What Is the Selbstbeteiligung?
The Selbstbeteiligung (deductible or excess) is the fixed annual amount you agree to pay toward your own medical costs before your private health insurer (private Krankenversicherung, PKV) starts reimbursing. In return for taking on that first slice of risk, your monthly premium (Beitrag) is reduced. It is one of the most effective levers you have for controlling the cost of private cover.
Deductibles in PKV typically range from €0 to €1,500 per year, with common steps at €300, €600 and €1,000. The exact options depend on your insurer and tariff.
The trade-off in one line: a higher Selbstbeteiligung lowers your guaranteed monthly premium but raises the maximum you might pay in a bad health year. The question is how much predictable cost you are willing to swap for variable risk.
How Much Does It Save?
As a rough guide, insurers reduce the premium by a portion of the additional deductible you accept. Choosing a €1,000 excess instead of €0 often cuts the annual premium by several hundred euros — though never by the full €1,000, because the insurer keeps a margin. The savings are most attractive for healthy people who rarely claim.
| Deductible | Typical premium effect | Best for |
|---|---|---|
| €0 | Highest premium | Frequent treatment, families wanting certainty |
| €300–600 | Moderate reduction | Most employees and professionals |
| €1,000–1,500 | Largest reduction | Healthy, higher earners comfortable self-insuring |
The Employer Subsidy Consideration
If you are an employee, your employer pays a subsidy (Arbeitgeberzuschuss) toward your premium, up to a legal maximum. Because the subsidy is tied to the premium, a very high deductible that pushes your premium well below the subsidy ceiling can mean you "leave money on the table". Self-employed people, who receive no employer subsidy, often benefit more clearly from a higher excess.
Does the Deductible Apply to Everything?
Not always. Many tariffs exclude preventive care (Vorsorgeuntersuchungen) from the deductible, so check-ups and screenings are reimbursed in full regardless of your excess. Outpatient and dental costs usually count toward the deductible; hospital (inpatient) treatment is sometimes treated separately. Always read how your specific tariff applies the Selbstbeteiligung across outpatient, inpatient and dental.
Choosing the Right Level
Ask yourself three questions:
- How often do you actually go to the doctor? If you rarely claim, a higher excess is usually money ahead over time.
- Could you comfortably absorb the full deductible in a bad year? Only take on an excess you could pay without stress.
- Are you employed or self-employed? Employees should weigh the Arbeitgeberzuschuss ceiling; the self-employed have more to gain from a higher excess.
One more point: changing your deductible later is a tariff change, which can sometimes trigger a new health assessment for richer benefits. Picking a sensible level at the outset avoids friction down the line.
Frequently Asked Questions
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