Not everyone can join Private Health Insurance (PKV) or will be accepted. Eligibility depends on income level, age, and health condition. It is therefore important to carefully evaluate the long-term implications before deciding to leave the statutory system.

Young, healthy, and well-earning individuals who are not subject to German social insurance contributions are typically welcomed by private insurers and often benefit from lower initial premiums combined with enhanced medical benefits.
However, unlike the GKV, there is no free family co-insurance and no reduced contribution rate for pensioners (KVdR).
Once insured privately, a return to the statutory system after the age of 55 is generally excluded.

The situation becomes more complex when privately insured employees or self-employed individuals marry or have children.
In PKV, every insured person — including children — must pay their own premium, whereas in GKV, the family insurance principle applies.
If one spouse is privately insured and the other is statutory, the question of where the children are insured depends on the income and insurance status of the higher-earning parent.
If that parent is privately insured, the children cannot be covered free of charge under the statutory family insurance and will require a separate paid contract, both in PKV or GKV.

Reasons for choosing private insurance, provided one is eligible and healthy enough to be accepted after detailed health questioning, often include:

• Lower initial cost for single, high-income individuals without dependents.
• Extended benefits such as chief-physician treatment, hospital comfort, shorter waiting times, and broader coverage for dental and optical care.
• Configurable tariffs ranging from economical to all-inclusive, allowing precise adjustment of coverage level and excess.

The topic of private health insurance is too complex for a quick online comparison.
Tariffs must be individually tailored to each person’s income, age, occupation, health, and family situation.
We provide independent consultation by

phone +49-611-945892402

or in person in the Rhein-Main area (Wiesbaden – Frankfurt – Mainz).
Our office is located approximately just 40 minutes from Frankfurt Airport on public transport.

Legal framework: Individual contracts are based on age, health, and selected benefits (VVG § 193, VAG § 152).
Capital funding with age reserves helps stabilize premiums in later life.
The Basistarif ensures mandatory acceptance under social conditions similar to the GKV.

Start PKV comparison (external calculator)

Back to top ↑

For clients who want a compact overview of private health insurance in Germany, we provide a factsheet from a major German private health insurer that we can offer where suitable. It summarises the main advantages of a PKV contract compared to statutory health insurance.

• Lifetime stable benefits with individually selectable coverage levels (contractual, not dependent on political reforms).
• Free choice of doctors and hospitals, often including top specialists and premium clinics.
• Faster access to appointments and shorter waiting times for diagnostics and treatment.
• Extended preventive care with additional screenings and modern diagnostic options beyond the statutory catalogue.
• Superior dental coverage, especially for implants and high-quality restorations.
• More treatment options in serious illness, including access to specialised clinics, innovative therapies and enhanced inpatient comfort (1–2 bed rooms, consultant treatment).
• Income-independent premiums, calculated based on age, health status and chosen coverage, supported by legally required old-age reserves to help stabilise premiums in later life.

You can download the original factsheet (in German) here:

Download PKV factsheet (PDF, German)

During a consultation we can go through this factsheet with you in English and compare these benefits with other providers and with the statutory system.

Back to top ↑

For clients who prefer to work in English, we provide an AI-translated application document that can be used
for full applications as well as for non-binding risk pre-assessments (preliminary underwriting requests).

• Suitable for private health insurance (PKV) and long-term care insurance.
• Can be used to request an anonymous quotation as well.
• For any official contract conclusion, a signed German version may be required by the insurer. We will gladly help you with this.
• Get a quote here (use your browser translation)

Download English PKV application (PDF)

If you are unsure whether to use the English form as a full application or only for a risk pre-assessment,
please contact us directly:

jb@vmwi.net
+49 611 945 89 2402

If you speak German and prefer a fillable document, please use the

German original PDF application

and send it back to us once completed.
You may still use the
English version
as a translation aid. This can help you avoid having to fill out the forms twice.

Back to top ↑

*Draft values as of Nov 2025; final confirmation pending by ordinance.

Back to top ↑

GKV – Health contribution

• General rate: 14.6% of gross income (up to BBG), split 50/50 → 7.3% employer / 7.3% employee.
• Additional contribution (Zusatzbeitrag): fund-specific percentage on top of 14.6%; shared equally since 2019.
• Illustration: with a 1.6% Zusatzbeitrag the split is 0.8% each. On the 2026 BBG (€5,812.50/month) that is about €470.81 per side for health insurance alone.

Long-term care insurance (Pflegeversicherung, PV)

• Base rate: 3.4% of income up to the PV-BBG (same value used here for simplicity), split 50/50 → 1.7% employer / 1.7% employee.
• Childless surcharge: +0.6% employee-only. Thus employee PV share becomes 2.3% when childless; with children it stays 1.7% (can reduce further per child depending on rules).
• Illustration (BBG 2026): employer PV ≈ €98.81/month (1.7% of €5,812.50). Employee PV ≈ €98.81/month with children; €133.69/month if childless (2.3%).

Back to top ↑

Self-employed pay the entire GKV contribution themselves (14.6% + Zusatzbeitrag + PV up to the BBG). A minimum assessment base applies even when income is low. PKV may offer lower entry prices but brings medical underwriting and long-term commitment.

Back to top ↑

Employees insured in PKV receive an employer subsidy towards their private premiums:

• Employer pays 50% of the actual PKV premium (incl. private long-term care), but only up to what the employer would pay in GKV/PV at BBG level.
• Monthly cap formula: BBG × (7.3% + half of fund’s Zusatzbeitrag) for health + BBG × 1.7% for care. The 0.6% childless surcharge is employee-only.
• Illustration with 1.6% Zusatzbeitrag: cap ≈ €569.63/month. Employer pays the lower of 50% of your PKV total or this cap.

Back to top ↑

• Default is the KVdS student scheme (reduced statutory rate with an estimated minimum of ~€110–€120/month incl. PV; varies).
• Opt-out within 3 months of enrolment; decision is binding for the study period (§ 8 SGB V).
• Family cover until 25 if income limits apply (§ 10 SGB V).
• PKV student tariffs can be cheaper at entry; review benefits and later premium steps carefully.
• Outgoing semesters and non-EU incomings: student travel/incoming insurance.

Back to top ↑

Beihilfe typically covers 50% (children up to 80%) of eligible costs; the remainder is insured via a beihilfe-compliant PKV. Some states offer an alternative flat employer allowance towards GKV.

Back to top ↑

Returning EU/EEA/Swiss citizens at older age may face limits when re-entering GKV. Admission generally requires previous GKV membership or provable equivalent cover in an EU system. Without this, PKV Basistarif may be the only option. Plan re-entry before return to Germany to avoid gaps.

Back to top ↑

• Appointments: PKV patients often receive faster specialist appointments (GOÄ higher reimbursement; no EBM budgeting).
• No quick switching: moves between GKV and PKV are structurally limited; choices are typically long-term.
• Decide on benefits, not only price: consider access to specialists, family coverage, long-term contribution path, and portability.

Back to top ↑

GKV: dental, hospital add-on (single/double room, chief physician), ambulatory extras, and travel cover.
PKV: ambulatory/inpatient/dental upgrades, daily sickness allowance, retirement contribution relief, international cover.

Compare hospital add-on plans (for GKV)

Back to top ↑

Often mandatory for visas; covers private treatment and repatriation. Ideal for students, au pairs, visitors and expats.

Travel & Incoming Plans (Schengen compliant)

Back to top ↑