Best Private Health Insurance in Germany
Which PKV plan is best for expats in Germany? We break down what makes a good private health insurance plan and what to look for by age, income, and situation.
There is no single "best" private health insurance plan in Germany, the right PKV depends on your age, health, employment situation, and what you actually want covered. What there is: a clear framework for deciding, and a set of providers that consistently perform well for expats.
What makes a PKV plan good?
PKV plans differ on four main dimensions. Price is only one of them, and often not the most important one.
How much has this insurer raised premiums over the past 10–15 years? Some providers have a track record of stable premiums; others have increased significantly. A cheap plan today that doubles in 10 years is not a good deal.
What's actually included? Look at: dental (crowns, implants), vision (glasses, contact lenses), alternative medicine, mental health, inpatient and outpatient treatment. A basic plan can leave you with significant out-of-pocket costs.
How quickly does the insurer pay? Do they have an English-language service line? Do they dispute claims frequently? This matters far more than it seems, you won't know until you actually need to claim.
PKV is a long-term contract. The insurer needs to still be solvent in 30–40 years. Larger, established providers have stronger capital reserves and are rated accordingly.
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Best plan by situation
The "best" PKV for a 28-year-old employee earning €90k is very different from the best plan for a 42-year-old freelancer. Here's how to think about it by situation, including which providers consistently perform well in each case:
| Situation | What to prioritise | Providers often recommended |
|---|---|---|
| Young expat employee (25–35), healthy | Broad coverage, English service, premium stability, strong dental | AXA (English-language support, international network), Hallesche (comprehensive plans), Ottonova (fully digital, expat-friendly app) |
| Employee over 40 | Insurer's rate-increase history over 15 years, avoid high deductibles | Debeka (largest insurer, historically stable premiums), Barmenia (competitive mid-range) |
| Freelancer / self-employed | Krankentagegeld (sick pay) from day 1 or day 7, essential. Cost vs full GKV rate. | Signal Iduna (strong freelancer sick-pay bundles), Hallesche, AXA |
| Family with children | Each child needs own PKV policy, run total cost incl. children vs GKV family | GKV often wins for 2+ children. If PKV: Debeka and Barmenia have competitive child rates. |
| Civil servant (Beamte) | Beihilfe-Ergänzungsplan only, covers the portion Beihilfe doesn't (50–30%) | Debeka (market leader for civil servants), DKV, Barmenia |
| Expat planning to stay long-term | Worldwide coverage, English-speaking claims team, no repatriation gaps | AXA, Ottonova (English app and support), Feather (English-first broker + plans) |
These are starting points, not a ranking. Premiums are personalised, two 30-year-olds can get very different quotes from the same insurer. Always get a comparison for your specific age, health history, and situation. A broker who accesses the full market will find options a single provider never shows you.
Key benefits to compare between plans
When comparing PKV plans, these are the specific benefits that vary most and matter most in practice:
- Dental: Does it cover crowns and implants, or just fillings? What's the annual limit?
- Vision: Glasses and contact lenses, annual allowance and how often?
- Mental health: Number of psychotherapy sessions covered, waiting period
- Alternative medicine (Heilpraktiker): Naturopath treatments, physiotherapy beyond standard
- Inpatient: Private room, chief physician (Chefarztbehandlung), included or optional?
- Sick pay (Krankentagegeld): Essential for freelancers, from which day, how much per day?
- Deductible (Selbstbehalt): A higher deductible lowers monthly premium but means you pay more when you claim. Only useful if you're healthy and rarely use healthcare.
- Return premium (Beitragsrückerstattung): Some plans refund 1–3 months of premiums if you submit no claims. Sounds good, but can discourage you from using the insurance you're paying for.
Major PKV providers in Germany
Germany has over 40 private health insurers. These are the most commonly recommended for expats and employees, each with different strengths:
| Provider | Known for | Good for |
|---|---|---|
| Debeka | Largest PKV insurer in Germany, very stable premiums, good claims service | Long-term stability, civil servants |
| Hallesche | Strong comprehensive plans, good dental and alternative medicine coverage | Employees, freelancers wanting broad coverage |
| AXA | International network, English-language service | Expats, people who travel frequently |
| Barmenia | Competitive mid-range plans, good dental | Price-conscious employees |
| Signal Iduna | Strong freelancer products including sick pay bundles | Self-employed, freelancers |
| Gothaer | Solid mid-range, good mental health coverage | Employees looking for balanced plans |
Important: Provider rankings change over time as plans are updated and premiums shift. Never choose based on a list, always get a current comparison for your specific age, health, and situation.
How to find your best PKV plan
Every insurer only shows you their own products. You'll never know if a competitor offers better coverage for less. Always compare across the market.
A good broker who works with multiple insurers can run a proper comparison for your exact situation, age, health history, required coverage, budget. This costs you nothing; the broker is paid by the insurer.
Look at the same coverage level across multiple providers. Focus on what's included, not just the monthly premium. The cheapest plan is rarely the best value over 10+ years.
Ask your broker how much this insurer has raised premiums over the last 10–15 years. This is public data. An insurer that raises premiums 3–4% annually will cost dramatically more in 20 years than one that raises 1.5%.