How much does private health insurance cost in Germany?

The costs, the amount of the contributions, in the private health insurance in Germany depend on various factors: The age at the conclusion of the contract, the state of health and the desired benefits. Also the deductible and provisions for age play a role in the amount of contributions. This article provides information on how high the premium per month in German health insurance can be, how it differs between public or private health insurance and how much savings potential there is.

Medizinisch geprüft - Siegel
Reviewed by our insurance experts

Germany has a reputation for its excellent health insurance system. With state-of-the-art treatments, great access to knowledgeable physicians, and a structure that allows you to choose your ideal health insurance plan. Expats in Germany are very fortunate with the Germany health insurance system.

It’s essential that you do your research when you’re determining the most effective plan. Health insurance is an important choice that can have serious effects on your health and happiness abroad. There are many deciding factors to consider when it comes time to selecting the right insurance plan for you and your lifestyle: coverage, cost, which company to pick?

How high are the premiums for private health insurance in Germany per month?

The cost of the contributions in the private health insurance depend on different factors and differ from private health insurance companies. While in the public (or statutory) health insurance only the income is taken as a reference value, the entry age, the desired scope of services, a possible deductible and, in the case of pre-existing conditions, a possible risk surcharge determine the amount of the premium for private health insurance.

When calculating premiums, a distinction must also be made between employees, the self-employed, civil servants and family members.

In the statutory health insurance, spouses and children are included in the family insurance free of charge, as long as they do not have their own income. In private health insurance, this does not matter. A separate contract is required for each insured person.

PKV Costs

How much does an employee pay in private health insurance?

ottonova's private health insurance offers three coverage options for salaried employees, each with a different scope of benefits: the Premium Economy, Business Class and First Class tariff.

The monthly premium differs depending on the private health insurance plan selected.

Example calculation for salaried employees in private health insurance

Let's assume that the applicant is 35 years old at the start of the insurance and has no pre-existing conditions. Based on our information, the following premium per month for private health insurance (German short: PKV)* results:

Basic contribution:

487,91 Euro

Daily sickness allowance:

48,72 Euro

Premium relief in old age:

60,02 Euro

Long-term care insurance:

48,15 Euro

Total contribution:

644,80 Euro

As an employee living in Germany your employer pays a contribution to your health insurance. After deducting the employer's contribution of 322.41 euros, the total amount is 322.39 euros per month.

*The sample calculation is based on the ottonova Business Class 100 tariff most frequently chosen by salaried employees.

Is private health insurance for employees cheaper than public health insurance?

The monthly co-payment for German public (or statutory) health insurance for salaried employees at this income level is 540.79 euros. Salaried employees can save up to 1.400 euros per year with private health insurance compared to the health insurance cost with a public health insurance insurance.

What are the advantages of private health insurance?

How much does private health insurance for the self-employed cost?

If you are self-employed the contribution is the same as for salaried employees, with the difference that there is no employer's contribution here, which is deducted from the monthly contribution costs.

Example calculation for self-employed in private German health insurance

Let's stick to the figures of the calculation example of the employed person and adopt them one-to-one to a potential freelancer:

Basic contribution:

487,91 Euro

Daily sickness benefit:

48,72 Euro

Premium relief in old age:

60,02 Euro

Long-term care insurance:

48,15 Euro

Total contribution:

644,80 Euro

The amount of the daily sickness allowance depends in Germany on how many employees the self-employed person has.

However, it is also possible with some insurers in private health insurance oif you are self-employed to take out a daily sickness allowance from the first day of illness. However, the recommendations speak against it due to the high costs.

To keep the private health insurance premium as low as possible, many self-employed persons opt for a relatively high personal contribution in private German health insurance.

Why is the ottonova Expat tariff cheaper than other tariffs?

In order to keep your premiums as stable as possible, private health insurance in Germany factors aging reserves (or old-age provisions) into their tariffs. That means you are paying more in young years and your premium doesn't have to rise when you get older and your health costs get higher.

Because the Expat tariff can only be contracted for a period of five years there is no need for additional aging reserves. That's why the Expat tariff is cheaper than our other private health insurance plans.

If you plan to stay in Germany for a longer time than five years you can choose from our other private health insurance plans.

Who is eligible for the ottonova Expat tariff?

ottonova private health insurance offers this special Expat tariff for Non-EU citizens with temporary work visa who plan on staying only for five years in Germany.

What is the cost of private health insurance for a child in Germany?

The contribution for the child amounts to 161.50 euros per month, adjusted for the employer's contribution of 50 percent only 80.75 euros. The annual savings compared to statutory health insurance for salaried employees in this example is still 954.84 with a significantly better price-performance ratio.

In addition: the contribution for a daily sickness allowance and for compulsory nursing care insurance is omitted and premium relief in old age is possible.

Important to know: Separate tariffs for children in private health insurance in Germany

Children must be insured separately in private health insurance. If the higher-earning parent is privately insured, the children must also be privately insured.

*The example also provides for a ten percent deductible.

How do private health insurance costs develop in old age?

In principle, the insurance premium is reduced in old age, because some parts of the premium no longer apply. These are the contribution for the daily sickness benefit and the premium surcharge of ten percent.

The exact amount of the premium in old age depends on the age of entry, the selected tariff, the amount of the deductible and how well the insurer has managed the age reserves. Another factor is whether the policyholder has integrated an age relief component into the contract.

At ottonova, 50 percent of premiums are invested in age reserves and it is possible to take out a premium relief component. From the age of 64 or 67, there is the option of reducing premiums. Thus, the amount can be reduced between 100 euros and up to 400 euros per month.

➜ More information on private health insurance in Germany in old age

How does the premium calculation work in German health insurance?

While the cost of public health insurance is based on the idea that everyone pays into a shared pot, private insurance is calculated differently. Germans believe strongly in planning for the future. And to ensure that your healthcare costs for the future are covered, your premium each month goes towards securing your treatments, for now and for whatever comes next.

In the private system, the cost of your monthly premium is calculated by the health insurers based on your age at the time you sign up. The premium calculation is based on the so-called equivalence principle. This means that a group of persons of the same age, the collective, is considered when calculating the premiums. Therefore, the entry age also plays a role, as each age group is considered separately.

The base cost is the same for any 26-year-old, or any 34-year-old, and so on. This sum already factors in important variables like possible inflation, rising costs of health treatments, and more. But more importantly, this price is also calculated at double the price required for your current calculated health status.

Why? To ensure your financial security in the future. Half of the premium you pay now will go towards paying for your anticipated health costs. The other half is set aside and conservatively reinvested by the insurance company to ensure that your costs will stay stable in the future.

Unlike in the statutory health insurance, the younger members in the private health insurance do not co-finance the rising costs of the older generation. Under private health insurance, each collective must provide care for itself.

The rule here is that the insurance premium exceeds the likely costs incurred at a young age. The resulting surpluses are accumulated at interest as so-called old-age provisions or premium reserves for old age. The provisions and accrued interest then compensate for the presumably higher premiums in old age.

If the health condition of a collective member deteriorates, this does not lead to an adjustment of the individual premium for the private health insurance of this same member due to the individually increased costs. The additional expenses for the one insured person are allocated to the collective in this tariff and this age group as part of a premium adjustment only for this one private health insurance.

What are risk surcharges in private health insurance?

Risk surcharges apply if certain pre-existing conditions are present when the private health insurance policy is taken out. A certain additional percentage premium is charged for certain medical conditions.

The calculation of risk surcharges varies from insurance company to insurance company.

A risk surcharge is also not fixed for the entire insurance period. If the clinical picture on which the surcharge was based no longer occurs for a long period of time, the insured person should talk to the insurer about cancelling it. There are medical conditions that allow a date to be agreed upon at the time the contract is concluded, at which time a renewed risk assessment will take place.

If the insured person has the choice between risk exclusion for certain clinical pictures or a risk surcharge, he should always opt for the risk surcharge to avoid possible massive costs.

➜ More information on the risk surcharge

Are there also premium increases in private German health insurance?

Premium increases in tariffs from private health insurers can be expected in Germany, for example, if healthcare costs rise at an above-average rate. This can be due to disproportionate salary increases for employees in the healthcare sector or adjustments to fee schedules. If pharmaceutical manufacturers increase the cost of their products, this can also lead to an adjustment in premiums for an health insurance provider. Inflation can also drive up costs.

In addition: the legislator regulates when the insurance premium may increase. The prerequisite for a premium adjustment is that the costs within an age group of a tariff deviate upwards by more than ten percent from the original calculation.

In contrast, the public health insurance system’s rates may increase every year, and they will. The current demographic situation guarantees it. With the current system, in which every young healthy insured person pays towards a shared pot that goes towards financing the rest of the insured bodies, the shift towards an older population with fewer young people to contribute toward the costs means that costs will continue to increase, year after year. The private system makes sure that your individual healthcare costs are taken care of.

What treatment costs should private health insurance companies reimburse in any case?

The tariffs of private health insurance should in any case reimburse all costs that include medically necessary treatment, but certainly go beyond that. These benefits include, for example, reimbursements for dental prostheses or visual aids such as glasses and contact lenses. But also the basic billing of the doctor at least at 3.5 times the rate of the fee schedule, as well as the assumption of alternative healing methods such as alternative practitioners, treatment by a chief physician or a single or double room in the hospital.

What is the deductible in private health insurance in Germany and how high is it?

In private health insurance, the deductible is the portion of the bill for treatment that the policyholder pays in order to reduce the insurance premium.

ottonova offers a choice of three deductible levels:

➜ Learn more about the deductible in private health insurance here!

Do I have to advance treatment costs in public or private health insurance system?

In public health insurance your doctor bills your health insurance provider directly. In private health insurance the policyholder himself/herself gets billed by the doctor and has to pay the bill until a certain deadline. But they don't have to pay in advance because they can submit the bill to the insurer for reimbursement. So, they can pay the outstanding amount only after the insurer has paid. With ottonova invoices are reimbursed within a few days.

Espen Markus Mjøs
HIER SCHREIBT Espen Markus Mjøs

Espen Markus - originally from Norway - is sales agent in ottonova's English sales team. He's in contact with potential customers every day and answers Expats' questions about German health insurance.

ottonova sales experts
HIER SCHREIBT ottonova sales experts

Our ottonova team of experts has over 40 years of experience in private health insurance and answers questions about it every day. What are old-age provisions and for whom does private health insurance make sense? What is the actuarial interest rate and which tariff is right for you? They know!

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