Private Health Insurance in Germany

The complete guide to private health insurance (PKV) in Germany for expats. Compare the top providers, understand costs, and find the right plan, all explained in English.

10 min read Updated 2026-03-01

Written by Marco Maurelli

Germany has one of the most complex health insurance systems in the world, and if you earn above a certain threshold, you have a choice most people never realise exists. Private health insurance (PKV) is not just for wealthy Germans. It's available to any employee earning over €77,400/year, all self-employed people, and civil servants, regardless of nationality.

This guide covers everything: what PKV is, who qualifies, which providers are worth considering, and how to figure out whether it makes financial sense for your situation.

What is PKV (Private Krankenversicherung)?

PKV stands for Private Krankenversicherung, Germany's private health insurance system. Unlike the public system (GKV), PKV premiums are based on your age and health status, not your income. This single difference makes PKV dramatically cheaper for most working-age expats.

Flat premium
Your premium doesn't rise with your salary. Earn more, pay the same.
Faster access
Priority specialist appointments. Private hospital rooms. Chief physician treatment.
Better coverage
Dental, vision, alternative medicine, most PKV plans cover far more than GKV.
Cannot be cancelled
PKV contracts in Germany are legally protected. You cannot be dropped for getting sick.

Who qualifies for PKV in Germany?

Eligibility depends on your employment status:

✓ Eligible
Employees earning €77,400+/year
The Jahresarbeitsentgeltgrenze (JAEG) for 2026 is €77,400 gross. If your salary exceeds this, you can opt out of GKV and join PKV. Your employer still pays half your premium (up to ~€440/month).
✓ Eligible
Self-employed & freelancers
No income threshold applies. Self-employed people can join PKV at any income level. Given that GKV costs €900–1,300/month for the self-employed, PKV is often the only financially viable option.
✓ Eligible
Civil servants (Beamte)
The German state pays a Beihilfe (subsidy) of 50–70% of medical costs for civil servants. PKV covers the rest. Nearly all civil servants use PKV as a result.
✗ Not yet eligible
Employees earning below €77,400
You must stay in GKV until your salary exceeds the €77,400 threshold. Once you cross it, you can apply for PKV, there is no mandatory waiting period.

Long-term expats: If you've been in Germany for several years and your salary has been above €77,400, you may have been eligible to switch to PKV for some time, and simply didn't know. Switching is still possible. The only way to know for certain is to have a specialist check your situation, which we do for free.

Top PKV providers in Germany

There are over 40 PKV insurers in Germany. Most are traditional, they require health questionnaires, have strict underwriting, and offer comprehensive coverage. A few are digital-first and more expat-friendly. Here's an honest overview of the major players:

Traditional
Germany's largest insurer. Comprehensive coverage, strong brand recognition, wide network. Higher premiums but excellent service and stability.
  • Excellent coverage and benefits
  • Trusted brand, 130+ years in Germany
  • Strong dental and vision coverage
Best for: Those who want premium coverage and don't mind a higher price
Traditional
Consistently rated one of the best PKV providers in Germany by independent comparison portals. Excellent value for coverage quality. Highly recommended for expats by specialists.
  • Top ratings from Stiftung Warentest
  • Competitive premiums for excellent coverage
  • Strong Alterungsrückstellungen (age reserves)
Best for: Expats wanting best-in-class coverage at competitive price
Traditional
Mid-market provider with flexible plan structures. Good for expats with families, their family plans are competitive. Solid customer service and digital app.
  • Flexible tariff structures
  • Good family plan options
  • Reasonable premiums
Best for: Expats with families, value-focused buyers
Traditional
Known for competitive entry-level plans and flexible upgrade options. Popular with younger expats and those new to PKV who want good value without overcommitting on coverage level.
  • Competitive entry-level premiums
  • Good upgrade pathways as income grows
  • Solid coverage fundamentals
Best for: Younger expats, value-conscious buyers
Traditional
Germany's largest PKV insurer by membership. Originally focused on civil servants, now open to all eligible groups. Known for stable premium increases over time.
  • Germany's largest PKV provider
  • Historically stable premiums
  • Strong reserves and financial stability
Best for: Long-term stability seekers, civil servants
Traditional
International brand with strong presence in Germany. Good option for expats who value an internationally recognised insurer. Offers comprehensive plans with good international coverage.
  • International brand, globally recognised
  • Good international coverage clauses
  • Comprehensive plans available
Best for: Expats who travel frequently or may relocate
Digital-first
Germany's first fully digital PKV. App-based claims, digital doctor consultations, English-language support. Popular with younger tech-savvy expats. Higher premiums for the digital experience.
  • Full English language support
  • App-based claims and management
  • Telemedicine included
Best for: Expats who want English support and digital experience
Classic
Mid-sized German insurer with a strong reputation in PKV, travel, and expat health insurance. Competitive premiums, solid coverage, and a track record of reliable claims handling.
  • Competitive PKV premiums
  • Strong coverage for specialists and dental
  • Good claims record and financial stability
Best for: Expats looking for solid coverage at competitive rates

Important: Premiums above are illustrative estimates. Your actual premium depends on your age, health history, chosen coverage level, and deductible (Selbstbehalt). Two people the same age can pay very different premiums. Always compare personalised quotes before deciding, which is exactly what a specialist broker does for you, for free.

GKV vs PKV cost calculator

Calculate your premium

Answer 4 quick questions. We'll show your exact public health insurance (GKV) cost and a realistic private health insurance (PKV) estimate side by side — based on 2026 rates.

Step 1 of 4

What's your employment situation?

What does PKV cost in 2026?

PKV premiums are based on three things: your age when you join, your health status, and your chosen coverage level. Here are realistic ranges for a healthy person joining today:

Age at entryPKV monthly premiumGKV at €90k salaryMonthly saving
25–30€200–280/month~€730/month~€450–530
30–35€260–350/month~€730/month~€380–470
35–40€300–420/month~€730/month~€310–430
40–45€370–500/month~€730/month~€230–360
45–50€430–600/month~€730/month~€130–300

Employer subsidy: If you are employed, your employer pays half your PKV premium, up to the amount they would pay for GKV (currently ~€440/month). This effectively halves your out-of-pocket cost for most plans.

Average annual saving (employed, age 30–40, salary €90k)
€2,880 – €3,600 / year
Most expats who switch save €240–300/month net of employer subsidy

PKV vs GKV at a glance

GKV (Public)PKV (Private)
Premium basis% of incomeAge + health
Employer contribution~50% (capped)~50% (capped at GKV equivalent)
Family membersFree if not workingSeparate premium per person
Specialist accessVia GP referral, long waitsDirect access, short waits
Hospital roomShared wardPrivate/semi-private room
DentalBasic onlyComprehensive (plan-dependent)
VisionNot coveredCovered (plan-dependent)
Can be cancelled by insurerNoNo
Premiums rise with ageOnly if income risesYes, but reserves slow this

How to choose the right PKV provider

Choosing PKV is one of the biggest financial decisions you'll make in Germany. Getting it wrong, picking the wrong provider, wrong coverage level, or wrong deductible, can cost you thousands over time. Here's what actually matters:

1
Coverage quality, not just premium

The cheapest plan is rarely the best. Look at what's actually covered: dental, vision, inpatient/outpatient, alternative medicine, mental health. A €30/month saving can cost you €3,000 when you need treatment.

2
Alterungsrückstellungen (age reserves)

Every PKV insurer must legally build age reserves to keep premiums manageable as you get older. Check a provider's track record on premium increases over time, not just their entry rate.

3
Deductible (Selbstbehalt)

A higher Selbstbehalt lowers your monthly premium. €600–1,200/year deductible is common. Only choose a high deductible if you're healthy and rarely use healthcare, it's not always worth it.

4
Sick pay (Krankentagegeld) if self-employed

If you're self-employed, add Krankentagegeld (sick pay) to your plan. You have no employer sick pay. PKV sick pay kicks in from day 1 or day 7, essential protection if you're ill for any length of time.

5
Never compare alone

There are 40+ insurers with hundreds of plan variants. Reading through German-language insurance contracts is slow and error-prone. A specialist broker compares the whole market and explains your options in English, for free.

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Common questions about PKV

Can I get PKV if I'm not German?
Yes. PKV eligibility has nothing to do with nationality. As long as you meet the income threshold (if employed) or are self-employed, you can join PKV regardless of where you're from.
What if I have a pre-existing condition?
PKV insurers can exclude pre-existing conditions, charge a loading (higher premium), or in rare cases decline you. Minor conditions are usually fine. Serious ongoing conditions may result in exclusions for related treatment. A specialist broker knows which insurers are most lenient with which conditions.
Can I switch back to GKV if things change?
Yes, but with conditions. If your salary drops below €77,400 and you become employed, you must return to GKV. If you remain self-employed, switching back is difficult after age 55. This is why the decision should be made with long-term thinking in mind.
What happens if I leave Germany?
Most PKV contracts can be suspended or cancelled if you permanently leave Germany. Some providers offer international coverage. If you plan to leave within 1–2 years, PKV may not be worth the switching effort.
Is PKV worth it if I have a family?
It depends. GKV provides free coverage for non-working spouses and children, a significant benefit. PKV charges a separate premium per family member. If you have a non-working partner and two children, GKV's family coverage can outweigh PKV savings. Run the numbers with a specialist before deciding.
How long does PKV approval take?
Typically 2–4 weeks from application to confirmed approval. The health questionnaire is the main variable, insurers may ask follow-up questions. Most healthy applicants under 45 are approved without issue within 2 weeks.