Germany operates under a dual health insurance system, where residents can choose between statutory health insurance (GKV) and private health insurance (PKV).
Many high earners, younger individuals, and those seeking more flexible coverage options find PKV attractive due to benefits like:
- Tailored services
- Shorter waiting times
- Potentially lower premiums compared to GKV
Switching to private health insurance can be a significant financial and healthcare decision, impacting not only immediate costs but also long-term planning.
Careful preparation helps ensure the move is both beneficial and sustainable.
Check Eligibility
Income thresholds, professional status, and specific regulations determine who can move to PKV.
Employees must have an annual income above €73,800 in 2025 to qualify for switching.
Self-employed individuals and freelancers generally have access to PKV, except for cases such as those insured through the Künstlersozialkasse (KSK).
Civil servants often find PKV attractive due to substantial state subsidies, making premiums significantly lower.
Students may choose PKV at the beginning of their studies, but once this choice is made, returning to GKV later is usually very difficult.
Rules are applied strictly, so knowing the criteria in detail helps avoid application setbacks.
- Employees: Annual salary exceeding €73,800 (2025 threshold)
- Self-employed/freelancers: Generally eligible, with some exceptions (e.g., KSK members)
- Civil servants: Benefit from significant subsidies
- Students: Can opt for PKV only at the start of studies, with limited flexibility to return to GKV later
Assess Suitability and Risks
Personal circumstances play a major role in determining if PKV is sustainable long-term. Health condition is a primary factor, as insurers may add risk surcharges or refuse coverage based on medical history.
Those considering starting a family must remember that PKV does not include free coverage for spouses or children, unlike GKV.
Just like family therapy, the family insurance covers so much more and is beneficial for bigger families!
Younger applicants usually enjoy lower premiums, while older applicants often face higher monthly costs.
Stable income is essential since PKV premiums remain due regardless of employment changes.
Falling below the income threshold in later years could require rejoining GKV under different terms, affecting financial plans.
- Current health and medical history
- Family planning and coverage needs
- Age-related premium differences
- Employment and income stability
- Possible future return to GKV if income drops
Research and Compare Plans
Evaluating PKV plans involves more than looking at monthly premiums. Deductibles, included benefits, and long-term premium stability all influence the decision.
Important benefit areas include dental coverage, hospital accommodations, alternative medicine options, and international health coverage.
Some insurers maintain more stable premiums over time, which can reduce the risk of large cost increases.
Independent brokers or consultants can offer unbiased guidance, but care is necessary with commission-based sellers who might prioritize profit over suitability.
- Monthly premiums and deductibles
- Dental, hospital, and alternative medicine coverage
- International coverage options
- Historical stability of premiums
- Source of advice (independent vs. commission-based)
Plan the Timing
A well-thought-out transition schedule plays a significant role in ensuring the move to PKV is smooth and financially efficient.
Timing affects not only the premiums you lock in but also your ability to avoid administrative issues during the changeover.
GKV generally enforces a two-month notice period, meaning you cannot simply cancel and leave immediately.
However, special termination rights may be granted under certain situations, such as starting a new job that meets PKV eligibility requirements or experiencing significant changes in personal circumstances.
Maintaining continuous coverage is critical. The official end date of your GKV plan should directly align with the start date of your PKV policy to prevent any gaps in medical protection.
The coordination becomes particularly important for those with ongoing treatments or upcoming medical appointments.
Younger and healthier applicants often gain an advantage by switching sooner, as premiums are calculated based on current health and age.
Waiting too long could result in higher monthly costs and stricter acceptance terms.
- Respect the standard two-month notice period for GKV to avoid penalties or delays
- Check for possible special termination rights in your situation
- Ensure GKV coverage ends on the exact day PKV coverage begins
- Consider an earlier switch to secure lower premiums
- Gather and prepare all necessary documents before initiating the process
Application Process
Applying for PKV is a structured procedure requiring careful attention to detail.
Each insurer evaluates applicants individually, using both personal and financial data to determine acceptance and premium rates.
A health questionnaire is the first step, requesting information on past illnesses, surgeries, medications, and lifestyle habits.
Providing accurate and truthful answers is essential, as undisclosed conditions can lead to contract termination later.
Proof of income is also required, particularly for employees, to demonstrate eligibility under the annual income threshold.
Many insurers will request a medical risk assessment, which might include a doctor’s examination or specific diagnostic tests.
Based on these evaluations, the insurer will issue a personalized offer, outlining premium amounts, deductibles, coverage options, and conditions.
Reviewing this offer thoroughly ensures that the chosen plan aligns with your needs and financial goals.
Once accepted, the insurer issues an official insurance certificate, which is required for informing your employer and other relevant parties about your new coverage.
- Complete the detailed health questionnaire accurately
- Submit proof of income to confirm eligibility
- Participate in medical risk assessment if required
- Review the insurance offer carefully before signing
- Obtain the PKV insurance certificate for employer and administrative purposes
Cancel Statutory Health Insurance
Exiting GKV is a formal process that involves specific administrative steps and documentation.
A written notice of cancellation must be submitted to your GKV provider, either by post or electronically if the insurer offers that option.
The step should be done only after securing PKV coverage to prevent lapses in healthcare access.
Upon processing your request, the GKV provider will issue a confirmation of cancellation (Kündigungsbestätigung), which serves as proof that your membership is ending.
This proof must then be provided to your employer, who will update payroll and stop deducting GKV contributions. If you are self-employed, the confirmation should be kept for your own records and provided to relevant authorities if requested.
Without submitting valid proof of PKV coverage, the GKV provider will not finalize your cancellation, and you may still be billed.
Careful tracking of all documents ensures there are no delays or unwanted payments during the transition period.
- Submit a formal written cancellation to GKV
- Obtain an official confirmation of cancellation (Kündigungsbestätigung)
- Provide proof of PKV coverage to your employer or directly to GKV
- Confirm that termination has been processed before stopping payments
Summary
Switching to private health insurance in Germany offers enhanced flexibility, tailored benefits, and potential cost savings for certain groups such as high earners, young professionals, and those with stable incomes.
The decision also involves significant commitments that extend far into the future, making careful evaluation essential.
Eligibility, long-term affordability, and coverage suitability should all be considered before proceeding.
With proper research, timing, and documentation, the transition can be smooth, providing access to a different tier of healthcare services while aligning with individual lifestyle and financial goals.