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Switching from a public (GKV) to a private (PKV) health insurance means that neither you, nor your employer, pay GKV contributions anymore. As a result, your monthly salary increases by an estimated 613 €. Instead, you pay 430 € each month for private health care, after support from your employer. This results in monthly net savings of 183 €.

Indeed your employer pays up to half your PKV expenses for you, your children and partner, but this support is limited to 613 € per month. All the cost estimates take this subsidy into account, and also the obligatory Pflegeversicherung (nursing home insurance).

For selfemployed the situation is different and we have a separate calculator. If you would like to know how to choose between GKV and PKV als a Selbstständiger, click here.

These annual savings amount, in total over your working life, to 133.078 €, but it would cost you in total 136.444 € extra in retirement. Typically PKV costs much more in retirement, and some of these costs are offset by subsidies that are based on how much public pension you have accrued.

Indeed these are complex calculations, which we can share with you in detail.

If you don't plan to retire in Germany you only need to focus on the savings during your working life, and the PKV usually makes more sense for you. Likewise if you are young and already meet the income cut-off point to switch to the private insurance, PKV is likely to be more attractive.

But if you do plan to retire in Germany you need to weigh both savings and future costs. Assuming that you invest the money you save during your working years at a 4 % annual return, choosing PKV will save you 30.498 € over a lifetime. If you see a minus sign here, it means that there will be a net cost.

Because you cannot go back to public insurance in retirement, you also need to make sure you can afford the private health insurance out of your retirement income and savings. At the start of retirement, the PKV will cost you each month an extra 4.570 € compared to the GKV.

Our Pensionfriend advisors specialize in health care plans as well and can sign you up. We suggest you book a free consultation to discuss in detail: if switching to PKV makes sense in your case, what then would be the best plan, and how to safe efficiently so you have enough money in retirement to pay for the extra cost.

And dont forget, if you partner does not work it also may add to the cost. We can estimate that too for you, and similarly show you the employer and government support you can get for your switch.

PKV vs GKV: Is Private Health Insurance Worth It?

PKV premiums vary based on the level of the program and are depending on your age and health condition. The table below provides an indication of the costs before employer subsidy of up to 613 € per month.

Gross PKV Plans Monthly Premium

Note that each additional child adds 70–200 € to the cost--before employer subsidy--until they are on their own. A partner without income means an extra policy on top of your own.

A PKV can make financial sense if:

• Your earnings are above the 77.400 € threshold (JAEG 2026) that allows you to switch and your income is likely to stay high.

• If you are youngish. Then the PKV can be very attractive, as the premiums are lower and you have many years to build up a public pension, which is the basis of the subsidy on your PKV in retirement. Up to the mid fourties a PKV could save money, if you have no children.

• You have good health. With good health you can even get lower premia when you do not visit a medical professional. Without good health premiums may end up much higher

• If you don't plan on many children: Each child needs a separate PKV policy. If you are young PKV can still be attractive as you may have relatively more years without paying a child policy. Also if your partner has a PKV you effectively share the costs.

• If you don't plan to retire in Germany as that saves you the cost difference in retirement.

Civil servants (Beamte) are a special case. Beihilfe typically covers 50–70 % of costs (often 70–80 % in retirement or with multiple children), so Beamte insure only the remainder via PKV Beihilfe tariffs, which are much cheaper than full PKV. For most Beamte, PKV is more financially advantageous than GKV, though health, entry age, and preferences can affect the outcome.

Especially for people planning a (larger) family, with variable income, who are older or thinking about retiring in the near future, GKV offers more predictable costs and far less financial risk.

And crucially, switching back can be very difficult. Especially over 55, it is nearly impossible, but even under 55, it may require you to take a much lower earning job. So you need to consider your decision from a lifetime perspective.

Health Insurance and Unemployment

Public Health Insurance (GKV) and Job Loss

If you become unemployed in Germany, your GKV coverage continues without interruption. According to the Bundesministerium für Gesundheit, recipients of Arbeitslosengeld (ALG I) are subject to compulsory GKV membership.

Under § 251 Abs. 4a SGB V, the Federal Employment Agency (Bundesagentur für Arbeit) pays your health insurance contributions for as long as you receive Arbeitslosengeld (ALG I).

If your ALG I runs out and you have a spouse or partner in GKV, you may qualify for free coverage under their policy via Familienversicherung (§ 10 SGB V).

On the other hand, if your partner is on a PKV, you cannot stay in the GKV for free. Since there is no 'family insurance' link between PKV and GKV, the public fund will reclassify you as a voluntary member.

When this happens: You will have to pay a monthly premium out of your own pocket (approx. 220 €–250 €/month in 2026), calculated on a minimum 'fictitious' income of 1.318,33 €, even if your actual income is zero. In this case, your partner is legally responsible for covering these costs as part of their maintenance obligation (Unterhaltspflicht).

Private Health Insurance (PKV) and Job Loss

If you were in PKV before becoming unemployed, receiving ALG I generally triggers compulsory GKV membership under § 5 Abs. 1 Nr. 2 SGB V.

However, under § 8 Abs. 1 Nr. 1a SGB V, you can apply for an exemption within three months, provided you were not in GKV in the five years prior to receiving ALG I and your PKV coverage is equivalent to GKV.

If the exemption is granted, the Federal Employment Agency (Bundesagentur für Arbeit) contributes toward your private health insurance premium while you receive ALG I, but only up to the amount that would have been payable under statutory health insurance (§ 174 SGB III).

If you are not eligible for ALG I, you can generally remain in PKV; in such cases, many people who are facing financial hardship switch to the Basistarif, a regulated, reduced-cost tariff capped at the maximum GKV contribution rate, which can be reduced by up to 50  % in cases of financial need according to the Bundesministerium für Gesundheit.

Note: the above applies if you are under 55. If you are 55 or older, returning to GKV is heavily restricted. This is covered in further detail below.

The Rule of 55: Can I Switch Back To GKV Later?

The "Rule of 55" (based on § 6 Abs. 3a SGB V) is a strict legal regulation in Germany, designed to prevent people from switching from PKV back to the GKV system shortly before retirement. Once you turn 55, you cannot return to the GKV simply by reducing your working hours, becoming a part-time employee, or becoming unemployed.

When You Can’t Switch Back

• If, in the last 5 years before the requested switch, you were not insured in the GKV at all

• If at least half of the last 5 years you were:

  • Exempt from GKV insurance (due to high income),

  • Insurance-free (e.g., a civil servant/Beamter), or

  • Self-employed full-time.

Exceptions: When a Switch is Possible After 55

• You can return if you take up a new job where your income is below the mandatory insurance threshold (JAEG: 77,400 € annually in 2026), and you were legally insured in the GKV for at least one day within the last five years.

• Family Insurance (Familienversicherung): If your spouse is in the GKV, you can switch into their family insurance for free. This requires that your own total income (including investments/rent) is low (in 2026, under 565 €/month, or 603 € for mini-jobs).

• Returning from Abroad: If you move to a non-EU country and then return, or if you were compulsorily insured in another EU country's statutory system, you might gain access to the German GKV, although new regulations as of 2026 are tightening this loophole.

In practice, this means that for most PKV members over 55, returning to GKV is effectively impossible. PKV becomes a permanent commitment, premiums will keep rising with age, regardless of your income or financial situation in retirement.

How Much Does Private Health Insurance Cost in 2026?

There is no single monthly premium for private health insurance (PKV) in Germany, as costs depend on several individual factors. The main elements that determine your premium include:

• Age: Younger applicants usually pay lower premiums, and starting early can help lock in favourable rates.

• Health Status: Your medical history and current health influence pricing, with pre-existing conditions potentially increasing premiums or leading to coverage limitations.

• Employment Status & Job Title: Whether you are employed or self-employed, as well as your occupation, can affect your premium. Certain professions may have lower risk profiles, which can reduce costs.

• Coverage Level: Basic plans are less expensive, while comprehensive coverage (including dental, vision, and alternative therapies) raises costs.

• Deductible Options: Choosing a higher deductible can reduce monthly premiums while maintaining substantial coverage.

Overall, the PKV-Verband reports that the average monthly private health insurance cost in Germany (2026) is expected to be around 617 €. This figure provides a general reference for planning, but your individual cost may be higher or lower depending on your personal profile.

PKV vs. GKV: Long-Term Premium Development (2006–2026)

To understand how these insurance costs evolve, it is useful to examine historical data for both systems. This context provides a long-term view of how average contributions have developed in Germany.

This chart illustrates the evolution of average contribution income per fully insured person from 2006 to 2026, based on data from the Wissenschaftliches Institut der PKV (WIP).

Over these twenty years, GKV premiums increased by an average of 3,9 % per annum, while PKV premiums rose by an average of 3,4 % per annum.

At first glance, this may seem like an argument for PKV, but the key difference is that under § 223 Abs. 3 SGB V, GKV contributions are calculated only up to the contribution assessment ceiling (BBG), meaning increases are capped relative to your income.

PKV premiums, on the other hand, rise regardless of your income and increase with age, which is why the long-term cost picture looks very different, especially in retirement.

In our view, you should mainly count on the costs increasing at least one percent faster than inflation. Medical costs and service levels continue to increase over time. In our calculations, we assume that the cost increases by 3,5 % annually.

Get a Full Picture Before You Decide

PKV can look attractive on paper, but before deciding, keep these points in mind:

The calculator above gives you a solid starting point. But every situation is different. At Pensionfriend, we use detailed calculations, including the impact of investing or not investing your savings and Net Present Value (NPV) calculations, to make the lifetime cost of health insurance, pensions, and investment decisions concrete and transparent.

Not Sure Which Health Insurance Is Right for You in Germany?

Our advisors can run detailed scenarios for your specific situation, so you can make this decision with a full picture, not just the one your broker is showing you.

Check here how much you need to save for a secure or early retirement in Germany.

Discuss your health insurance choice. We know this is complex. Let us help you review both your health insurance options and your long-term financial planning.

Frequently Asked Questions

Kids in the PKV: What Does a Child Cost in Private Health Insurance?

In GKV, your children are covered for free under your own policy (Familienversicherung) as long as they have no significant income. In PKV, that does not exist.

Every child in PKV requires their own individual contract. Premiums are calculated based on the child's age, health, and chosen coverage level:

Does My Child Need to Be in PKV if One Parent Is Privately Insured?

If both parents are in PKV, each child needs their own separate policy. If one parent is in GKV, the child can be covered for free under that parent's policy, but only if the PKV parent does not earn more than the GKV parent (§ 10 Abs. 3 SGB V).

In practice, because PKV requires a high income, the PKV parent usually earns more, so free family coverage is rarely available.

What Happens to Your PKV During Parental Leave (Elternzeit)?

During parental leave (Elternzeit), your employer stops contributing to your PKV premium. Under § 2 BEEG, Elterngeld replaces about 67 % of your previous net income, up to 1.800 € per month. For incomes below 1.000 €, it can increase to up to 100 %.

Your full PKV premium remains payable out of your pocket during this period. If you have children on separate PKV policies, those costs add up on top. Some insurers let you pause add-ons like sick pay coverage (Krankentagegeld) to lower the bill slightly, but the core premium stays.

PKV for Your Partner: Does Private Health Insurance Cover Spouses?

No. Unlike GKV, where a spouse with little or no income is covered for free under the Familienversicherung (§ 10 Abs. 1 SGB V), PKV has no equivalent.

Every adult needs their own separate policy, with premiums based on age, health status, and chosen benefits.

Does my Partner Need to Be in PKV if I Am?

No. Your partner is not required to join PKV just because you are. They may still qualify for GKV, for example, if they are unemployed and receiving benefits, a student, or not primarily self-employed. Hence, if they are employed, they are eligible on their own right for a GKV policy.

If your partner earns above the annual limit of 77.400 € (JAEG 2026), or is self-employed, they are not legally required to enroll in the GKV and can freely choose between GKV and PKV.

If your partner has no income, for example, as their unemployment benefits run out, or they don't work and become your partner, this is worth thinking through carefully, as they will need a separate PKV policy which can add several hundred euros per month to your household costs.

If your partner then starts working again, their insurance situation depends on their income and employment status. According to the Federal Ministry of Health (BMG), employees must earn more than 603 € per month (exceeding the Minijob threshold) to be automatically covered by the public system (GKV). So it can save substantial PKV premium payments if your partner then finds a job earning more than this minimum and is covered by GKV.

Note that this only applies to married couples or registered Lebenspartner; the rules do not apply to unmarried individuals covered at no extra cost under the Familienversicherung (§ 10 Abs. 1 SGB V). In PKV, every adult needs their own individual contract, with premiums based on age, health status, and chosen benefits.