Private Health Insurance (PKV) in Germany — What Expats Need to Know
PKV is one of several health insurance options available to expats in Germany. This page covers everything specific to the private route. For a complete overview of all options including GKV and incoming insurance, see our full insurance guide.
What Is Private Health Insurance (PKV)?
Germany has a dual health insurance system consisting of public health insurance (Gesetzliche Krankenversicherung or GKV) and private health insurance (Private Krankenversicherung or PKV). While GKV covers approximately 87% of the population, PKV offers an alternative path with different trade-offs — often enhanced coverage, shorter wait times, and access to premium medical services, but with considerations around long-term costs and family coverage that every expat should understand before choosing.
Unlike GKV, where premiums are based on a percentage of your income, PKV premiums are determined by your age at entry, health status, and the level of coverage you choose. This means younger, healthier individuals often benefit from lower premiums and significantly better coverage compared to GKV.
Who Can Get PKV in Germany?
Private health insurance is available to the following groups:
- Employees earning above the JAEG: In 2026, the Jahresarbeitsentgeltgrenze (JAEG) is EUR 77,400 per year. Employees who consistently earn above this threshold can opt out of GKV and choose PKV.
- Self-employed and freelancers: There is no income threshold. All self-employed individuals in Germany can choose PKV from day one.
- Civil servants (Beamte): Civil servants are always eligible and receive Beihilfe (government aid covering 50-80% of costs), making PKV particularly affordable.
- Students: New students can opt for PKV within the first 3 months of enrollment by requesting an exemption from GKV.
- New arrivals: Depending on employment type and visa status, newcomers to Germany may be eligible from the start.
Not sure if you qualify? Take our eligibility quiz to find out in just 2 minutes.
Benefits of PKV
Private health insurance offers several advantages over public insurance:
- Direct specialist access: See any specialist without a referral from your GP.
- Shorter wait times: Priority appointments, often within days rather than weeks or months.
- Private hospital rooms: Single or double rooms with chief physician treatment.
- Comprehensive dental coverage: Up to 100% coverage including implants and orthodontics.
- Mental health coverage: Broad psychotherapy and counseling benefits.
- International coverage: Protection during travel and stays abroad.
- Income-independent premiums: Your premiums are based on your health profile, not your salary.
How to Apply for PKV
The process of switching to PKV typically follows these steps:
- Verify your eligibility by checking your income against the JAEG threshold (for employees) or confirming your self-employed/civil servant status.
- Compare insurers and tariffs to find the best coverage for your needs and budget. Our insurer rankings can help.
- Consult with a licensed broker who can provide personalized advice and handle the application process. This service is free. Contact us to get started.
- Complete the application including a health questionnaire for medical underwriting.
- Cancel your current GKV policy once your PKV application is approved (your broker will guide you through this).
- Begin your PKV coverage on the agreed start date.
The entire process typically takes 4-8 weeks. Read our detailed switching guide for step-by-step instructions.
PKV Costs and Contributions
Understanding PKV costs requires looking beyond the monthly premium. Here are the key factors:
- Base premium: Determined by your entry age, health status, and coverage level. Starting from approximately EUR 340-450/month for comprehensive coverage.
- Employer contribution: Employers pay approximately 50% of your PKV premium, up to the maximum GKV employer contribution (about EUR 403/month in 2026).
- Deductible (Selbstbeteiligung): Choosing a higher annual deductible (EUR 300-1,500) reduces your monthly premium significantly.
- Tax deductions: PKV premiums for basic coverage are tax-deductible as Sonderausgaben (special expenses).
- Aging provisions: A portion of your premium goes toward aging provisions (Alterungsrueckstellungen) to limit increases in later years.
Use our insurance calculator to estimate your monthly costs and potential savings.
Frequently Asked Questions
Answers to the most common questions about PKV in Germany.
Switching back to public insurance (GKV) is possible under certain conditions. Employees must reduce their income below the JAEG threshold (EUR 77,400 in 2026) for at least one year. After age 55, returning to GKV is essentially impossible. Self-employed individuals can return to GKV if they take up employment with income below the threshold.
PKV premiums are based on your age, health status, and chosen coverage level rather than income. For a healthy 30-year-old, comprehensive coverage typically starts from EUR 340-450 per month. Employers cover approximately 50% of the premium (up to ~EUR 403/month). Self-employed individuals pay the full premium themselves.
If you leave Germany permanently, you can cancel your PKV policy. Some insurers offer international coverage continuations or travel health insurance add-ons. If you return to Germany later, you would need to apply again, potentially at higher premiums due to increased age.
PKV requires medical underwriting. Pre-existing conditions must be declared in your application. Insurers may accept you with a risk surcharge, exclude specific conditions temporarily or permanently, or in rare cases decline coverage. Working with an experienced broker is highly recommended to find insurers with favorable terms for your specific conditions.
Unlike GKV, PKV does not offer free family co-insurance. Each family member (spouse, children) needs their own policy. However, children can often be insured at significantly reduced rates. Some insurers offer family packages. If one spouse is in GKV and earns more, children may be covered under GKV for free.
The JAEG (Jahresarbeitsentgeltgrenze) or annual income threshold is EUR 77,400 in 2026. Employees must earn above this amount to be eligible for PKV. It applies only to employees; self-employed professionals and civil servants have no income requirement. The threshold is adjusted annually by the government.
The entire switching process typically takes 4-8 weeks. This includes: consultation and plan selection (1-2 weeks), application and medical underwriting (1-2 weeks), approval and policy issuance (1-2 weeks), and GKV cancellation notice period. Planning ahead is important, as GKV requires a cancellation notice period.
PKV premiums do not automatically increase with age like GKV premiums increase with salary. However, premiums may rise due to medical inflation and claims development. German law requires PKV insurers to build aging provisions (Alterungsrueckstellungen) to limit premium increases in old age. Choosing an insurer with strong aging provisions is important for long-term affordability.
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