Health Insurance Costs in Germany
What you will actually pay — premiums, deductibles, employer contributions, and hidden costs for GKV, PKV, and incoming insurance explained.
GKV (Public Insurance) Costs
GKV contributions are calculated as a percentage of your gross income, up to the contribution ceiling (BBG) of €69,750/year in 2026. Your employer pays roughly half. Family members are covered for free.
| Component | Rate | Note |
|---|---|---|
| General health insurance rate | 14.6% | Split equally between employee and employer |
| Supplementary rate (avg.) | 1.7% | Split equally between employee and employer |
| Nursing care insurance | 3.4% | Split equally, with surcharges for childless |
| Childless surcharge (age 23+) | +0.6% | Paid entirely by the employee |
| Total (without childless surcharge) | 19.7% | Employee pays roughly half |
What Determines Your PKV Premium?
Unlike GKV, your PKV premium is not based on income. Instead, it depends on four key factors.
Age at Entry
The younger you are when you join, the lower your starting premium. Insurers calculate lifetime risk based on your entry age.
Health Status
Pre-existing conditions may result in risk surcharges. Healthy individuals get the best rates. A medical questionnaire determines your risk profile.
Coverage Level
Higher coverage means higher premiums. You can choose basic, comfort, or premium tariffs that determine which treatments and services are included.
Deductible (Selbstbehalt)
Choosing a higher annual deductible (€300–€1,200) significantly lowers your monthly premium. You pay out-of-pocket up to this amount before the insurer covers the rest.
GKV vs PKV vs Incoming: Cost Comparison
Example costs for a 32-year-old employee earning \u20AC85,000/year with no pre-existing conditions.
| Category | GKV | PKV | Incoming |
|---|---|---|---|
| Monthly premium | ~€450–€520 | ~€300–€650 | ~€30–€150 |
| Employer contribution | ~50% of premium | Up to ~€403/month | None |
| Your net cost (employee) | ~€225–€260 | ~€150–€350 | Full premium |
| Premium basis | % of income (up to BBG) | Individual risk profile | Age and duration |
| Family members | Free co-insurance | Separate policy each | Separate policy each |
| Annual adjustment | Linked to income/rates | Based on medical inflation | Fixed for term |
These are approximate figures for illustration. Actual costs vary based on the insurer, tariff, and individual health profile. Use our calculator for a personalized estimate.
Employer Contributions
For GKV: Your employer pays roughly 50% of all GKV contributions — including the general rate, supplementary rate, and nursing care insurance. This split happens automatically through payroll.
For PKV: Your employer also contributes to your PKV premium — 50% of your premium, up to a maximum of approximately €403 per month in 2026. This cap is tied to the maximum employer GKV contribution.
For incoming insurance: Employers do not contribute to incoming or travel insurance premiums. You pay the full cost yourself.
Self-Employed? No Employer Contribution
Freelancers and self-employed individuals pay the full premium themselves. This is one of the biggest cost differences compared to employed PKV members.
Tax Deductibility
GKV contributions are automatically deducted pre-tax through payroll. Your employee share reduces your taxable income.
PKV premiums for basic coverage (Basiskrankenversicherung) are fully deductible as special expenses (Sonderausgaben) on your German tax return. Additional coverage components (single-room hospital, enhanced dental) may be partially deductible depending on your overall special expense allowance.
Incoming insurance premiums are generally not tax-deductible in Germany since they are not recognized as statutory health coverage.
For self-employed individuals, the tax savings on GKV or PKV can be substantial since you pay the full premium yourself without an employer subsidy.
Aging Provisions (Alterungsr\u00FCckstellungen)
One of the most important financial mechanisms in PKV is the aging provision. A portion of your monthly premium is set aside into a reserve fund managed by the insurer.
This reserve is designed to cover the increasing healthcare costs you will naturally incur as you age. Without aging provisions, your premium would skyrocket in your 60s and beyond.
The earlier you join PKV, the more time your aging provisions have to accumulate, leading to more stable premiums in retirement. This is a key reason why joining young is advantageous.
~10%
of premium goes to aging provisions (typical)
30+ years
of accumulation for optimal benefit
Portable
partially transferable when switching PKV insurers
Frequently Asked Questions
Common questions about health insurance costs in Germany.
PKV uses an equivalence principle: your premium reflects your personal risk (age, health, coverage level), not your income. This means a 30-year-old earning €80,000 pays the same premium as a 30-year-old earning €200,000, assuming the same health and coverage.
Yes. In GKV, non-working spouses and children are covered through Familienversicherung at no additional cost. This is one of the biggest financial advantages of GKV for families. In PKV, every family member needs their own policy and pays a separate premium.
Incoming insurance usually costs between €30 and €150 per month depending on the provider, your age, and the coverage level. It is designed as affordable short-term coverage and does not include the comprehensive benefits of GKV or PKV.
GKV contributions rise when general or supplementary rates increase, or when your income goes up. PKV premiums can increase due to rising medical costs — typically 2-3% per year, cushioned by aging provisions. Incoming insurance rates are usually fixed for the policy term.
Aging provisions (Alterungsrückstellungen) are savings built into PKV premiums to offset higher healthcare costs as you age. A portion of your monthly premium is set aside in a reserve fund. This is why PKV premiums in your 20s-40s are slightly higher than pure risk cost — but this investment prevents dramatic premium increases in retirement.
Calculate Your Potential Savings
Use our insurance calculator to see a personalized cost comparison between GKV and PKV based on your age, income, and situation.