Question 1

What is the difference between public and private health insurance?

Accepted Answer

Public health insurance (GKV) is the solidarity system: contributions are based on income, not age or health. Family members without income are covered for free. Private health insurance (PKV) calculates individual premiums based on age, health status, and chosen coverage. Each person needs their own contract. GKV offers standardized basic benefits, while PKV allows individual packages with often shorter waiting times and chief physician treatment.

Question 2

At what salary can I switch to private insurance?

Accepted Answer

As an employee, you must exceed the annual earnings threshold (JAEG) to switch to PKV. In 2026, this is EUR 73,800 gross per year (EUR 6,150/month). Self-employed and civil servants can choose freely regardless of income. Important: the salary must permanently exceed the JAEG, not just temporarily.

Question 3

How much is the public insurance contribution in 2026?

Accepted Answer

The general GKV contribution rate in 2026 remains 14.6% of gross income (up to the assessment ceiling of EUR 66,150/year). Additionally, each insurer charges an individual additional contribution averaging 1.7% in 2026. Employer and employee split both contributions equally. Long-term care insurance adds 3.4% base rate (childless persons over 23 pay a 0.6% surcharge).

Question 4

Are children really covered for free in public insurance?

Accepted Answer

Yes, children can be covered for free through family insurance in the GKV as long as they have no income above the marginal employment threshold. This applies until age 18, or until 25 if in education or university. In PKV, each child needs their own contract — which can become expensive with multiple children.

Question 5

Why do private insurance premiums rise so much with age?

Accepted Answer

PKV premiums rise for two reasons: medical utilization increases with age, and premium adjustments become necessary due to rising healthcare costs and medical advances. While PKV insurers build age provisions (Alterungsrueckstellungen), these often aren't sufficient to fully offset premium increases. On average, PKV premiums rise about 3% annually.

Question 6

Can I join public insurance as a freelancer?

Accepted Answer

Yes, freelancers can voluntarily remain in or return to GKV if they meet the requirements. The minimum contribution is based on a fictional minimum assessment basis. However, self-employed pay the full contribution without an employer share. Whether GKV or PKV is cheaper depends on income, age, health, and family situation.

Question 7

Can I switch back from private to public insurance?

Accepted Answer

Switching back from PKV to GKV is only possible under specific conditions: your income must fall below the JAEG (e.g., through part-time work or job change), or you become unemployed. After age 55, returning to GKV is virtually impossible — even with declining income. This age limit is legally enshrined with very few exceptions.

Question 8

Why is private insurance so cheap for civil servants?

Accepted Answer

Civil servants receive Beihilfe from their employer: 50% of medical costs are covered (70% for married, 80% for children). PKV only needs to cover the remainder, resulting in significantly lower premiums. Since GKV doesn't account for Beihilfe and charges full contributions, PKV is almost always more economical for civil servants.

Question 9

What happens to my private insurance if I become unemployed?

Accepted Answer

When receiving unemployment benefits (ALG-I), you typically become mandatory GKV-insured, with the employment agency paying contributions. The same applies for ALG-II (Buergergeld). Those who opt out of mandatory insurance can stay in PKV, with the agency paying a subsidy equal to the GKV contribution. After unemployment, you may be able to return to PKV.

Question 10

Is a high deductible in private insurance worth it?

Accepted Answer

A higher deductible significantly reduces monthly PKV premiums: with EUR 1,200 deductible, you typically save 20-25% compared to no deductible. Whether it's worthwhile depends on your health. If you rarely visit the doctor, a high deductible can pay off. But in years with treatment needs, you pay more out of pocket. A middle option (EUR 300-600) often offers the best compromise.

Guide: Health Insurance Comparison Calculator

Public vs Private Health Insurance in Germany 2026: The Honest Comparison — Who Benefits from Private Insurance?

GKV Additional Contribution 2026: Which Health Insurer Is Cheapest?

Private Insurance as an Employee: When Can You Switch and When Should You?

Switching Back from Private to Public Insurance: Is It Still Possible?

Family Insurance in GKV: Who Is Covered for Free and What Are the Limits?

Private Insurance in Old Age: Why Premiums Rise and What Age Provisions Do