What is Private Health Insurance (PKV)?
German Private Health Insurance (known as Private Krankenversicherung or PKV) is a risk-based insurance system run by private insurance companies. Unlike the public system, your monthly premiums are not determined by your income. Instead, they depend on your age, health history, and the exact level of medical coverage you choose.
Who Can Opt for Private Insurance?
In Germany, you are only allowed to choose private health insurance if you meet one of the following criteria:
- High Earners: Employees with a gross annual salary exceeding €69,300.
- Freelancers & Self-Employed: Regardless of their income level.
- Students: Over the age of 30, or students under 30 who explicitly opt-out of the public system at the start of their studies.
- Civil Servants (Beamte): Who receive state subsidies (Beihilfe) that make private insurance highly attractive.
The Pros: Why Choose Private Health Insurance?
Private insurance offers several exclusive privileges that make it the system of choice for many:
- Faster Doctor Appointments: Private patients are highly lucrative for doctors, meaning you can often book specialist appointments within days rather than weeks.
- Superior Hospital Coverage: Guaranteed single/double room stays and treatments by the chief physician (Chefarzt).
- Dental coverage: High-end dental cleanings, implants, and orthodontics are usually covered up to 80-100%, compared to minimal coverage in public health funds.
- Cheaper for Young Healthy Professionals: A young freelancer or single high earner can often pay significantly less for a premium private policy than the maximum cap of the public system (which is around €800+/month).
The Cons: What to Watch Out For
While private insurance offers excellent care, it has important trade-offs:
- No Free Family Insurance: You must pay a separate individual premium for your spouse and each child.
- Medical Questionnaire: You must pass a health screening. Existing conditions (diabetes, chronic pain, mental health therapy) can lead to higher premiums or rejection.
- Long-term Commitment: It is legally very difficult to switch back to public health insurance, especially if you are over 55.
Expat-Friendly Private Insurers
For expats relocating to Germany, we recommend modern, digital-first insurers:
Ottonova: Germany’s first fully digital private health insurer. They offer a completely English mobile app, English customer service, a digital concierge to book your doctor appointments, and fast paperless claims processing. They are tailored specifically for tech expats and freelancers.
Feather: A digital broker that makes getting private health quotes simple, explaining the health check questions in clear English and offering fully transparent plans.