What to expect from German private health insurance in 2026

Choosing between public and private health insurance in Germany isn’t always straightforward.

For employees, one key factor is the annual salary threshold that decides whether you must stay in the public system or can switch to private insurance.

In 2025, that threshold is set at €73,800 per year. However, with wages rising across the country, the line is expected to shift higher in 2026, making private health insurance more difficult to access for many mid-level earners.

At the same time, premiums for both public and private plans are projected to increase, leaving many wondering what to expect.

In this guide, you’ll learn:

• The current salary threshold for private health insurance and how it’s changing in 2026
• What happens if your income goes above or below the limit
• How the process of switching from public to private actually works
• What private health insurance will likely cost in 2026 and why prices are rising

By the end, you’ll have a clear understanding of what the new thresholds mean for you, and how to plan your health insurance choice with confidence.

What is the salary threshold for private health insurance?

The salary threshold sets the line between staying in Germany’s public health insurance (GKV) or being free to choose private health insurance (PKV).

In 2025, the annual gross income threshold is set at €73,800 (that’s €6,150 per month) for employees. The threshold doesn’t apply to the self-employed, retirees, and students (although most companies will still expect these groups to earn at least €30,000 per year to ensure they can pay their bills).

In German, it’s called the “Versicherungspflichtgrenze” (compulsory insurance threshold). It shouldn’t be confused with the contribution assessment ceiling (Beitragsbemessungsgrenze). It’s the maximum salary amount on which public health insurance costs are calculated. If you earn more than this ceiling, your extra income isn’t subject to higher payments.

This threshold is updated each year based on overall wage trends in Germany. For 2025, it rose from €69,300 in 2024, a €4,500 increase (about 6.5 %).

What happens once you earn more than €73,800?

Crossing the €73,800 mark doesn’t mean you’re automatically switched to private insurance. It simply unlocks the option.

Here’s how the process usually works.

Step 1: employer confirmation

Your employer checks your annual gross income against the threshold. If your salary meets the requirements, they’ll provide written confirmation directly to your public health insurance. If you want to receive a copy, you’ll have to ask.

Step 2: Notify your current insurer

You must notify your public insurance provider, such as TK, that you’d like to leave. They’ll require proof of eligibility, usually your employer’s confirmation plus your private insurance contract.

Step 3: Apply for private health insurance

Before leaving the public health insurance system, you need an accepted private health insurance policy.

Insurers typically request a health questionnaire, and occasionally a doctor’s report.

What happens if your salary drops below the threshold?

Falling under the €73,800 mark has consequences.

For most employees, it means automatic re-entry into statutory health insurance. The rule is straightforward: if your regular income no longer clears the threshold, you lose the option to be privately insured and must rejoin the public system.

Your employer will usually notify both the insurer and payroll to trigger the change.

There are cases where staying on your private health insurance is still possible:

• You’re over 55: once you pass this age, switching back to GKV becomes nearly impossible, regardless of salary. Learn more about how to get health insurance after 55.
• Civil servants with Beihilfe receive state subsidies for private insurance and aren’t forced into the GKV.
• Long-term private health insurance patients: under certain conditions, you may be allowed to remain voluntarily, but this depends on your history and the insurer’s confirmation. Contact us for more details.

What if the salary drop is temporary?

Certain life events can impact your earnings temporarily. Here’s what happens in the most common cases:

• Maternity or parental leave: special protections apply. Many employees can remain privately insured, despite a reduced income, as benefits replace a portion of their salary.
• Part-time work: If the reduced salary is permanent and below the threshold, public health insurance rules apply again (you’ll have to switch back).
• Unemployment: Public health insurance usually becomes compulsory, with the job agency covering contributions. Learn more about health insurance during unemployment.

What will the salary threshold be in 2026?

Looking ahead to 2026, the salary threshold is expected to climb again.

Current estimates suggest it will rise to around €77,000–€ 78,000, an increase of about 5–6% year-over-year. These figures aren’t official yet (the government will publish the binding numbers in late 2025), but the projection reflects strong wage growth of about +5.3% in 2024.

What does that mean for you?

Let’s take a look:

1. A higher threshold means fewer employees will qualify. Mid-level earners may require additional years of raises before advancing to the next level.
2. At the same time, the Versicherungspflichtgrenze (contribution ceiling) for GKV also increases. For high earners who remain in GKV, this means higher monthly contributions.

Why is the threshold increasing?

The threshold follows wage developments. Recent increases in salaries have been (mainly) driven by:

• Collective wage agreements negotiated by unions.
• Labor shortages in many sectors are driving up salaries.
• Inflation is raising nominal wages across the board.

What will private health insurance cost in 2026?

Premiums in private health insurance are expected to climb again in 2026. While each insurer sets its own tariffs, the market trend is clearly upward.

For example, Hallesche has indicated increases of about +12% for Standard, +7% for Plus, and +8% for Premium plans. Certain short-term tariffs, unchanged since 2021, are expected to remain stable for now.

Mandatory long-term care insurance (Pflegepflichtversicherung) is also set to increase by around 10%, adding a hidden layer of cost for private health insurance members. Many overlook this when comparing public vs. private health insurance.

Why are costs increasing?

The main reason is rising healthcare costs (more than 10% annually), especially for hospital stays and treatments.

Interestingly, the more comprehensive tariffs are rising at a slower rate. That’s because high-cost services, such as those provided by chief physicians, haven’t grown as rapidly, while the prices of everyday treatments and drugs have surged.

Conclusion

The rules for private health insurance in Germany are set to change again in 2026, with higher salary thresholds and rising premiums on the horizon.

For employees, this means that qualifying for PKV will become more challenging, while staying in GKV will also become more expensive as contribution ceilings rise.

Understanding these changes now helps you plan your next step (whether that’s budgeting for higher public contributions, preparing the paperwork to switch, or weighing the long-term trade-offs).

If you’re considering your options, start by exploring what switching from public to private might look like.