GKV vs PKV: choosing German health insurance

Health insurance is mandatory in Germany, and one of the first big decisions you make is statutory (GKV) versus private (PKV). It is also one of the hardest to reverse, so it is worth understanding before you choose.

Who can even choose PKV

Most employees start in GKV by default. You can opt into private cover only in certain cases:

• Employees: once your gross salary passes the annual threshold (the Versicherungspflichtgrenze), around €77,000 a year (2026) and updated every year.
• Self-employed and freelancers: free to choose from the start, whatever the income.
• Civil servants and some students: special rules that often favour PKV.

Statutory (GKV), in short

Contributions are a percentage of your gross income, not your health, up to an upper limit. A non-working spouse and your children can usually be covered at no extra cost, and changing jobs or funds is simple. It is the predictable, family-friendly default.

Private (PKV), in short

Premiums are based on your age and health when you join, not your income, and can buy faster appointments and broader benefits. It can be cheaper while you are young, single and healthy, but premiums tend to rise as you age, and each family member is priced separately.

When PKV tends to be worth it

• A high, stable income well above the threshold, especially single or dual-income without children.
• Self-employed with a solid income who want broader cover.
• You plan to stay in Germany and can absorb premiums that rise over time.

When GKV is usually the better call

• You have, or plan to have, a family: free dependent cover is a big advantage.
• Your income is variable or uncertain, or may be lower later.
• You value predictability and the option to change funds easily.

Common mistakes to avoid

• Picking PKV young for the low premium, without planning for how it climbs with age.
• Forgetting that in PKV your partner and each child are charged separately.
• Choosing the cheapest PKV tariff, then finding thin coverage when you need it.
• Assuming you can switch back to GKV easily. After 55 it is very hard, and often not possible.
• Cancelling any cover before the next one is confirmed.

This is general information, not advice. The right answer depends on your income, age, health and family plans, so we model both for your exact numbers before you commit. It is one of the decisions where a second opinion genuinely pays off.