Private Health Insurance in Germany In Germany, there are two main forms of healthcare coverage: statutory health insurance (GKV) and private health insurance (PKV). Self-employed individuals, freelancers, employees with higher salaries, or civil servants are all eligible for private health coverage. The private healthcare system or PKV includes about 8.7 million people in Germany.
Nonetheless, the risks associated with taking out private health insurance and the prospect of being reverted to the public health system, especially among the young, make this option hard to bite. In the sections that follow, we present some considerations that can be used in evaluating whether you fall under the coverage of PKV.
What Is Private Health Insurance in Germany(PKV)?
In contrast to statutory health insurance, which is built around a unified benefits package (the GKV), PKV is more tailor-made. PKV policyholders usually enjoy Additional benefits such as quicker access to medical appointments, dental care coverage, and even the use of private room or specialist’s room in hospitals.
Enrolment to PKV contributes is a product of the benefits selected, age and health of an individual. There is also a tendency that in older age groups, especially the very old, the premiums under GKV can increase sharply, while this is usually not the case for members of PKV. Members of GKV pay premiums which are related to their incomes subject to a maximum limit specified by law, and without extra premiums of the particular health insurances.
How Does Private Health Insurance Work?
PKV operates on a reimbursement model:
- You visit a doctor or hospital and pay upfront for treatment.
- The provider issues a bill.
- You submit the bill to your insurance provider, who reimburses the eligible amount.
Additionally, PKV members must secure private long-term care insurance. A supplementary daily sickness allowance insurance policy is also recommended for income security during extended illness.
Who Can Join PKV?
Eligibility criteria for PKV include:
- Employees: Those earning over €66,600 gross annually in 2023. About 65% of PKV members are employees.
- Self-Employed and Freelancers: Professionals like doctors, lawyers, or consultants.
- Civil Servants: Eligible for government subsidies (“Beihilfe”).
- Students: Particularly those over 25 who can no longer stay on family insurance.
Evaluating Health Insurance Plans
It is important to thoroughly evaluate and compare different policies before one picks the ideal PKV policy. A lot of providers have their own specific calculators and allow you to calculate your premiums based on the individual parameters and level of coverage desired. One is recommended to add dental cover and daily sickness benefits in the estimate. In order to better adjust the policy to your needs, one may seek the help of an experienced financial consultant.
Key Private Insurers in Germany
In 2023, there were 46 private health insurers in Germany. According to the Map-Report (2021), the top-rated insurers based on financial performance, customer service, and flexibility include:
| Insurer | Financial Score | Service Score | Flexibility | Total |
|---|---|---|---|---|
| Debeka | 21.50 | 28.20 | 33.20 | 82.90 |
| Signal Iduna | 24.00 | 22.15 | 34.45 | 80.60 |
| LVM | 24.90 | 23.50 | 31.45 | 79.85 |
| R+V | 24.40 | 26.05 | 26.20 | 76.65 |
PKV Benefits
PKV covers standard medical, hospital, and dental treatments but also allows policyholders to enhance their plans with additional services like:
- Private clinics
- Specialist care and treatments
- Single-occupancy hospital rooms
- Comprehensive dental coverage
- Vision correction (glasses, lenses)
Costs and Contributions
PKV contributions are not income-based but depend on:
- Age: Younger individuals typically pay lower premiums.
- Health Condition: Pre-existing conditions may lead to higher costs.
- Coverage: Adding features like private hospital rooms or dental implants increases premiums.
Employers contribute up to €403.99 monthly for PKV premiums (2023 rates), while self-employed individuals bear the full cost.
Is PKV Cheaper for the Self-Employed?
For a self-employed software developer (age 35, annual income €62,000, no pre-existing conditions), the monthly PKV cost varies:
| Coverage | Monthly Premium |
|---|---|
| General ward, shared room | €450 |
| Specialist care, semi-private room | €500 |
| Full coverage, private room | €660 |
For comparison, the maximum GKV rate in 2023 would be €703 plus additional contributions. In many cases, PKV is cheaper for young, healthy individuals.
Do PKV Premiums Increase with Age?
Yes, PKV premiums tend to rise due to:
- Increased healthcare needs with age.
- Medical advancements raising treatment costs.
Insurers mitigate costs by collecting higher premiums in youth to build reserves for later years. However, advancements in medical care can lead to unexpected price adjustments.
Reimbursement and Repayment
There are some PKV schemes where the members are able to receive back some of the premiums paid in case there were no claims raised during the span of one year. This amount will vary based on the performance of the insurer and the particular clauses of the policy.
Final thoughts
Unlike the compulsory health insurance scheme in Germany, private health insurance offers a wide range of benefits and flexibility to members. However, it requires planning and ensures consideration of other aspects including age and the cost of premiums which inexorably increases with age. It is advisable to seek the services of an insurance advisor in order to get the most appropriate plan for your situation.
Braj Verma is a resident of Rajgarh in Madhya Pradesh and is a content writer and freelancer by profession. He has a degree in Political Science from Barkatullah University, Bhopal. He has expertise in subjects like credit cards, banking, loan, insurance, political analysis and digital marketing.