📘 PKV Guide

Waiting Periods in PKV: When Your Cover Actually Starts

Some PKV benefits start immediately; others only after a waiting period. Here is how Wartezeiten work, where they apply, and how to have them waived.

What Is a Waiting Period?

A waiting period (Wartezeit) is the time between your private health insurance (private Krankenversicherung, PKV) policy starting and certain benefits becoming claimable. It exists so that people cannot take out cover only once they already need expensive treatment. Crucially, not all benefits have a waiting period, and where one applies it can often be waived.

Good news: acute illness and accident treatment are generally covered from day one. Waiting periods mainly affect planned, predictable benefits such as dentures, orthodontics, psychotherapy and childbirth.

General vs Special Waiting Periods

German PKV distinguishes two types:

Benefit areaTypical waiting period
Acute illness / accidentsNone — covered immediately
General benefits~3 months
Dentures, orthodontics~8 months
Psychotherapy, childbirth~8 months

How Waiting Periods Are Waived

The most common way to remove waiting periods is to undergo a medical examination (ärztliche Untersuchung) when you apply. If the insurer is satisfied about your health, it will usually waive both the general and special waiting periods, so your cover responds in full from the start. Many applicants do this precisely to access dental or maternity benefits sooner.

Waiting periods are also typically waived when you switch directly from statutory insurance (GKV) or another PKV policy without a gap, because you were already continuously insured. Continuity of cover is recognised, so you do not start the clock again.

Why It Matters for Planning

If you are planning a family or anticipating major dental work, the eight-month special waiting period matters. Take out cover — or arrange a waiver via medical exam — well in advance, because childbirth and dentures begun during the waiting period will not be reimbursed. Forward planning here directly affects what you can claim.

Key Takeaways

Understanding Wartezeiten lets you time your cover so that the benefits you need are available exactly when you need them.

Frequently Asked Questions

Are emergencies covered immediately in PKV?
Yes. Acute illness and accident treatment are generally covered from the first day. Waiting periods mainly apply to planned benefits such as dentures, orthodontics, psychotherapy and childbirth.
How long are PKV waiting periods?
The general waiting period is typically about three months, while special waiting periods for areas like dentures, orthodontics, psychotherapy and pregnancy are usually around eight months.
How can I avoid waiting periods?
Usually by undergoing a medical examination at application, which generally waives both general and special waiting periods. Switching directly from GKV or another insurer without a gap also typically avoids them.

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