Private Health Insurance for Families in Germany
When a single professional considers switching to PKV, the calculation is relatively straightforward. When a family is involved, the decision becomes considerably more complex — and the answer is often different. The key issue is that GKV includes free co-insurance for non-working spouses and children, while PKV requires a separate, paid policy for every family member.
Core family rule: Under GKV, non-earning spouses and all children are covered for free. Under PKV, each person — including every child — needs their own policy at additional cost. This single difference often tips the financial comparison in favour of GKV for families.
The Cost of Insuring Children Under PKV
Children's PKV premiums are significantly lower than adult premiums, but they are not free. A child PKV policy typically costs between €80 and €180 per month depending on the insurer and the level of coverage chosen. A family with three children on PKV would therefore add approximately €240–€540 per month in children's premiums alone — costs that simply do not exist under GKV's family co-insurance model.
| Scenario | GKV Monthly Cost | PKV Monthly Cost |
|---|---|---|
| Single earner, no children | ~€350–€450 (employee share) | ~€350–€500 |
| Two earners, no children | ~€700–€900 combined | ~€700–€1,000 combined |
| One earner + non-working spouse | ~€350–€450 (spouse free) | ~€700–€950 (two policies) |
| Two earners + 2 children | ~€700–€900 (children free) | ~€860–€1,300+ (4 policies) |
When PKV Can Still Work for Families
Despite the additional cost per family member, PKV can still be the better option for families in specific situations:
The Non-Working Spouse Problem
Perhaps the single biggest financial disadvantage of PKV for families is the non-working spouse situation. Under GKV, a spouse who earns below a threshold (approx. €505/month in 2026) is co-insured for free. Under PKV, the spouse requires their own full policy — typically €300–€600 per month. This alone can add €3,600–€7,200 per year to the family's insurance costs compared to GKV, which is a major consideration.
What Happens When Children Turn 25?
Under GKV, children are co-insured for free until age 25 (or until they start earning). Under PKV, children have their own policies from birth and are not affected by age in the same way. However, when a PKV-insured child starts working, they must assess whether to continue their own PKV policy or move to GKV based on their employment situation and income.
Getting the Right Advice for Your Family
Given the complexity of the PKV vs GKV decision for families, professional advice is particularly valuable. The right answer depends on both parents' incomes, employment status, the number and ages of children, any pre-existing conditions, and long-term career plans. Contact us for a free personalised consultation to model the real costs for your specific family situation.