What is the difference between public and private health insurance?

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.

At what salary can I switch to private insurance?

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.

How much is the public insurance contribution in 2026?

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).

Are children really covered for free in public insurance?

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.

Why do private insurance premiums rise so much with age?

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.

Can I join public insurance as a freelancer?

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.

Can I switch back from private to public insurance?

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.

Why is private insurance so cheap for civil servants?

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.

What happens to my private insurance if I become unemployed?

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.

Is a high deductible in private insurance worth it?

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.

Private Insurance as an Employee: When Can You Switch and When Should You? | Health Insurance Comparison Calculator

The JAEG Threshold 2026: EUR 73,800

As an employee, you may only switch to PKV once your gross annual salary exceeds the annual earnings threshold (JAEG). In 2026, this is EUR 73,800 — equivalent to a monthly gross salary of EUR 6,150. This threshold is adjusted annually and typically rises moderately.

Important: the salary must permanently exceed the JAEG. A one-time bonus, overtime or temporary salary increase is not sufficient. Your employer reports the anticipated exceedance to the health insurer, which then issues an exemption from mandatory insurance. The JAEG should not be confused with the assessment ceiling (BBG) of EUR 66,150, which determines the maximum contribution in GKV.

Step by Step: How to Switch

The switching process follows clear steps. First, ensure your salary permanently exceeds the JAEG — ideally you already have a payslip that documents this. Then obtain PKV quotes and carefully compare tariffs. Pay attention not only to the current premium but also to the scope of coverage, the insurer's premium stability track record and the level of age provisions.

After selecting a tariff, apply to your GKV for exemption from mandatory insurance. After approval, cancel your GKV membership and join the PKV. Note the deadlines: the exemption must be applied for within three months of first exceeding the JAEG. If you miss this deadline, you must wait until the next calendar year.

An important note: the exemption from mandatory insurance is irrevocable as long as your salary exceeds the JAEG. So think very carefully before taking this step.

When Does Switching Really Pay Off?

Switching to PKV is particularly worthwhile for young, healthy, single and childless employees with stable, high income. In this profile, PKV premiums are often EUR 50 to EUR 150 lower monthly than GKV contributions. The younger you are, the lower the entry premium in PKV, and the longer you benefit from the more favorable conditions.

The calculation is less clear-cut for families: the free family insurance in GKV is an enormous advantage. A married employee with two children would need to insure all family members individually in PKV — the additional costs can easily be EUR 500 per month. In many cases, GKV's family insurance advantage far outweighs the initial PKV savings.

Health status also plays an important role: those with pre-existing conditions pay significant risk surcharges of 10 to 40 percent in PKV, or may not be accepted at all in the worst case. In GKV, there is no health examination — everyone is insured at the same conditions.

The Long-Term View Decides

The most common mistake when switching to PKV is looking only at the current premium. What matters is the long-term development: PKV premiums rise significantly with age, while GKV contributions remain relatively stable. A currently favorable PKV premium can become a cost problem in 20 years.

Our calculator shows you the cumulative cost development over 30 years. A 30-year-old employee with EUR 80,000 gross typically saves EUR 10,000 to EUR 15,000 with PKV in the first 10 years. But after 25 years, the picture often reverses, and PKV is cumulatively more expensive. Make sure to plan long-term!

Risks of PKV Switching for Employees

The biggest risk factor is the limited return path: after 55, returning to GKV is nearly impossible. If your career changes, you go part-time or become unemployed, PKV can become a financial burden. The situation is particularly critical for women who want to switch to part-time after having a child.

Salary increases can also become a problem: in GKV, your contribution rises proportionally with salary up to the BBG — but never beyond. In PKV, it rises independently of salary — and often faster than many expect. Also consider that your life circumstances can change: marriage, children, job changes or self-employment fundamentally alter the calculation.

Our Advice: Use the Calculator

Before taking the irrevocable step into PKV, you should thoroughly calculate your individual situation. Our GKV-PKV calculator shows you not only the current contribution comparison but also the long-term projection, the break-even point and the family insurance advantage. This way you make an informed decision.