Private health insurance in Germany: Essentials
- Private health insurance (PKV) offers a broader range of benefits and significantly better healthcare depending on the tariff than statutory health insurance. However, those interested in full private health insurance must meet specific requirements.
- Employees with an annual income of €69,300 or more (status 2024), freelancers and the self-employed, students, and civil servants can take out full private health insurance.
- Privately insured people can choose the significant health benefits and structure their insurance accordingly, giving them the freedom of choice and flexibility to tailor their coverage to their specific needs.
- The premiums for private health insurance depend on the chosen tariff, age, and state of health at the start of insurance. Young policyholders without pre-existing conditions usually pay significantly lower premiums than public health insurance, making private health insurance an affordable and valuable option for their healthcare needs.
- You can find private comprehensive health insurance offers from numerous private insurance companies. We particularly recommend the policies from FinTech insurers ottonova and Feather, which provide high-performance rates at favorable conditions. All their benefits and services are available in German and English.
The healthcare system in Germany
German health insurance is based on the two pillars of public and private insurance.
Statutory health insurance
Statutory health insurance (Gesetzliche Krankenversicherung, GKV) must be taken out by all employees whose annual income is below the compulsory insurance limit of currently €69,300. On the other hand, freelancers, the self-employed, students, and civil servants are, in most cases, free to decide whether to take out statutory or private insurance. Special conditions apply to students in both statutory and private health insurance.
The statutory health insurance system covers 90% of all residents in Germany, who can currently choose between 95 statutory health insurance funds. The contributions depend on income and are currently 14.6% of gross income, half paid by the employer for salaried employees. Spouses and children without income can be insured free of charge.
The scope of benefits public health insurance provides is identical for all insured people. Public health insurance companies cover standard medical care and, in some cases, various additional services.
A statutory health insurance scheme in Germany is a nonprofit corporation under public law.
Private health insurance
Compared to public health insurance, private insurance (Private Krankenversicherung, PKV) has the following characteristics:
- Capital-financed offers from private companies
- Premium calculation based on the scope of benefits of the tariff and several other factors
- Permanent, contractually guaranteed scope of benefits
- Reimbursement of medical services based on the scale of fees for doctors and other medical service providers
- Direct billing of healthcare costs between doctors and insured people, reimbursement by the insurance company (exception: hospital treatment — direct billing with the insurer is also possible here)
Requirements for private comprehensive health insurance
Private health insurance is an individually agreed contract according to which the scope of insurance coverage is determined.
Compared to public health insurance, you receive more comprehensive benefits with a private policy. Premiums are also partially lower, especially for younger, healthy policyholders.
The prerequisite for taking out private comprehensive health insurance is that there is no obligation to be insured by public health insurance. The following groups of people meet this requirement:
- Employees with an annual income of at least €69,300 per year/€5,775 per month
- Freelancers and self-employed people
- University students
- Civil servants and their family members
- People with an income below the low-income threshold of currently €538 (status 2024)
In some cases, there is no alternative to a private health insurance provider, as these people cannot be insured by public health insurance. This affects people without health insurance who were last privately insured or—like freelancers and the self-employed—are generally not subject to mandatory insurance in a public health insurance fund.
Regulations for the health insurance of expats
The same rules apply to health insurance for expats living in Germany for more than 12 months as for German passport holders.
Expats from countries outside the EU and the European Economic Area must provide proof of international health insurance before entering the country. However, this insurance cover is insufficient if you plan a long-term or permanent stay in Germany. Please decide to take out domestic health insurance in Germany at an early stage.
Important: Insurance cover through the European Health Insurance Card (EHIC)
The European Health Insurance Card (EHIC) allows citizens of EU countries and Iceland, Norway, Switzerland, and Liechtenstein to claim medical benefits throughout the EU. However, in the long term, it does not replace the coverage provided by comprehensive health insurance.
Benefits of private health insurance
Your insurance contract contains individual agreements on the benefits of your private insurance. You can tailor your insurance coverage to your needs by choosing the correct tariff.
Medical services are only reimbursed if they are explicitly covered in your policy. Most private health insurance providers offer policies with a modular structure so that you can add various benefits to your plan.
Benefit security in private health insurance
All benefits are guaranteed for the entire term of the contract. Benefits can be adjusted by switching to a different tariff, adding further modules, or canceling additional benefits.
Although private insurance only covers treatment costs if they are medically necessary, the scope of benefits usually significantly exceeds the standard care the public health insurance funds provide. Depending on the tariff, the costs are covered up to the maximum rate of the applicable fee schedule (for doctors: 3.5 times the rate) or unlimited.
If you have private insurance, you can also use the services of private doctors and therapists not licensed by the health insurance funds.
Criteria for choosing a tariff
Private comprehensive health insurance covers outpatient and inpatient medical treatment, dental and orthodontic treatment, psychotherapy, remedies and aids, medication, and alternative medical treatment, depending on the tariff.
If you choose private health insurance, you should pay particular attention to the following points:
- Free choice of doctor and direct access to specialists without going through your family doctor
- Reimbursement of costs for dentures, visual aids, and medical aids at the maximum rate of the scale of fees for doctors and dentists (for implants and other dentures: at least 75% of the costs)
- Reimbursement of aids — for example, insulin pumps, walking aids, wheelchairs, or prostheses — not based on lists but independently of the required aid based on medical necessity
- Treatment by alternative practitioners, complementary medical therapies
- Free choice of hospital, treatment by chief physician, 2-bed-room or single room in the hospital
- Health insurance cover abroad (generally unlimited within the EU, flexible choice outside Europe — we recommend at least one year of cover abroad)
- Daily sickness allowance, which is not automatically covered by private health insurance
Costs for private health insurance
If you plan to choose private health insurance, you should decide as early as possible. In addition to other factors, the age at the start of insurance and previous illnesses highly influence the premiums. Young, healthy policyholders typically pay significantly lower premiums compared to statutory insurance.
Employer subsidy for private insurance
Privately insured employees are entitled to an employer subsidy of 50% of their insurance premium, just like people with statutory insurance. The maximum subsidy is currently €421.76.
On average, private insurance contributions are €400-€700. By comparison, the maximum contribution for public health insurance is around €845 without employer subsidy: high-earning freelancers and the self-employed benefit to an exceptionally high degree from private health insurance.
Factors influencing the premium amount
- Scope of benefits of the tariff
- Age and state of health
- Risk profile of the profession practiced.
- High-risk hobbies (e.g., extreme sports, martial arts, motorsports)
- Deductible
In addition to your health insurance premium, you also pay a monthly contribution to mandatory long-term care insurance under private health insurance.
Premium development in private health insurance
The premiums for private health insurance are calculated for a group of insured people of the same age at the start of insurance. They must cover the insurer’s expenses for this group during the entire insurance period. If this cover is no longer provided, premiums will be increased.
Individual premium increases due to frequent or long-term illnesses are generally not possible.
Between 2013 and 2023, private health insurance premiums rose by 2.8%, while premiums for statutory health insurance increased by 3.4%.
To keep premiums stable in retirement age, private health insurance companies must build up old-age provisions for their policyholders and invest them at interest. The law stipulates old-age provisions of 10% of the monthly premium.
Applying for private health insurance
You can either apply for private health insurance directly with an insurance company of your choice or seek advice from an insurance broker, who should be an independent expert who does not work for specific insurance companies.
Health questions
You apply for private health insurance online. At its core are various health questions you must answer entirely and truthfully — otherwise, you risk losing your health insurance coverage.
The insurance company uses the health questions to calculate the risk associated with your insurance and the insurance premium. In the case of pre-existing conditions, insurers are entitled to charge risk surcharges, exclude certain illnesses from insurance coverage, or reject the insurance completely.
Waiting periods
If this is your first time having statutory or private health insurance in Germany, you must expect a waiting period of at least 3 months with all private health insurers. A waiting period of 8 months applies for childbirth, dental care, and psychotherapy. If you already had German health insurance before taking out the policy, the insurer will usually shorten the waiting period or waive it altogether.
There are generally no waiting periods after accidents and for subsequent insurance for spouses or children.
The best private health insurance in Germany
An insurance comparison will help you find a private health insurer and a tariff that best meets your needs. The Berlin-based FinTech company Getsafe can be beneficial here. Getsafe offers various insurance products for private consumers but does not offer comprehensive private health insurance—the company acts as a broker and advisor for private health insurance.
Our editorial recommendations are the private comprehensive health insurance from FinTech providers ottonova and Feather. Both insurers offer transparent and high-performance insurance tariffs and specialize strongly in the requirements of expats in Germany. They offer their websites, mobile apps, and personal consultations in German and English. You’ll be able to handle all insurance matters online.
ottonova insurance
ottonova is present on the market as a specialist for digital health insurance — in addition to private comprehensive insurance for the self-employed, employees, students and civil servants, the company offers private supplementary dental insurance, supplementary hospital insurance and company health insurance. In independent evaluations, ottonova regularly receives top marks.
ottonova’s private health insurance is available as regular and expat insurance, with a maximum term of 5 years.
ottonova´s regular health insurance tariffs
With ottonova, you can choose between the Premium Economy, Business Class Pro, and First Class Pro+ tariffs for your health insurance. An insured person aged around 32 pays €552, €615, or €654 per month (each with a 10% deductible/maximum of €500 per year without employer contribution). There is no provision for premium refunds.
You can flexibly configure the deductibles and daily hospital allowance, thus influencing the premium amount.
The insurance is valid worldwide. Visual aids, alternative practitioner treatments, and surgical corrections of visual acuity are covered at staggered amounts depending on the tariff. Dentures are reimbursed at 60%, 80% or 90%.
ottonova´s expat insurance
ottonova expat insurance is available in four tariffs:
- First Class: €167 per month, €500 deductible
- Premium Economy: €263 per month, €500 excess
- Business Class Pro: €325 per month, without deductible
- Business Class Pro: €352 per month, €500 excess
This insurance also offers worldwide coverage and includes all relevant medical benefits.
Feather insurance
In addition to comprehensive private health insurance, the insurance provider Feather offers a wide range of other insurance products, including private liability insurance, household contents insurance, supplementary dental insurance, pet health insurance, and dog liability insurance.
Private health insurance is available for a 30-year-old insured person in the Standard, Plus, and Premium tariffs from €236, €308, or €347 per month (without employer contribution, without deductible). Worldwide insurance coverage (outside the EU) is only valid for one month in each case. And Feather insurance reimburse medical practitioner costs.
Conclusion
You may now be wondering whether private health insurance is worthwhile. By choosing the correct tariff, you can tailor your insurance coverage to your needs. It is the better alternative to statutory health insurance, as it almost always offers significantly better healthcare.
If private health insurance is an option, you should benefit from affordable premiums as early as possible.
You can find particularly high-performance insurance offers from the digital insurers ottonova and Feather.
Frequently Asked Questions — FAQ
With private health insurance, you can almost always expect better benefits and usually lower premiums. However, there is no non-contributory family insurance in private insurance. This results in additional costs for families with children. However, many insurance companies offer particularly favorable rates for children and young people.
As a rule, no. Suppose you expect your income to rise again. In that case, you can take out qualifying insurance with your private health insurer to return to private insurance later without undergoing another medical examination. The qualifying insurance also retains the old-age provisions you have built up. Under certain conditions, however, you can be exempted from mandatory statutory health insurance.
If you work part-time after parental leave and your income from a full-time job is above the compulsory insurance limit, you can remain privately insured without any problems.
With a few exceptions, returning to statutory insurance is no longer possible after age 55.
The basic tariff in private health insurance is prescribed by law. It is available to everyone who can or must take out private insurance. Benefit exclusions, risk surcharges, or refusal of insurance are not possible in this tariff. Its scope of benefits corresponds to that of statutory health insurance. The insurance premium in the basic tariff may be, at most, the maximum premium for statutory insurance. If financial need exists or would be triggered by the insurance premium, the premium can be halved or paid by the social authorities. Returning to a previous regular tariff within two years without a new health check and losing old-age provisions is possible.