Health insurance in Germany is not cheap, but the difference between what you pay in GKV and what you could pay in private health insurance is often dramatic. If you earn above €77,400/year, the question is not just which system is better, but how much are you leaving on the table by staying in GKV.
This guide gives you the actual numbers, by salary, by age, by employment status, so you can compare your situation.
GKV costs by salary (2026)
GKV contributions are income-based. As an employee, you pay roughly 7.3% of your gross salary plus an additional contribution (Zusatzbeitrag) that averages around 1.7% in 2026, making the effective employee rate approximately 9.0%. Your employer pays the same share on top.
Contributions are capped at the Beitragsbemessungsgrenze: €5,812.50/month gross in 2026. Above this, your GKV contribution does not increase.
| Annual salary | Monthly gross | Your GKV share (~9%) | Employer GKV share | Total GKV cost |
|---|---|---|---|---|
| €60,000 | €5,000 | €450/month | ~€450/month | ~€900/month |
| €70,000 | €5,833 | ~€524/month | ~€524/month | ~€1,048/month |
| €77,400 | €6,450 | ~€523/month (capped) | ~€523/month | ~€1,046/month |
| €85,000 | €7,083 | ~€523/month (capped) | ~€523/month | ~€1,046/month |
| €100,000 | €8,333 | ~€523/month (capped) | ~€523/month | ~€1,046/month |
These are your employee share only. The employer pays an equivalent amount on top. For employed workers, the number that matters most is your out-of-pocket cost, the ~€520/month you see deducted from your payslip.
Private health insurance costs by age (2026)
Unlike GKV, private health insurance premiums are based on your age at entry, your health status, and the plan you choose: not your salary. The younger and healthier you are when you join, the lower your lifetime premiums.
The following figures are indicative for a standard mid-tier private health insurance plan (good hospital coverage, extended dental, vision) for a healthy person without pre-existing conditions:
| Age at entry | Monthly private premium (gross) | Employer subsidy (~€450) | Net out-of-pocket |
|---|---|---|---|
| 25–29 | €180–240/month | −€180–240 (fully covered) | €0–60/month |
| 30–34 | €240–320/month | −€240–320 (fully or near-fully covered) | €0–80/month |
| 35–39 | €300–380/month | −€300–380 | €0–130/month |
| 40–44 | €360–460/month | −€360–450 | €0–110/month |
| 45–49 | €430–560/month | −€450 | €0–110/month |
| 50–54 | €520–680/month | −€450 | €70–230/month |
The employer subsidy significantly reduces what you actually pay. For employees in their 30s and 40s, the net out-of-pocket private cost is often well below €150/month, a fraction of the €520+ they pay in GKV.
The employer subsidy explained
If you leave GKV and join private health insurance, your employer does not simply stop paying their GKV contribution. They are required by law to pay a subsidy toward your private premium.
The subsidy is 50% of your private health insurance premium, up to a maximum that mirrors the employer's GKV contribution, in 2026, this cap is approximately €450–460/month.
The employer subsidy is one reason private health insurance works out so well financially for employees, the benefit is built into the system. You effectively get a pay rise when you switch.
Health insurance costs for self-employed (2026)
For freelancers and self-employed people, the cost comparison is even more stark. There is no employer to pay half your GKV contribution, you pay the full amount yourself.
Private health insurance for a healthy self-employed person in their 30s typically costs €280–380/month: with no employer subsidy but also no income-based ceiling to worry about. The saving versus GKV is often €600–900/month. Self-employed buyers should also add Krankentagegeld (daily sickness allowance) to replace lost income while ill, since there is no employer sick pay.
| Employment status | GKV cost (€80k income) | Private cost (age 35, healthy) | Monthly saving |
|---|---|---|---|
| Employee | ~€523/month (your share) | ~€180/month (net, after employer subsidy) | ~€343/month |
| Self-employed / freelancer | ~€1,050/month (full rate) | ~€320/month (no employer subsidy) | ~€730/month |
What are the potential savings?
To put it plainly: if you are an employee earning above €77,400 and in your 30s or early 40s, switching from GKV to private health insurance typically saves €240–400/month net. Over five years that is €14,400–24,000.
These are real savings, not theoretical ones. They apply before you factor in the better coverage: shorter waiting times, better dental, vision, and worldwide protection, which private health insurance provides alongside those savings.
What determines your private health insurance premium?
Your private health insurance premium is calculated at the point of entry and is based on:
- Age at entry: the most important factor. Every year you wait increases your starting premium.
- Health status at entry: you complete a health questionnaire. Pre-existing conditions may result in surcharges or exclusions.
- Plan chosen: deductible level (Selbstbehalt), dental coverage, hospital room type, and other options all affect the premium.
- Insurer: premiums vary between providers for equivalent coverage. Comparison is essential.
- Gender: since 2012, insurers cannot price differently by gender (EU ruling), but age at entry remains a key variable.
Once you are insured, your premium can increase over time, but so-called Alterungsrückstellungen (legal aging reserves) are built into your contract from the start to slow this increase. These reserves, accumulated over years of contributions, are designed to keep premiums from rising as steeply in old age as they otherwise would.
The practical implication: join young. Every year you delay is a year of lower reserves and a higher starting premium. Someone who joins at 32 will almost always pay less over their lifetime than someone who joins at 42 for the same plan.