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At what point does private health insurance (PKV) make sense?

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Private health insurance: The optimal time to switch

Private health insurance is an option in Germany for certain groups of people, such as civil servants, the self-employed, freelancers, and employees with a certain annual income. However, it is not available to everyone. Even if you are exempt from mandatory insurance and generally have the option of private insurance, it is not always the best choice. Before making a decision, you should therefore clarify when private health insurance makes sense and whether statutory or private insurance is more advantageous.

Private health insurance – a decision for life

Choosing private health insurance is a lifelong decision. Therefore, it's crucial to thoroughly consider all the advantages and disadvantages, weigh the options, and carefully assess whether private health insurance is the right choice for you. Our expert advisors are here to assist you.

Private health insurance is only available to specific professional or personal groups in Germany. These groups are legally exempt from mandatory health insurance, but this does not mean they don't need health insurance coverage. They simply have the choice between private and statutory health insurance.

However, it is important to consider when private health insurance (PKV) becomes worthwhile. While PKV may be the more attractive option in some cases due to its numerous advantages, statutory health insurance, despite its benefits, can still be the better solution for some individuals.

For whom and from when does private health insurance make sense?

Private health insurance is particularly recommended due to its numerous advantages. More comprehensive coverage, customized pricing, access to modern treatment methods, and shorter waiting times for specialist appointments are just some of the benefits enjoyed by privately insured patients. For certain groups of people or professions, private insurance can be especially worthwhile due to their professional or personal circumstances.

Officials and their families Civil servants can benefit significantly from private health insurance (PKV) because they are entitled to government subsidies. These subsidies cover a portion of their medical expenses, meaning that civil servants only need supplementary insurance to cover the remaining costs not covered by the subsidies – typically between 20 and 50 percent. Thanks to the reduced cost of private health insurance, civil servants eligible for these subsidies are often better off. Compared to statutory health insurance, they generally pay less and yet receive more comprehensive benefits.
Private health insurance proves particularly advantageous for young and healthy policyholders Private health insurance is advantageous. Choosing private health insurance before the age of 40 is recommended, as many people at this age do not yet have pre-existing conditions that could hinder acceptance of their application. Furthermore, premiums are calculated based on risk, which benefits younger policyholders. As the private insurance policy continues, reserves can also be built up for old age, leading to stable premiums in the long run.
Private health insurance is particularly suitable for Single, childless people and small families Private health insurance (PKV) is attractive. Unlike statutory health insurance, there is no free family coverage. Each insured child and, if applicable, a non-working spouse or partner, therefore requires their own premium, which can increase costs. For this reason, private health insurance is primarily suitable for singles, childless couples, or families with a maximum of one or two children. However, statutory health insurance can often be more advantageous for larger families or those planning to start a family.
students They can also opt for affordable private health insurance, as they are exempt from mandatory insurance. This is particularly attractive if they don't meet the requirements for free family coverage, for example, due to their age or their parents' private health insurance membership. Private health insurers offer students specially discounted rates, often under €100 per month. Our BKC advisors can help you determine whether private health insurance is the right choice for you and how to obtain the appropriate coverage in case of illness.

And when is statutory health insurance the better choice?

The advantages of private health insurance are compelling, but there are situations where statutory health insurance can be the better choice. One advantage of statutory health insurance (GKV) is that contributions are calculated based on income, which can be particularly beneficial if your income fluctuates. Another plus is free family coverage, which allows unemployed partners and children to be insured free of charge.

It is advisable to consider statutory health insurance in the following cases:

If you suffer from (serious) pre-existing conditions: People with pre-existing conditions may have difficulty obtaining private health insurance, as insurers may demand expensive risk surcharges or even deny access to the desired coverage. Statutory health insurance, on the other hand, is subject to mandatory coverage and must insure every applicant regardless of their health status.
If you want to include children/your partner in your insurance: The statutory health insurance (GKV) offers free family insurance, which families with several children or an unemployed partner can benefit from.
If your income fluctuates significantly: In the statutory health insurance system (GKV), costs are based on your financial resources, so lower incomes result in correspondingly lower contributions. This is advantageous if your income is subject to significant fluctuations.

It's possible to benefit from the advantages of private health insurance even if you opt for statutory health insurance by taking out supplementary insurance policies to close coverage gaps and expand your protection. Our experts are happy to assist you. Contact us now!

Choosing private health insurance isn't just a matter of age and health, but also of personal circumstances. Our team is ready to answer your questions about private health insurance and determine if and when it would be beneficial for you. We'll also help you find the right coverage for your needs. Schedule an appointment now for a consultation.