Switching to Private Health Insurance in Germany
Want to switch from public (GKV) to private health insurance (PKV) in Germany? Here's the complete step-by-step guide, eligibility, timing, process, and what to watch out for.
Switching from GKV to PKV in Germany is entirely possible, and for many expats, it's one of the best financial decisions they make. But you need to do it right. The process has rules, timelines, and a few traps for the unwary.
The good news: if you qualify, the actual switch is straightforward. It usually takes 2–4 weeks from first conversation to confirmed PKV policy. This guide walks you through every step.
Can you switch to PKV?
Your eligibility to leave GKV depends on your employment status and income.
- Your gross annual salary is above €77,400 (the 2026 JAEG threshold)
- You have been above the threshold for at least 12 months in a row, OR you've crossed it due to a pay rise and the new salary is confirmed for the coming year
- You are not in a Minijob or apprenticeship contract
- There is no income threshold for the self-employed
- You can switch to PKV from day one of self-employment
- You are responsible for 100% of your own premium (no employer subsidy)
- GKV costs you €900–1,300+/month as a freelancer, PKV is almost always cheaper
Timing for employees: If you crossed the €77,400 threshold with a salary increase this year, you can typically switch from January 1 of the following year. However, if your new salary was above the threshold for the full previous calendar year, you may be able to switch immediately. Your HR department or a broker can confirm your exact date.
Step-by-step: how to switch from GKV to PKV
Check your gross annual salary against the 2026 JAEG threshold of €77,400. If you're an employee, verify with your HR whether your salary meets the threshold. If you're self-employed, you're eligible regardless of income, just confirm you're registered as selbstständig.
There are 40+ PKV providers in Germany with hundreds of plan configurations. Going directly to one insurer means you only see their products. A broker who advises across the whole market, like MyHealthcareBroker, will compare providers, identify the right plan for your profile, and present the options clearly in English. This service is free to you.
Every PKV application requires a medical history questionnaire. Typical questions cover hospital stays in the past 5 years, chronic conditions, ongoing medications, mental health treatment, and surgeries. Answer truthfully, any material misrepresentation can void your contract later. A good broker will help you interpret each question correctly.
Once the insurer approves your application, they'll issue a Versicherungsschein (policy confirmation) with your start date, premium, and coverage details. Review this carefully. Your broker will check it with you. Only proceed to the next step once you have this in hand.
Send a written cancellation to your current Krankenkasse. GKV requires 2 months' notice, effective at the end of a month. Include your membership number and requested end date. You must also attach your PKV confirmation, GKV will only accept your cancellation if you can prove you have alternative coverage arranged. Never leave a gap.
Notify your HR or payroll team that you've switched to PKV and provide your new insurer's bank details. Your employer will stop paying the GKV contribution split and will instead pay the Arbeitgeberzuschuss (employer PKV subsidy) directly into your salary. This is capped at approximately €450/month in 2026.
The health questionnaire, what to expect
The health questionnaire is the part of the PKV application that most people are nervous about. Here's what you actually need to know.
What's typically asked
- Hospital stays and inpatient treatments in the past 5 years
- Ongoing medications or treatments
- Chronic conditions (diabetes, heart conditions, autoimmune disorders, etc.)
- Mental health treatment (therapy, psychiatric medication) in the past 5 years
- Surgeries in the past 5–10 years
- Known diagnoses that are being monitored
What happens with pre-existing conditions
Pre-existing conditions don't automatically disqualify you. Depending on the condition and insurer, they may lead to:
- Standard acceptance: minor or resolved conditions often have no impact
- A premium surcharge (Risikozuschlag): for higher-risk conditions
- An exclusion clause (Ausschluss): that specific condition is excluded from coverage
- Decline: in rare cases with very serious ongoing conditions
The golden rule: Always disclose fully and honestly. If you conceal a condition and later make a claim related to it, the insurer can void your policy. The downside risk of non-disclosure is far greater than any short-term premium saving. A broker will help you frame your answers correctly within the truth.
The younger and healthier you are, the simpler this process tends to be. Every year you wait in GKV is potentially another year of health events that need to be disclosed.
When is the best time to switch?
Unlike some European insurance systems, you don't have to wait for an annual enrollment window. You can switch from GKV to PKV at any point in the year, provided you meet the eligibility criteria.
Most popular. Aligns with annual salary increases and the new JAEG threshold. Clean cut for tax purposes. Also means you get the employer subsidy from the first payroll of the year.
Perfectly valid. PKV takes effect from the date you choose (must align with end of GKV notice period). Common when people change jobs or receive a significant pay rise that pushes them over the threshold.
GKV requires 2 months' notice from the end of the month. So if you want to start PKV on January 1, your GKV cancellation needs to be submitted by October 31. Plan ahead.
The best time to switch is as soon as you qualify. Every year you spend in GKV above the threshold is money left on the table, and your PKV premium will be slightly higher next year than this year.
Can you switch back to GKV?
Yes, but only under specific conditions. Contrary to popular belief, switching back is not impossible. But it's not automatic either.
Most people in PKV do not want to switch back. If you joined young and healthy, your PKV coverage is better and often cheaper than GKV would be, and you've built up actuarial reserves that reduce future premium growth. The fear of being "stuck" in PKV is largely overstated.
Common mistakes to avoid
Never, under any circumstances, cancel your GKV before you have written confirmation of your PKV policy in hand. A gap in health coverage in Germany is both dangerous and potentially illegal. The sequence must be: PKV confirmed → GKV cancelled.
If you contact a PKV provider directly, they will only show you their own plans. There are 40+ PKV insurers in Germany. The best plan for your profile might be with a company you've never heard of. Always use a broker who compares the full market.
Every year you delay costs you in two ways: you continue overpaying GKV, and your PKV entry premium will be slightly higher (because you're a year older). If you qualify today, the best time to act is now.
Withholding or understating health conditions on the PKV questionnaire can void your contract entirely if the insurer discovers a material misrepresentation. Always disclose fully. A good broker will help you do this correctly.
The cheapest PKV plan is often the worst option. Low-premium plans may have high deductibles, exclusions, or poor hospital coverage. Compare coverage terms, not just monthly cost. A broker will help you see the full picture.