For families the practical task is simply to price the whole household honestly and compare it against GKV’s free family cover, so no one is caught out by a cost they assumed away.
Frequently Asked Questions
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