Should You Switch to Private Health Insurance?
An Honest Lifetime Calculation
Most PKV articles are written to sell you a policy. This one is written to help you decide — including the cases where my honest answer as a broker is: stay public.
What You Need to Know
- PKV premiums do not depend on your income — they depend on your age, health and tariff. A healthy 30-year-old pays around €700–850/month gross for a high-quality full tariff, roughly €350–425 after the employer contribution.
- The comparison flips over a lifetime: GKV rises with your income and with political decisions; PKV rises with medical inflation and age. In 2026, around 60 % of privately insured people saw an average increase of 13 %.
- Three questions decide the switch: Will your income stay above the threshold? Do you plan children? Will you grow old in Germany — or leave?
- Returning to public insurance after 55 is practically impossible (§ 6(3a) SGB V). Treat the switch as a one-way door and decide accordingly.
A Broker's Interest — Declared Upfront
I earn my living arranging private policies — and I still tell roughly one in five of the people who sit down with me that switching would be a mistake. Not because private insurance is bad; because it is priced for a specific life, and if that life is not yours, the numbers turn against you slowly and then all at once. Here is the full calculation I walk my clients through, with nothing skipped.
First: Are You Even Allowed to Switch?
Employees need gross earnings above the 2026 threshold of €77,400 per year (Jahresarbeitsentgeltgrenze). The self-employed, freelancers and most GmbH managing directors can choose PKV regardless of income. If you are not sure where you stand, start with my eligibility guide or the 2-minute quiz.
What PKV Actually Costs — Real Numbers, Not Teaser Rates
These are the ranges I see in practice for high-quality full tariffs including sick-pay cover, not the €200 bait tariffs:
| Entry age | Gross monthly premium | Your share (employee, after employer contribution) |
|---|---|---|
| 30 | €700–850 | ~€350–425 |
| 40 | €1,050–1,300 | ~€540–790 |
| 50 | €1,200–1,500 | ~€690–990 |
| Family (2 adults + 2 children) | €1,500–2,000 | every person pays their own premium |
The employer pays at most €508.59/month (2026); above a gross premium of roughly €1,017 every additional euro is yours alone. If someone quotes you a full tariff at €400–450 or below, ask hard questions — something has been cut out.
For comparison: the GKV maximum is around €610–650/month own share (2026, at or above the contribution ceiling), and GKV covers non-working spouses and children at no extra cost — PKV never does.
Three Moments That Decide Everything
At 30–40: PKV usually wins on paper
A healthy single high-earner pays less in PKV than the GKV maximum and gets better benefits. This is the situation every sales pitch is built on — and for this situation, it is true.
At 40–55: the family test and the premium curve
Every child costs roughly €150–250/month extra in PKV, while GKV insures them free. A single-earner family of four in PKV pays €1,500–2,000/month with zero employer help beyond the cap. Meanwhile premiums climb: in 2026 alone, about 60 % of privately insured people received an average increase of 13 %, after a similar round in 2025. As a long-term planning figure I use around 3.5 % per year — but PKV increases arrive in irregular jumps, hit you in euros on a bigger base, and keep coming after retirement.
At 67+: the years the sales pitch skips
Your income falls; your PKV premium does not. Retirees keep paying full tariff premiums — the statutory 10 % surcharge ends at 60, and premium-relief components (Beitragsentlastung) help if you bought them early. A realistic planning corridor for a tariff entered at 30 is €700–1,000 per month in today's terms in retirement. This is survivable if you planned for it from day one — it is a crisis if nobody told you.
The One-Way Door: Returning to GKV
Under § 6(3a) SGB V, once you are 55 or older you can practically never return to public insurance, even if your income drops. Under 55, you need to genuinely end your insurance-free status — for example through employment below the threshold. I explain every route in detail in my PKV vs GKV guide — read it before you sign anything.
My Honest Checklist: Switch / Don't Switch
Switching tends to make sense if …
… your income is stable above €77,400, you are healthy (or have checked your insurability anonymously first), children are unlikely or your partner has own GKV coverage, and you will either stay in Germany long-term with retirement savings that account for PKV — or you know exactly what happens to your policy if you leave Germany.
Stay in GKV if …
… your income fluctuates, you plan a single-earner family, you value the option of returning to income-based premiums — or you are over ~45. That is roughly where I draw the line in practice: from this age on, I look very closely at what a switch is actually supposed to achieve before I recommend one, because the entry premium is high and the time to build the retirement cushion is short.
Frequently Asked Questions
Is private health insurance cheaper than public in Germany?
How much do PKV premiums increase each year?
Can I switch back to public insurance if PKV gets too expensive?
What happens to my PKV in retirement?
Should I switch to PKV just to save money?
This article reflects the legal values of 2026 (JAEG €77,400; maximum employer contribution €508.59/month) and premium ranges from my own advisory practice for high-quality full tariffs. It is general information, not individual advice — that is what the free consultation is for.
Sources
§ 6 SGB V (Versicherungsfreiheit; Abs. 3a: Rückkehr ab 55) · § 257 SGB V (Arbeitgeberzuschuss, 2026: max. 508,59 €/Monat) · JAEG 2026: 77.400 € · Deutsches Institut für Altersvorsorge / PKV-Verband: Beitragsanpassungen 2026 (Ø +13 % für rund 60 % der Versicherten) · Beitragsspannen: eigene Beratungspraxis, hochwertige Volltarife inkl. Krankentagegeld (Stand August 2026)