If you earn more than €73,800/year as an employee, are appointed as a civil servant or go self-employed, you can leave the statutory health insurance (GKV) and join German private health insurance (PKV). Use our PKV calculator to find out what private cover costs you in 2026 — including employer subsidy, deductible and premium refund.
How does PKV work?
Unlike the GKV, where contributions scale with your income, PKV premiums are actuarial. They depend on your entry age, tariff cover, deductible and health risk. Younger and healthier entrants pay less — and insurers build up old-age provisions (Altersrückstellungen) to soften premium hikes later in life.
2026 premium model — typical market averages
Across major insurers (Allianz, Debeka, DKV, Hallesche, Signal Iduna, Continentale) the Comfort tariff (outpatient, inpatient two-bed room, 60 % dental, no deductible) sits roughly at:
| Entry age | Basic | Comfort | Premium |
|---|---|---|---|
| 30 years | ~€300 | ~€425 | ~€610 |
| 40 years | ~€350 | ~€500 | ~€720 |
| 50 years | ~€455 | ~€650 | ~€935 |
| 60 years | ~€595 | ~€850 | ~€1,225 |
Employer subsidy (§257 SGB V): the €471.32 cap
Privately insured employees receive an employer subsidy — just like GKV members. The subsidy is 50 % of the PKV premium, capped at the parity GKV ceiling: in 2026 that's €471.32/month (€5,512.50 BBG × 17.1 % rate / 2).
- Premium €600/month → subsidy €300 (50 % below cap)
- Premium €800/month → subsidy €400 (50 % below cap)
- Premium €1,000/month → subsidy €471.32 (cap active)
Beihilfe — the civil-servant superpower
Civil servants receive Beihilfe from the state for medical bills — typically 50 % (active, with family), 70 % (federal, single) up to 80 % (pensioners). PKV only insures the gap. As a result, premiums for civil servants are spectacularly low:
- Civil servant 35 y., 70 % Beihilfe → typical PKV premium €150–€200/month
- Civil servant 55 y., 70 % Beihilfe → about €250–€350/month
Joining the GKV as a civil servant would cost ~8.55 % of gross with no Beihilfe entitlement. PKV is therefore the default choice for German civil servants.
Deductibles cut your premium fast
A yearly deductible noticeably reduces the monthly premium. Typical patterns:
| Annual deductible | Premium reduction | Break-even |
|---|---|---|
| €0 | — | — |
| €300 | ~7 % | ~€3,500 annual premium |
| €600 | ~14 % | ~€3,500 annual premium |
| €1,200 | ~22 % | ~€5,500 annual premium |
A €600 deductible is the usual sweet spot: at a €500 Comfort premium (€6,000/year) you save ~€840/year — and even if you exhaust the deductible you still keep €240/year.
Premium refund (BRE) — up to 6 months back
If you submit no invoices in a calendar year, your insurer refunds 1–6 monthly premiums:
- Allianz, AXA: up to 6 monthly premiums
- Debeka, DKV: 3–4 monthly premiums
- Signal Iduna, Hallesche: 2–4 monthly premiums
The refund is tax-free. Before submitting any invoice always ask: is the refund I would lose larger than the reimbursement I'd gain?
Worked example: Employee, age 40, Comfort, €600 deductible, 2-month BRE
- Premium (table): €500 × 0.86 (deductible factor) = €430/month
- Employer subsidy: 50 % = €215/month (below cap)
- Your share: €215/month = €2,580/year
- + Deductible (max.): €600
- − Premium refund (2 mo.): €860
- Effective annual cost: €2,320
For comparison: at €6,000 gross/month a GKV member pays 17.1 % → €513/month employee share = €6,156/year — about €3,836/year more.
GKV vs. PKV — the honest balance
Pro PKV:
- Better cover (chief physician, alternative medicine, higher dental, single room)
- Income-independent premium
- Premium refund for claim-free years
- Tariffs with deductible options
Con PKV:
- No free family cover like GKV — every child and non-working partner needs an own contract
- Premiums rise with age (medical inflation, dwindling Altersrückstellungen)
- Return to GKV after age 55 is virtually impossible
- Cash-flow burden: you pay first, then claim back
Who can switch to PKV?
- Employees earning above the income threshold (JAEG €73,800/year in 2026)
- Civil servants — eligible from day one
- Self-employed and freelancers — anytime, no income limit
- Students — until end of 14th semester or age 30
Common pitfalls
- Choosing a basic tariff too aggressively — low entry premium often hides weak coverage that gets expensive in old age.
- Deductible too high — chronic patients use it up every year and forfeit the savings.
- Always claiming refunds — at a €1,500 reimbursement and €1,000 refund you should claim.
- Forgetting family planning — every child adds a separate PKV contract (~€150–€200/month).
- Ignoring long-term care — the Pflegepflichtversicherung is added but cheaper than in GKV.
PKV premiums in your tax return
PKV basic-cover premiums are fully deductible as Sonderausgabe (§10 EStG). Allocation in Anlage Vorsorgeaufwand:
- Line 13: Own PKV premiums (basic health cover)
- Line 14: PKV premiums for compulsory long-term care
- Line 15: Optional cover, daily-allowance and dental supplements — capped at €1,900/€2,800
Since the 2010 Bürgerentlastungsgesetz, basic-cover premiums are fully tax-deductible — at €500/month you reduce taxable income by €6,000/year.
Related calculators
- Private Health Insurance Calculator — compute your PKV premium
- Statutory Health Insurance Calculator (GKV) — compare with the public option
- Dental Insurance Calculator — top up GKV dental cover
- Gross-Net Calculator — check whether you cross the PKV threshold