Just compulsory health insurance or is it better to have private health insurance? If you can afford it, for some people it is almost an emotive topic in the “buy or rent” category. But when does it really make sense to switch from statutory health insurance (GKV) to private health insurance (PKV)? And what is the best way to proceed?

First of all, you have to know that this change is usually a lifelong decision: once you switch to private health insurance, it is no longer so easy to return to compulsory health insurance. But you may want to do this: for example, because you can no longer afford the regular increase in PKV contributions, for example during retirement or if your income is not kept up to date. Because, unlike the GKV, PKV contributions are independent of how much you earn or receive as a pension.

So think carefully about whether, in addition to advantages such as treatment by an experienced doctor or faster consultations, private health insurance will be financially beneficial to you in the long term. How to proceed:

1. Who can have private health insurance?

Firstly, you should check if you can switch to private health insurance.

  • You are employed: You will then only be able to switch to private health insurance if your gross income exceeded the so-called annual salary limit the previous year and remains so the following year, or directly if you exceed it by changing jobs. The limit usually increases each year: in 2024 it will be 69,300 euros.
  • Are you a civil servant or self-employed: With some exceptions, you will be free to choose between GKV and PKV, regardless of your income.
  • You study: You can then take out private health insurance at the beginning of your studies. The decision usually applies to the entire course of study. You can then return to work at GKV, unless you become self-employed immediately after completing your studies.

2. When does private health insurance make sense?

Just because you are allowed to have private health insurance doesn't mean it makes sense. You should definitely be sure that you can afford the contributions (in the long term). Therefore, you must definitely meet the following criteria:

You are still young and healthy: It is best to take out private health insurance if you are under 40 years old. Because part of the contributions are allocated to so-called retirement provisions. They make sure your contributions don't increase too much as you get older. For this to work, the insurance company must be able to save as much money as possible as quickly as possible. The later you switch to private health insurance, the more difficult it will be and your total contribution will increase significantly.

Plus, your medical history will probably be even smaller when you're younger. This also saves you high contributions. Unlike the GKV, a medical check-up is carried out before entering the PKV. If you have certain pre-existing conditions (for example, high blood pressure, diabetes or mental illness), this often results in a risk surcharge on your premium, or you only receive very few private health insurance offers.

You don't work in a risky job: Otherwise, you will also have to count on surcharges (e.g. as a roofer, demolition expert or specialist) and therefore a high overall contribution or only a small selection of rates. It is also difficult for jobs where insurers doubt whether you can afford long-term private health insurance (e.g. newsstand owner or showman).

Your family planning is already decided: Are you planning a family? You should know this exactly before deciding on private health insurance. Because that changes a lot: first of all, in private health insurance there is no free family insurance as there is in compulsory health insurance. Therefore, you will also have to insure your children privately and pay extra for this.

What to take into account when taking parental leave in private health insurance

Secondly, for most private health insurance rates, you must continue paying your contributions during parental leave; If you are employed, your employer's private health insurance subsidy, which is currently a maximum of 422 euros per month, will no longer apply. Then you will have to pay this amount additionally.

Thirdly, there is no child sickness benefit or similar aid in private health insurance. In general, families tend to be cheaper with mandatory health insurance.

You earn well or have assets (or are a public official): Above all, it is important that you not only earn well now, but that you can be sure that it will continue to do so. If you are employed, think carefully about how secure your job or industry is. If you are self-employed you should already know that your business model works sustainably. Or you have assets to be able to overcome difficult phases.

Because returning to statutory health insurance is difficult: the self-employed, for example, have to do it. B. return to employment, and if you are over 55, returning is generally almost impossible. You can read the exact conditions for returning to statutory health insurance in our financial advice guide.

If you are a public official, you will not only have a secure job, but at the same time the State will cover at least 50 percent of your health expenses: the so-called subsidy. Therefore, officials only have to secure the remaining expenses and come out considerably cheaper. Therefore, private health insurance is usually the best option for them.

There is even an 80 percent subsidy for children, as long as child benefit is paid. For this reason, private health insurance often makes sense for students if their parents are public servants. Otherwise, the GKV is usually the best option when it comes to studying, especially if you can have free family insurance through your parents' GKV.

3. How do you find a good PKV?

Do you meet all the criteria, have you thought carefully and are convinced that private health insurance is right for you? So make sure you know which services are indispensable and important. We have created a detailed service description (PDF) for you. Only then can you start looking for a suitable rate.

However, you should never look for your private health insurance yourself. There are simply too many different rates, insurers, and factors that determine which rate best suits your needs. Therefore, be sure to seek advice. Where? We have just examined the suitable insurance brokers in the financial guide Finanztip and selected them based on criteria such as experience, market coverage and the number of advisors.

On the consumer portal Finanztip we recommend Buddenbrock Concepts, BVLG – Public Service Delivery Made Easy, Hoesch and his partner Dr. Dieter Homburg, independent financial advisory center and financial specialists from Schlemann.

Decide for yourself whether you really should have private health insurance

Important: Just let the intermediaries advise you on choosing the right rate, but do not expect a neutral assessment as to whether you should take out private health insurance. You must make this decision yourself beforehand using our criteria above.

It is best to bring the general description of the Finanztip service to the consultation. This means that you will be able to directly compare during the conversation which rate best covers your needs. You can also use our checklist (PDF) for the consultation itself, which will allow you to check whether you have discussed all the important points. You can read all the details in our PKV financial advice guide.