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If you are an employee and earn an annual gross income of less than €73,800 or become unemployed, you must go back to the statutory health insurance whether you want to or not. However, if you continue to earn at least €73,800 per year or more, there is no reason to go back to the statutory health insurance, as the contributions there are usually much higher. For instance, TK (Techniker Krankenkasse) already more than €1,000 per month, including long-term care insurance, with the tendency to increase.

The premiums in private health insurance never increase solely because an insured person gets older; the entry age is effectively frozen. If an adjustment to a tariff is necessary, it always applies to all individuals insured under that tariff. In comparison, the premium amount in statutory health insurance increases at a much faster and higher rate than any other tariff in private health insurance. The contribution for TK (Techniker Krankenkasse) will already be €1,100 next year, and this is for really weak benefits. Furthermore, within the scope of private health insurance, there are almost tax-free options to exempt one's health insurance contributions after retirement. Please contact us for more information on this.

In private health insurance, there is only a one-sided termination right in favor of the insured person. The insurance company only has the right to terminate the contract in case of willful deception by the policyholder."

Generally, one has a payment deadline of 30 days at the doctor's office. If the bills are submitted on time, the health insurance company settles the invoice with the insured during this period. For higher expected treatment costs at the hospital, the billing is directly handled with the health insurance company, and the insured person receives the bill only for verification. In many aspects, it is beneficial to initially pay smaller bills on your own to receive a premium refund at the end of the year, which is usually much higher than the pre-paid invoices.

GKV vs PKV: Key Differences

Public insurance (GKV) offers comprehensive coverage but with limitations:

Restricted doctor choice and longer wait times

Higher dental co-payments

Limited hospital options and shared rooms

Minimal coverage for complementary medicine

Restricted coverage for medicines and aids

Private insurance (PKV) provides more extensive benefits:

Wider doctor selection and shorter wait times

Better dental coverage, including advanced treatments

Choice of hospitals and private rooms

More options for complementary medicine

Broader coverage for medicines, vision aids, and remedies

While GKV ensures basic care for all, PKV offers more flexibility and comprehensive coverage, often at a higher cost.

Employees

In Germany, not everyone is eligible to enroll in private health insurance. Employees can only enroll in private health insurance if their annual income exceeds the compulsory insurance limit, which is set by the federal government annually, based on income development. In 2024, this limit was 73,800 Euro anual and 6,150 per month.

Freelancers/self‐employed

Self employed individuals, freelancers, and civil servants can always enroll in private health insurance, regardless of their income. If they are unable to switch to private health insurance, they can also set up a private supplementary health insurance in addition to public insurance. This additional coverage is available for both outpatient and inpatient treatments, as well as for dental treatments. By combining the benefits of statutory health insurance with additional benefits of supplementary insurance, they can achieve a coverage level that is similar to private health insurance.

A private health insurance allows insured individuals to choose their own doctor or hospital. Additionally, it offers a higher level of benefits compared to statutory health insurance. One of the biggest differences between the two types of insurance is in the coverage for dental treatment and dentures. Without supplementary dental insurance, large co‐payments are possible when covered through public (statutory) health insurance. Furthermore, private health insurance companies usually also reimburse alternative medical treatments which are not typically covered by statutory health insurance companies. Privately insured patients have the option to stay in single or double rooms and benefit from chief physician treatment for inpatient treatments in the hospital. They also have the flexibility to choose the scope of services that best suit their individual needs. Additionally, private health insurance can offer some cost advantages, particularly for young and healthy policyholders who opt for an affordable plan. The premium for private health insurance can also be further reduced by agreeing to an annual deductible, which is not an option for public insurance.

Hearing aids

Remedies such as physiotherapy, radiation, etc.

Additional coverage for specialized clinics and private rooms

High coverage for expensive but effective cancer medicine

Preventive care measures like dental cleanings

It is important to note that these options may vary depending on thespecific plan and the insurance provider.

While statutory health insurance offers a set service catalog based on government regulations (subject to constant change), the benefits in private health insurance are agreed upon permanently and cannot be changed by the insurer. This means that privately insured patients can access the latest and best forms of treatment, which may not be available under public insurance. In particular, very costly treatments for severe conditions such as cancer are often not covered under public insurance, while private insurance will cover these treatments.

Since the benefits of the different health insurance companies vary greatly, it is important to fully understand what is and is not covered under a specific plan. To ensure stable premiums over time, it is crucial to choose a trustworthy insurance company. Some providers have been able to offer stable premiums over a long period, while others have had to significantly increase premiums. Long term rate stability is possible but only if the insurance company is carefully selected, ideally with the help of an English speaking expert.

More flexibility in choosing healthcare providers

More extensive coverage for dental treatment, vision aids, hearing aids, and alternative medicine

Option for single or double rooms and chief physician treatment for inpatient treatments

The ability to choose the scope of services based on individual needs

Potentially lower costs for young and healthy policyholders, who can opt for an affordable plan

The option to agree to an annual deductible, which can lower the premium

The premium does not depend on income, but on age, state of health, and existing medical conditions

The benefits also play an important role in terms of cost

Different tariffs and the option for customers to put together their desired service individually in the form of a modular principle.