This is a complete guide to German private health insurance in 2024.
Today we’ll show you exactly how to:
- Understand if private health insurance is the right option for you
- Pick the best insurance plan for your needs
- Calculate private health insurance costs
- And lots more
Let’s get started.
What is private health insurance in Germany?
Private health insurance in Germany, also known as PKV, is one of two healthcare systems in Germany. It covers about 10% of people in Germany. It’s mainly used by self-employed individuals, people with high incomes and civil servants.
Here is what you need to know:
- PKV offers the flexibility to tailor coverage to your needs.
- It also provides access to a wider network of services.
- Wait times are much shorter than with public health insurance.
- Premiums are usually lower than those for public insurance.
- The costs are calculated based on the services you choose and your personal risk factors (age and health history), which is known as the equivalence principle.
- You need to pay medical bills first and then get reimbursed later.
- Switching from public to private is easy if you fit the eligibility criteria. Switching back is harder.
- Private insurers can deny applications based on risk factors, like pre-existing conditions or age.
Who is eligible to be privately insured in Germany?
In Germany, certain groups of people can choose private health insurance over the standard statutory health insurance. Here’s a breakdown of who can choose private insurance:
- Self-employed individuals or freelancers
- High-income employees
- Civil servants
- Students
- Children, as long as one of the parents is privately insured
Let’s take a closer look at each of these…
- Self-employed individuals
This includes freelancers, business owners, and specific professionals like artists and publicists.
Technically, you can opt for private health insurance without any restrictions based on income. However, there is usually a minimum income requirement set by insurance companies. On average, this internal limit is set at €30,000 gross annually.
Private insurance for freelancers has lower fees than statutory insurance and offers better benefits.
Find out more with our guide to health insurance for freelancers and the self-employed in Germany.
- High-income employees
Employees earning more than €69,300 annually (as of 2024) can switch to private insurance.
This option can be more affordable since private insurance premiums aren’t based on income (which is the case for public health insurance).
High-income employees also get a subsidy from their employer for private insurance, up to the maximum allowed for statutory (public) insurance, which is €422 per month in 2024.
Find out more with our guide to health insurance for expats in Germany.
- Civil servants
Civil servants are partially covered by a government assistance program called “Beihilfe,” which pays for 50% of most health expenses. Private insurance can cover the rest of the health costs.
Civil servants and their children get particularly favorable rates. They also have the option to pause their insurance for a period with a guarantee that they can resume it later under the same conditions.
- Students
Students over 30 or in a non-state-accredited university are required to obtain either private health insurance or expat (incoming) health insurance.
If you wish to switch to private health insurance as a student, you must satisfy one of these criteria:
- You started your studies less than 3 months ago.
- You just turned 25 years old, so you cannot stay on your parents’ statutory (public) insurance plan.
Private insurance for students is usually cheaper than for working individuals (thanks to special student rates) and provides better benefits than statutory (public) insurance.
Plus, students receiving BAföG (a type of educational aid) may get help with their health insurance costs, making it even more affordable.
Find out more with our guide to health insurance for students in Germany.
- Families & children
In private health insurance, each family member needs their own plan, unlike statutory (public) health insurance, where one plan covers the whole family. Plans for children are typically cheaper, especially until they turn 21.
What does German private health insurance cover?
The main advantage of private health insurance is that you can customize your coverage exactly as you want it. Here are some things you can choose to include in your contract:
- Outpatient services: plans usually pay for all the costs of regular doctor visits and visits to specialists.
- Medication: all plans cover the cost of prescription medications. The best plans also cover non-generic drugs.
- Choice of room: You can choose a single, double, or shared room with multiple beds.
- Choice of doctor: You can choose to be treated by a senior physician or a specialist. The best plans will also allow you to be treated by heads of departments.
- Dental: The best plans cover a minimum of 90% of the cost for regular dental treatments and 75% for costly dentures. Most insurers set a maximum that can be reimbursed during the first years of coverage.
- Visual aid: Some plans cover expenses for glasses, contact lenses, or laser treatments.
- Sickness benefits: This benefit ensures that in case of sickness, you can still receive some income. This is crucial for the self-employed to maintain a livelihood when they cannot work.
Once you sign up, the services outlined in your contract are guaranteed for the entire duration of the contract. This means your insurance cannot change your coverage (unlike public insurance), but it also means you cannot easily add coverage later if it’s not already included, which could lead to increased costs.
How much does private health insurance cost?
According to the Association of Private Health Insurance, private health insurance costs an average of €529 monthly. Employers pay half of it, so you actually only pay €264.50. Self-employed people will have to pay for it themselves, though.
However, the price you pay for private health insurance varies based on several factors:
- Your provider
- Your coverage level
- Your age at when you sign up
- Your occupation and employment status
- Your health status when signing up
If you’re wondering how much your premiums might be, you can use our private health insurance cost calculator.
How do private health insurance cost change with age?
Private health insurance: Pros & cons
Private health insurance offers comprehensive benefits compared to other types of insurance, but it may not always be the ideal choice. Here’s a detailed look at its benefits and drawbacks:
Advantages
- Customizable coverage: You can tailor your insurance plan to suit your specific needs, which may eliminate the need for additional health insurance.
- Choice of providers: You have a wider selection of doctors and hospitals to choose from, giving you more control over your healthcare.
- Shorter wait times: You can often get medical treatment faster than with public insurance, reducing waiting periods.
- Fair contribution system: The cost of your insurance is based on the services you choose, not on your income level. You can also influence your costs through deductibles and cash-back rewards.
- Guaranteed services: The services you receive are guaranteed by your insurance contract, unlike public insurance, where benefits can change due to government decisions.
Disadvantages
- Limited coverage: Some medical treatments, such as psychotherapy, may not be fully covered under private insurance plans.
- Costly to switch providers: If you want to change insurers for better terms, it can be expensive as new premiums might be much higher.
- Difficult to return to public insurance: Once you switch to private insurance, it can be challenging to return to public health insurance.
Who should get private health insurance?
We briefly mentioned the main pros and cons of private health insurance. Still, it’s important to note that whether or not private health insurance is the right choice always depends on a person’s lifestyle and situation.
Here is who we think should seriously consider getting privately insured:
Freelancers & self-employed individuals
Unlike employees, self-employed people must pay their health insurance contributions entirely out of their own pocket. Private health insurance is, therefore, often the more cost-effective option and also offers better benefits.
Students
Students should stay on their parents’ family insurance for free if they qualify. However, if they are too old or earn too much, they need to get their own insurance and pay for it themselves. In this case, private health insurance or expat health insurance are the better alternative.
High earners
In the statutory health insurance system, contributions are based on income, so higher earners pay more. In contrast, private health insurance costs depend on the chosen services, making it often cheaper and more effective, especially since family members may not require separate contributions.
Young people
Private health insurance is often better than public insurance, especially for young people. Joining private insurance early helps build savings that can lower costs when you’re older. Younger people also usually have fewer health issues, making it easier for them to qualify for private insurance.
Switching from statutory to private health insurance
If you qualify for private health insurance, you can switch from public to private coverage. The usual notice period for leaving public health insurance is two months before the end of the month. However, if your annual income exceeds the legal limit (JAEG) for the first time, you can switch without notice.
Once you’ve chosen a private insurance plan, you need to apply by answering questions about your health. Our experts are available to assist you with this process. After your application is approved, you will receive a confirmation, which you must submit to your current insurer within the notice period for the cancellation to be valid. If the switch isn’t possible, you’ll stay with your current insurer.
Private Health Insurance FAQ
If you are under 55 years old and receive unemployment benefits, you will automatically be covered by statutory health insurance. To remain privately insured, you must apply for exemption from compulsory insurance. If you are over 55 years old, you will generally remain privately insured.
Generally, private health insurance covers treatment outside Germany as long as the treatment isn’t the main reason for traveling. Within Europe, there are usually no time limits for coverage. Many plans offer worldwide coverage for a certain period during travel, providing insurance outside Europe in emergencies.
However, since German fee schedules are used, there may be gaps in coverage. It’s often a good idea to have additional travel health insurance. Check your plan’s details to understand the exact coverage.
Yes, you can apply for private health insurance even with pre-existing conditions, but there are a few things to keep in mind:
- Health Questions: Insurers will ask about your medical history. This can include treatments in the last five years or hospital stays in the last ten years, depending on the company.
- Risk Surcharges: Insurers might charge you extra or exclude certain services from coverage if you have serious illnesses or allergies. This can also apply if you’re significantly underweight or overweight.
- Application Rejection: In some cases, insurers may deny your application due to serious health issues.
Private health insurance doesn’t offer a single-family plan; you need to pay a separate premium for each person. This allows each family member to choose coverage that fits their specific needs. For example, couples can select different services based on their preferences.
Children’s private health insurance is relatively inexpensive, starting at about €100 per month, because it doesn’t include age-related provisions. Additionally, employers often cover 50% of the children’s premiums up to a certain limit.
As a private patient, you pay your doctor’s bills upfront and are usually reimbursed by your health insurance within a month. For hospital stays, you can use Feather’s digital health insurance card not to pay astronomic sums.
Disputes can arise if doctors charge for treatments not covered by insurance, leaving you to cover the costs. It’s important to verify your insurance coverage and discuss potential charges with your doctor before undergoing complex treatments.
Yes, you can deduct private health insurance contributions on your tax return. Enter them as “special” expenses in the pension expenses section (line 48). The maximum deductible amount is €1,900 for employees, retirees, and public officials and €2,800 for freelancers.
If your private health insurance application is denied, you have a few options to consider:
- Try Another Company: Different insurance companies have different criteria. You might find another company willing to offer you coverage.
- Apply for Basic Coverage: Consider applying for the basic tariff, which provides services similar to statutory health insurance. You’ll need to meet specific requirements for this option.
Conclusion
That’s it for our private health insurance in Germany guide!
Now, we’d love to hear from you:
- Is private health insurance right for you?
- Do you prefer the statutory system?
- Or you might still have some questions?
Let us know in the comments or book a call with one of our experts!
