How to Switch from Public to Private Health Insurance in Germany
Switching from Germany's public health insurance system (GKV) to private health insurance (PKV) is a significant financial and lifestyle decision. The process is more involved than simply choosing a new provider — it requires meeting eligibility criteria, passing a health assessment, giving notice to your GKV fund, and carefully timing your switch.
Important: Switching to PKV is relatively straightforward once you meet the criteria. Switching back to GKV is considerably harder. Treat this decision as long-term or permanent before proceeding.
Step 1: Confirm Your Eligibility
Before you do anything else, confirm that you legally qualify to leave GKV:
- Employees: Your gross salary must exceed €77,400 in the current year, and you must expect to remain above this threshold next year
- Freelancers/self-employed: You are immediately eligible — no income threshold applies
- Civil servants: You are eligible from the start of your career
- Students: Eligible via special student PKV plans before age 30 (or within 14 semesters)
Step 2: Compare PKV Tariffs
There are over 40 PKV providers in Germany offering hundreds of different tariffs. Key factors to compare include:
| Factor | What to Look For |
|---|---|
| Hospital tariff | Does it include Chefarztbehandlung and private room (Einbettzimmer)? |
| Dental coverage | What % is covered for implants and high-quality prosthetics? |
| Sick pay (Krankentagegeld) | Especially important for freelancers — covers income loss after day 42 |
| International coverage | Worldwide emergency vs. planned treatment abroad |
| Premium trajectory | Check historical premium increase rates of the insurer |
| Beitragsrückerstattung | Does the tariff offer a no-claims refund? |
| Financial stability | Look at the insurer's Alterungsrückstellungen per member |
Step 3: Complete the Health Assessment (Gesundheitsprüfung)
All PKV applications require you to honestly complete a Gesundheitsprüfung — a health questionnaire covering pre-existing conditions, ongoing treatments, medications, recent hospital stays, and chronic illnesses. Based on your responses, the insurer may:
- Accept you at standard premiums
- Apply a surcharge (Risikozuschlag) for specific health risks
- Exclude specific conditions from coverage (Leistungsausschluss)
- In rare cases, decline the application
Honesty is legally required. Failing to disclose conditions can result in the insurer voiding your policy later. Read our pre-existing conditions guide for more detail.
Step 4: Give Notice to Your GKV Fund
Once your PKV application is approved and you have your policy start date confirmed, give written notice to your GKV provider. The standard notice period is two full calendar months. Your GKV fund will issue a Kündigungsbestätigung (cancellation confirmation) — keep this document as you will need it.
Step 5: Provide PKV Proof to Your Employer
Your employer needs your PKV Versicherungsnachweis to stop deducting GKV contributions from your salary and to begin paying the PKV Arbeitgeberzuschuss instead. Without this, you may temporarily be double-contributing.
When Is the Best Time to Switch?
The optimal time to switch to PKV is when you are young, healthy, and earning above the threshold. Each year you delay, your entry age increases, and so do your baseline premiums. If you have any health changes in the interim, you may face surcharges or exclusions that wouldn't have applied earlier.