Waiting Periods in Private Health Insurance in Germany
When you take out a new PKV policy in Germany, you will typically encounter Wartezeiten — waiting periods during which specific types of planned treatment are not yet covered. Understanding these is essential so you are not caught out shortly after your policy begins.
Always covered from day one: Emergency medical treatment is covered immediately regardless of any waiting period. Wartezeiten apply only to non-emergency, planned treatments.
The Two Standard Waiting Periods
| Type | German Term | Duration | What It Covers |
|---|---|---|---|
| General Waiting Period | Allgemeine Wartezeit | 3 months | Most standard medical treatments not covered by the special period |
| Special Waiting Period | Besondere Wartezeit | 8 months | Psychotherapy, maternity care, complex dental, orthodontics |
What Is Always Covered From Day One?
- Emergency medical treatment — ambulance, A&E, emergency surgery
- Accident injuries — covered immediately under virtually all tariffs
- Acute illness GP consultations — typically covered immediately
- Emergency dental treatment — pain relief and acute dental emergencies
When Are Waiting Periods Waived?
The 8-Month Maternity Waiting Period
The 8-month maternity waiting period is one of the most practically significant Wartezeiten. If you became pregnant within 8 months of starting PKV without prior continuous coverage, some maternity-related hospitalisation costs may not be fully covered. Crucially:
- Routine prenatal check-ups are covered immediately under most tariffs
- Switching from GKV immediately before pregnancy typically waives this period
- Emergency obstetric care is always covered regardless
The Dental and Orthodontic Waiting Period
Major dental restoration and orthodontic treatment plans initiated within the waiting period are typically not covered once the period ends — they must not be started until coverage is active. Routine check-ups and emergency dental treatment are generally exempt. If you are planning significant dental work, check the exact timing relative to your policy start date before booking any consultations that could be interpreted as initiating a treatment plan.
Psychotherapy and Psychiatric Treatment
The 8-month waiting period for psychotherapy affects planned, ongoing therapy — not acute psychiatric crises. If you are already in treatment when joining PKV, discuss this with your insurer before switching. Some insurers will exclude ongoing treatment as a pre-existing condition rather than apply a blanket waiting period.
Standard Waiting Periods at a Glance
German private insurers apply contractual waiting periods (Wartezeiten) during which certain benefits are not yet payable. These are defined by the model insurance conditions (Musterbedingungen) and are broadly consistent across insurers:
| Benefit type | General waiting period |
|---|---|
| General medical treatment (GP, specialists, medication) | 3 months |
| Dental treatment & prosthetics | 8 months |
| Maternity & childbirth | 8 months |
| Psychotherapy & orthodontics | 8 months |
The clock starts on the policy's effective date, not the application date. Emergencies arising from accidents are typically covered immediately, regardless of any waiting period.
How to Have Waiting Periods Waived
Most insurers will waive the waiting periods entirely if you submit a clean medical examination report (Gesundheitszeugnis) carried out at your own expense. Waiting periods are also commonly waived when you switch directly from another German health insurer — both GKV and PKV — provided there is no gap in cover, because the time you were previously insured is credited to you.
Key point: A waiting period is different from a benefit exclusion. Waiting periods are temporary and apply to everyone; exclusions (Leistungsausschlüsse) are permanent and relate to specific pre-existing conditions assessed at underwriting.
Official Sources & Further Reading
This guide is based on official German regulatory and government sources. Figures such as the income threshold (JAEG) change annually — always confirm current rules with these bodies or a licensed broker before deciding.
- BaFin — Federal Financial Supervisory Authority, regulator of private health insurers.
- PKV-Verband — Association of German Private Health Insurers (Verband der Privaten Krankenversicherung).
- Bundesgesundheitsministerium (BMG) — Federal Ministry of Health.
- SGB V — German Social Code Book V, the statutory basis for insurance obligation and the JAEG threshold (§6).
- Vermittlerregister — official register to verify any German insurance broker's §34d GewO licence.