Private Health Insurance Cost in Germany

How much does health insurance cost in Germany? Real 2026 cost breakdowns for GKV and PKV by income, age, and employment status, with actual monthly figures.

8 min read Updated 2026-03-01

Written by Marco Maurelli

Health insurance in Germany is not cheap, but the difference between what you pay in GKV and what you could pay in PKV 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
Note on the cap: GKV contributions stop increasing once your salary exceeds the Beitragsbemessungsgrenze (€5,812.50/month in 2026). This is why your GKV cost is essentially identical at €80k and at €120k, but your PKV cost does not rise with income at all.

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.

PKV costs by age (2026)

Unlike GKV, PKV 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 PKV plan (good hospital coverage, extended dental, vision) for a healthy person without pre-existing conditions:

Age at entry Monthly PKV 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 PKV 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 PKV, your employer does not simply stop paying their GKV contribution. They are required by law to pay a subsidy toward your PKV premium.

The subsidy is 50% of your PKV premium, up to a maximum that mirrors the employer's GKV contribution, in 2026, this cap is approximately €450–460/month.

Example: Employee, age 36, PKV premium €360/month
PKV gross premium€360
Employer pays (50%)−€180
Your net out-of-pocket€180/month
GKV cost (same person)€523
Monthly saving−€343/month
Annual saving€4,116/year

The employer subsidy is one reason PKV 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.

GKV for self-employed in 2026
At €60,000/year income
~€820–900/month
At €80,000/year income
~€1,000–1,100/month
At the contribution ceiling
~€1,100–1,300/month
GKV includes Pflegeversicherung (nursing care levy). Rates include the employer's share, which the self-employed pay themselves.

PKV 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.

Employment status GKV cost (€80k income) PKV 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 PKV typically saves €240–400/month net. Over five years that is €14,400–24,000.

Conservative estimate
€240/month
€2,880/year · €14,400 over 5 years
Typical case
€330/month
€3,960/year · €19,800 over 5 years
Self-employed
€700/month
€8,400/year · €42,000 over 5 years

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 PKV provides alongside those savings.

What determines your PKV premium?

Your PKV 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, 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.

Frequently asked questions

How much does GKV cost per month in Germany?
For an employee, approximately 9% of your gross salary up to the contribution ceiling. At €80,000/year, you pay around €520–525/month. Above the ceiling (~€70,000/year), your contribution is capped at ~€523/month regardless of how much more you earn.
How much does PKV cost per month in Germany?
It depends on your age and health at entry. For a healthy person in their 30s, a comprehensive PKV plan typically costs €280–380/month gross. After the employer subsidy (~€180/month), your net out-of-pocket is often €100–200/month, significantly less than GKV.
Does my employer pay for private health insurance in Germany?
Yes. If you switch to PKV, your employer is legally required to pay a subsidy equal to 50% of your PKV premium, capped at approximately €450–460/month in 2026. This subsidy makes PKV significantly more affordable for employees than for the self-employed.
Does health insurance get more expensive as you get older in Germany?
In GKV, premiums are income-based and do not directly increase with age. In PKV, premiums do rise with age, but Alterungsrückstellungen (aging reserves) slow this considerably. PKV contracts are also legally protected, you cannot be cancelled, and the reserves you build up stay with you. The key is to join PKV young.
Is PKV cheaper than GKV for expats in Germany?
For most expats earning above €77,400 who are under 45 and in reasonable health, yes, PKV is cheaper than GKV and provides better coverage. The savings are typically €240–370/month for employees and €600–900/month for the self-employed.
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