German Private Health Insurance FAQ

Q1: What is the private health insurance minimum salary threshold in Germany?

To qualify for private health insurance (PKV) in Germany, employees must earn above the statutory salary threshold. For 2026, this amount is €77,400. This eligibility criterion applies to employees but not to self-employed individuals or freelancers, who can directly choose PKV. The threshold is updated annually by the German government.

For more details, please visit our page on private health insurance minimum salary threshold in Germany.

Q2: What is private health insurance (PKV) in Germany?

Private health insurance (PKV) in Germany provides a premium alternative to public health insurance (GKV). PKV offers benefits such as private doctor access, shorter waiting times, and private hospital rooms. It is ideal for expatriates, freelancers, and high-income earners who prefer personalized healthcare services.

Learn more about PKV in Germany by visiting our What is PKV in Germany? page.

Q3: What are the benefits of private health insurance in Germany?

Private health insurance (PKV) in Germany offers a wide range of benefits, including faster access to medical specialists, private hospital rooms, comprehensive dental care, and extensive coverage for outpatient treatments. PKV plans are customizable to meet your individual healthcare needs, whether you require more specialized treatments or additional international coverage.

For more information on the benefits, visit our page on benefits of private health insurance in Germany.

Q4: What is the difference between public and private health insurance in Germany?

Public health insurance (GKV) in Germany is income-based and provides universal coverage for employees and their dependents, with contributions shared between the employee and employer. Private health insurance (PKV), on the other hand, offers more personalized coverage options, including private rooms, faster access to specialists, and a broader range of treatments. PKV premiums are based on age, health, and desired benefits, allowing more flexibility and customization.

To learn more about the difference, visit our page on difference between public and private health insurance in Germany.

Q5: Can expats switch from public to private health insurance in Germany?

Expats in Germany can switch from public health insurance (GKV) to private health insurance (PKV) if they meet the required income threshold of €69,300 per year (as of 2024) or if they are self-employed. However, once you switch to PKV, it can be difficult to return to public health insurance unless you meet certain conditions, such as a significant drop in income.

Learn more about switching from public to private insurance by visiting switching from public to private insurance in Germany.

Q6: What is the cost of private health insurance for freelancers in Germany?

The cost of private health insurance for freelancers in Germany varies based on factors such as age, health, and coverage level. Freelancers can expect to pay anywhere from €300 to €800 per month. PKV offers flexibility in choosing coverage that suits the freelancer’s specific healthcare needs, providing both affordable and premium options.

For more information, visit our page on cost of private health insurance for freelancers in Germany.

Q7: Is private health insurance better for families in Germany?

Private health insurance (PKV) can be more beneficial for families who require specialized treatments or want personalized healthcare services. However, each family member must have their own policy, which can increase costs. Public health insurance (GKV) may be more cost-effective for families since it covers dependents at no additional charge.

Find out more about family health insurance on our page private health insurance for families in Germany.

Q8: How can expats find the best private health insurance in Germany?

Expats in Germany can find the best private health insurance by researching providers such as Allianz, Mawista, and HanseMerkur. Key factors to consider include the premiums, coverage options, and the availability of English-speaking customer service. Consulting with an insurance broker can help expatriates choose the best PKV plan based on their healthcare needs.

For a comprehensive guide, visit finding the best private health insurance for expats in Germany.

Q9: What happens if I move abroad with private health insurance?

If you move abroad, many private health insurance providers in Germany offer international coverage for medical emergencies. However, for long-term stays, you may need to adjust your policy. It’s important to consult your insurer to ensure you have adequate coverage while living overseas.

For more information on international coverage, visit moving abroad with private health insurance.

Q10: What are the tax benefits of private health insurance in Germany?

Private health insurance premiums in Germany are partially tax-deductible. The portion of your premiums that cover essential healthcare services can be deducted from your taxable income. This can be especially beneficial for high-income earners, as it helps reduce your overall tax burden.

For more on the tax benefits of PKV, visit tax benefits of private health insurance in Germany.

Q11: What happens if I lose my job and have private health insurance?

If you lose your job, you may need to switch to public health insurance (GKV) if you become unemployed. However, if you become self-employed or start freelancing, you can continue with your private health insurance (PKV). It's essential to discuss your options with your insurer during this time of transition.

Learn more about what to do if you lose your job on our page what happens if I lose my job and have private health insurance.

Q12: Can I switch back to public health insurance from private?

Switching back to public health insurance (GKV) from private health insurance (PKV) in Germany is not easy. Generally, this is only allowed if your income drops below the threshold or in cases of unemployment. It's important to evaluate your long-term healthcare needs before making the switch back to public insurance.

Find out more about switching back to public insurance on our page switching back to public health insurance in Germany.

Q13: Are there private health insurance options for students in Germany?

Yes, there are private health insurance options specifically designed for students in Germany. Providers like Mawista offer affordable PKV plans that cover medical, dental, and emergency healthcare needs for students, particularly those over 30 or pursuing a second degree.

Learn more about private health insurance for students in Germany on our page private health insurance options for students in Germany.

Q14: What is the waiting period for private health insurance in Germany?

The waiting period for private health insurance in Germany generally ranges from a few weeks to several months, depending on the insurer and the policy. During this waiting period, coverage for specific treatments or pre-existing conditions may be limited, but emergency medical services are typically covered immediately.

Find out more about waiting periods on our page waiting period for private health insurance in Germany.

Q15: Is private health insurance mandatory for freelancers in Germany?

No. Freelancers in Germany are not required to take public health insurance (GKV) and can opt for private health insurance (PKV) instead. PKV is a popular choice for freelancers as it offers customized coverage based on their specific needs and allows them to access premium healthcare services.

Learn more about PKV for freelancers on our page is private health insurance mandatory for freelancers in Germany.

Q16: Why do freelancers in Germany prefer private health insurance?

Freelancers in Germany often prefer private health insurance (PKV) because it offers more flexibility in choosing coverage that suits their individual healthcare needs. Unlike public insurance (GKV), which is income-based, PKV allows freelancers to choose the level of coverage they need and enjoy faster treatment and access to specialists. PKV is a preferred choice for many young professionals and freelancers due to its premium healthcare services.

To understand why freelancers prefer PKV, visit our page why freelancers prefer private health insurance in Germany.

Q17: How does private health insurance handle pre-existing conditions?

Private health insurance (PKV) in Germany may cover pre-existing conditions, but coverage depends on the insurer and the specific plan. Some insurers may require additional medical assessments or impose waiting periods for certain treatments. It’s important to disclose all pre-existing conditions when applying for PKV to ensure proper coverage.

For more details, visit our page on how private health insurance handles pre-existing conditions in Germany.

Q18: Does private health insurance cover dental treatments in Germany?

Yes, private health insurance (PKV) in Germany generally covers a wide range of dental treatments, including routine check-ups, cleanings, and more advanced procedures like implants, crowns, and orthodontics. The level of coverage depends on the specific PKV plan chosen. For many, this makes PKV more advantageous compared to public health insurance (GKV), which typically offers limited dental coverage.

For more information on dental coverage, visit our page does private health insurance cover dental treatments in Germany.

Q19: Can retirees benefit from private health insurance in Germany?

Retirees in Germany can continue with private health insurance (PKV). However, premiums often rise as they age. PKV offers comprehensive coverage for a wide range of medical services, including specialist treatments, dental care, and private hospital accommodations. It’s important for retirees to assess the affordability of premiums as they age and consider their long-term healthcare needs.

For more information on private health insurance for retirees, visit our page private health insurance for retirees in Germany.

Q20: Does private health insurance cover mental health services?

Private health insurance (PKV) in Germany typically covers mental health services, including consultations with psychiatrists and therapists, as well as treatment in specialized facilities. Coverage for mental health services may vary depending on the plan, so it is important to review the details of the specific PKV plan to ensure adequate coverage.

For more details on mental health services coverage, visit our page private health insurance mental health coverage in Germany.

Q21: What additional benefits do private health insurance plans provide?

Private health insurance plans in Germany offer additional benefits such as faster access to healthcare providers, private room accommodations in hospitals, coverage for alternative treatments, and international health coverage. Some plans also cover dental care, preventive treatments, and enhanced mental health services, making PKV a comprehensive healthcare solution for many residents in Germany.

For more information on additional benefits, visit our page additional benefits of private health insurance in Germany.

Q22: How do private health insurance premiums change over time?

Private health insurance premiums in Germany typically increase over time due to factors such as age, health status, and inflation. PKV providers adjust premiums to reflect the policyholder’s changing risk profile. While premiums may be lower initially, they may rise significantly as you age or experience health changes.

Learn more about how premiums change over time by visiting our page how private health insurance premiums change over time in Germany.

Q23: What role does supplementary insurance play with private health insurance?

Supplementary insurance in Germany provides additional coverage alongside your private health insurance (PKV). It can cover treatments that are not included in your standard policy, such as dental, vision, and alternative treatments. Many people opt for supplementary insurance to expand their coverage and ensure they have access to a wider range of healthcare services.

For more information, visit our page on supplementary insurance with private health insurance in Germany.

Q24: How does private health insurance address chronic conditions?

Private health insurance (PKV) in Germany offers comprehensive coverage for chronic conditions, including ongoing treatment and medications. PKV allows policyholders to customize their plans based on their specific healthcare needs, ensuring they receive the appropriate treatment for chronic conditions. This level of flexibility is not always available under public health insurance (GKV).

For more information, visit our page on how private health insurance addresses chronic conditions in Germany.

Q25: Who qualifies for private health insurance in Germany?

In Germany, individuals who are employees earning above the threshold of €69,300 annually (2024), self-employed people, expatriates, and students in certain circumstances can apply for private health insurance (PKV). Additionally, freelancers can opt for PKV regardless of income. Students over 30 years old or those pursuing a second degree also have the option of taking out private health insurance.

To learn about eligibility requirements, please visit here.

Q1: Who is eligible for Private Health Insurance (PKV) in Germany?

Eligibility for PKV is mainly for: 1) Employees whose annual income exceeds the JAEG (Annual Remuneration Threshold). 2) Self-employed/Freelancers (regardless of income). 3) Civil Servants (Beamte) receiving Beihilfe. 4) Students who opt out of GKV (under 30) or those over 30.

Q2: What is the Annual Remuneration Threshold (JAEG)?

The Jahresarbeitsentgeltgrenze (JAEG) is the salary limit that frees an employee from compulsory Statutory Health Insurance (GKV). For 2025, the JAEG is €73,800 gross per year.

Q3: How long must an employee exceed the JAEG before switching to PKV?

An employee must exceed the JAEG for one full calendar year to become eligible to switch to PKV from the beginning of the following year.

Q4: Are self-employed individuals mandatory PKV-insured?

No. Self-employed and freelancers have the freedom to choose between PKV and voluntary GKV, regardless of their income level.

Q5: Is it possible to switch back from PKV to GKV?

Switching back to GKV is highly restricted, especially after the age of 55. The main ways are becoming unemployed (under 55) or taking a job where your salary consistently falls below the JAEG (mandatory GKV enrollment).

Q6: What is a *Gesundheitsprüfung* (Health Check) and why is it necessary?

The Gesundheitsprüfung is a mandatory health questionnaire required by PKV providers. It assesses your past medical history to determine your individual health risk and calculate your fair premium.

Q7: Can I be rejected by a Private Health Insurance company?

Yes. Unlike GKV, PKV companies are free to reject applicants based on pre-existing or chronic health conditions if the risk is deemed too high for their tariffs.

Q8: How does *Beihilfe* for Civil Servants work with PKV?

Civil Servants (Beamte) receive a state subsidy (Beihilfe) covering 50% to 80% of costs. They use PKV to cover the remaining gap (Restkostenversicherung), making private premiums significantly lower.

Q9: What is *Kleine Anwartschaft* (Dormant Insurance)?

An Anwartschaft is a low-cost contract that reserves your health status with the insurer, allowing you to enter PKV later without a new health check, regardless of subsequent medical issues.

Q10: Can I switch to PKV while pregnant?

Yes, but due to the Special Waiting Period (8 months), the PKV will likely not cover the costs of the birth or pregnancy-related treatments unless the policy was started well before conception.

Q11: How is the monthly PKV premium calculated?

The PKV premium is calculated using three main factors: Age at entry, Health status at entry, and the Chosen Scope of Benefits (Tarif).

Q12: What are *Alterungsrückstellungen* (Old Age Provisions)?

Alterungsrückstellungen are financial reserves legally built into your PKV premium from the start. They are invested to cover the naturally rising cost of healthcare in old age, helping to stabilize premiums later in life.

Q13: How much does the employer contribute to my PKV premium?

If you are an employee, your employer contributes 50% of your PKV premium, up to the maximum contribution they would pay toward GKV. This is the Arbeitgeberzuschuss.

Q14: How does the *Selbstbehalt* (Deductible) work in PKV?

The Selbstbehalt is a fixed annual amount you agree to pay out-of-pocket before your PKV begins reimbursing costs. Choosing a higher deductible leads to lower monthly premiums.

Q15: What is the *Beitragsrückerstattung* (Premium Refund)?

The Beitragsrückerstattung is a refund (e.g., 1-3 months of premiums) offered by many PKV tariffs if you submit no, or very few, medical bills for reimbursement during a calendar year (no-claims bonus).

Q16: Are PKV contributions tax deductible?

Yes. The portion of your PKV premium covering the basic, GKV-equivalent level of care (Basisabsicherung) is fully tax deductible as a special expense (Sonderausgabe).

Q17: Why do younger people pay proportionally more into PKV?

A significant portion of the early premium goes into Alterungsrückstellungen. This reserve is built up when you are young and healthy to prevent premiums from skyrocketing in old age.

Q18: What is the impact of a *Risikozuschlag* (Risk Surcharge)?

A Risikozuschlag is a calculated additional fee added to the standard premium to cover a specific, higher health risk (e.g., a chronic condition), ensuring acceptance despite the condition.

Q19: How often do PKV premiums typically increase?

Premium adjustments are not based on your age or individual health. They occur periodically (typically every 2-4 years) when the insurer’s overall medical costs for a collective of policyholders significantly exceed projections.

Q20: What is the *Basistarif* (Basic Tariff)?

The Basistarif is a statutory safety net that all PKV providers must offer. Its benefits mirror GKV standards, and its premium is capped at the maximum GKV contribution, ensuring affordability.

Q21: Are PKV benefits guaranteed for life?

Yes, PKV benefits are contractually guaranteed for the life of the policy. The insurer cannot unilaterally reduce the agreed-upon services.

Q22: What is *Chefarztbehandlung* (Chief Physician Treatment)?

This is a key PKV benefit in hospital tariffs, guaranteeing treatment by the hospital's Chief Physician (Head of Department) during an inpatient stay.

Q23: Does PKV cover hospital costs for a private room (*Einbettzimmer*)?

Yes, if the chosen tariff includes Wahlleistungen (Elective Services), it typically covers the cost difference for a single or double room during an inpatient stay.

Q24: Does PKV offer better dental coverage than GKV?

Generally, yes. PKV tariffs often cover 70% to 100% of high-quality services like implants, inlays, and high-end dentures (Zahnersatz), which GKV only minimally covers.

Q25: What is *Krankentagegeld* (Sick Pay Insurance)?

Krankentagegeld is a crucial, optional add-on that pays a daily, tax-free sum to replace lost income after the initial sick-pay period (usually 42 days). It is vital for the self-employed and high-earning employees.

Q26: Does PKV cover alternative and naturopathic treatments?

Most comprehensive PKV tariffs include coverage for Heilpraktiker (naturopathic practitioner) services, osteopathy, and acupuncture, which are usually excluded by standard GKV.

Q27: Why are waiting times for specialists often shorter for PKV patients?

Doctors generally receive higher fees for treating PKV patients compared to GKV patients, creating an incentive to prioritize appointments for the privately insured.

Q28: Does PKV provide worldwide coverage?

Yes. Most PKV tariffs include comprehensive coverage for emergency treatment worldwide for a limited period (e.g., 3-12 months per trip).

Q29: What are the typical waiting periods (*Wartezeiten*) in PKV?

There is usually an Allgemeine Wartezeit of 3 months and a Besondere Wartezeit of 8 months for specific services like psychotherapy, maternity, and complex dental work.

Q30: Does PKV cover regular health check-ups (*Vorsorgeuntersuchungen*)?

Yes. PKV covers preventative check-ups, often beyond the GKV standard, such as enhanced screening or earlier testing. Consult your tariff for specific details.

Q31: How does the reimbursement process (*Kostenerstattung*) work?

You receive and pay the doctor's bill upfront, then submit the invoice to your PKV provider (often via app) for subsequent reimbursement.

Q32: How long does it take for PKV to reimburse my costs?

Reimbursement times vary by provider, but are typically fast, with payment usually received within 10 to 30 working days after submitting the complete documentation.

Q33: How long do I have to submit a medical bill for reimbursement?

Most PKV contracts allow a generous timeframe, often several years (e.g., 3 years), but submitting them quickly is advised for cash flow and to qualify for the Premium Refund.

Q34: What is the *GOÄ* (German Medical Fee Schedule) and why is it important?

The GOÄ sets the legal limits for what doctors can charge private patients. PKV tariffs typically cover charges up to the 3.5x rate (Höchstsatz) of the GOÄ.

Q35: Can I change my tariff within the same PKV company?

Yes, you have a legal right (Tarifwechselrecht) to switch to any comparable or cheaper tariff within your current PKV provider without a new health check, preserving your Alterungsrückstellungen.

Q36: What is the downside of switching PKV providers entirely?

You risk losing a large portion of your accrued Alterungsrückstellungen and must undergo a new, full Gesundheitsprüfung where your older age and new conditions are assessed.

Q37: What if my doctor charges above the 3.5x GOÄ rate?

The PKV is generally only obligated to reimburse up to the 3.5x rate of the GOÄ. Any excess charge must usually be agreed upon in advance with the doctor, and the patient may be responsible for the difference.

Q38: Can I submit my medical bills electronically?

Yes. Nearly all modern PKV providers offer dedicated smartphone apps or online portals, allowing you to photograph and upload your bills for fast electronic processing.

Q39: How is my premium affected by my divorce/separation?

Your personal PKV contract remains unaffected. However, if your ex-spouse was co-insured in GKV, they may become mandatory GKV-insured, or their status may change based on your relative incomes.

Q40: Is it true that making fewer claims saves me money in PKV?

Yes, due to the Beitragsrückerstattung (Premium Refund), carefully deciding which small bills to submit (those below your deductible or the refund threshold) can save you more money than claiming every minor expense.

Q41: Is family insurance free in PKV?

No. Unlike GKV, PKV requires a separate, paid contract for every family member (spouse, children). Children’s premiums are usually lower than adult premiums.

Q42: What happens if one spouse is PKV and the other is GKV?

If the privately insured spouse earns more than the publicly insured spouse and above the JAEG, the publicly insured spouse cannot co-insure the children for free in GKV. The children must be privately insured.

Q43: What is the compulsory *Pflegepflichtversicherung*?

Pflegepflichtversicherung (Compulsory Nursing Care Insurance) is a separate, mandatory component of German health insurance. You must pay contributions for it, regardless of whether you are in PKV or GKV.

Q44: What happens to my PKV upon retirement?

Your PKV continues. You lose the employer subsidy, but the state pension fund provides a subsidy, and your accumulated Alterungsrückstellungen are used to stabilize the premium.

Q45: Can I get PKV if I am a member of the *Künstlersozialkasse* (KSK)?

Yes. The KSK subsidizes the contributions for GKV or PKV for self-employed artists and journalists. If you choose PKV, the KSK pays the employer-equivalent share of your premium.

Q46: What is the downside of choosing a tariff without Old Age Provisions?

Tariffs without Alterungsrückstellungen are cheaper now, but your premiums will increase sharply in old age as there is no reserve to stabilize costs. They are generally only suitable if you plan to leave Germany permanently.

Q47: Is it possible to secure PKV eligibility for later (e.g., as a student)?

Yes, through an Anwartschaft (Dormant Insurance). This low-cost contract reserves your current age and health status for future entry into PKV.

Q48: Does PKV cover a pension if I become permanently disabled?

No. PKV is for medical care. You need a separate Berufsunfähigkeitsversicherung (Occupational Disability Insurance) to cover loss of income due to permanent disability.

Q49: What is the difference between *Zusatzversicherung* and *PKV*?

PKV is comprehensive, full substitute health insurance. Zusatzversicherung (Supplementary Insurance) is optional insurance for GKV members to enhance specific areas like dental or private hospital room.

Q50: Can I get supplementary insurance for my GKV plan?

Yes, many PKV companies offer Zusatzversicherungen to GKV members to upgrade coverage areas like dental, hospital stay (Einbettzimmer/Chefarzt), or alternative treatments.

German Priovate Health Insurance FAQs

1. Eligibility, Application, and Switching (Voraussetzungen)

2. Costs, Premiums, and Financial Stability (Kosten & Prämien)

3. Coverage and Service Advantages (Leistungen)

4. Administration, Billing, and Management (Verwaltung)

5. Family, Long-Term, and Specific Scenarios