Planned Statutory Health Insurance Reform 2026 – Higher costs, fewer benefits?

A look at the German public health insurance reform plans

The German government is currently working on a major reform of statutory health insurance. The reason: a multi-billion euro funding gap in the GKV system. For you, this could mean higher premiums to pay, rising co-payments, and fewer benefits in the future.

Higher contributions possible

There is discussion about increasing both the contribution assessment ceiling and the income threshold for mandatory insurance by €300 per month each. For high earners, this would mean a noticeable increase in the maximum monthly contribution.

Higher co-payments planned

Increasing co-payments for dentures and medications are currently being discussed.

Certain benefits may be cut

Cuts are expected in areas such as homeopathy or preventive check-ups like skin cancer screening.

Family coverage under review

The premium-free co-insurance for spouses is at risk. A monthly contribution of 2.5% of the main insured spouse's salary is currently under evaluation.

Why more people are now considering private health insurance

While GKV benefits can be reduced at any time through political decisions, PKV benefits are contractually guaranteed. In addition, switching to private health insurance could offer the following advantages:

Contractually guaranteed benefits

Deine Leistungen in der PKV sind vertraglich fixiert – und das ein Leben lang.

Save up to € 4,371 € per year

Compared to statutory health insurance, private health insurance could help you save up to € 4,371 annually in contributions.

Top-notch coverage & faster appointments

Benefit from extensive healthcare services such as reimbursement of private medical bills, preventive check-ups regardless of age, and faster specialist appointments thanks to broader access to medical practices.

Financial reserves for retirement

Through aging reserves, you are less dependent on demographic shifts by building up reserves for old age today.

Why now could be the right time to switch to private health insurance

The earlier you switch to private, the lower your monthly premium is likely to be, since contributions are based on your age and health status. In addition, a switch could become significantly more difficult in the future due to the planned increase of the income threshold.

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What are the main differences between public and private health insurance?

Public health insurance:

• Everyone can take out public insurance.
• Your contribution depends on your salary: the more you earn, the more you have to pay.
• Premiums can reach up to € 1,261.31 a month which you share with your employer. As a self-employed person, you must cover the full costs yourself.
• Coverage is quite limited and benefits can be cancelled at any time.

Private health insurance:

• Employees with a salary above the annual income threshold of € 77,400, self-employed persons, civil servants and students are eligible for private insurance.
• Your monthly premium does not depend on your salary.
• Premiums depend on your health status, the desired scope of benefits and your age of entry: the earlier you decide to switch to ottonova’s private health insurance, the lower your monthly premiums will be.
• Coverage is much more extensive and benefits are guaranteed for the entire duration of your contract.

A comparison that is worthwhile for you.

Our example of a 32-year-old employee shows you the savings potential with our Business Class tariff compared to various public health insurance plans.

You would like to know how high your contribution is with us?

Unlike public insurance, your premium at ottonova is not dependent upon your income. This means a huge saving potential for you. Simply tell us your age and employment status to find out how much you can save.

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Myth check:
What you really need to know about German private health insurance

When it comes to private health insurance in Germany, you have probably heard a lot and might have some doubts. We'll show you why common myths are not always true. Let's check the facts! 🚀

Is it too expensive in old age?

When it comes to private health insurance premiums, many people think of high financial burdens in retirement. In fact, some cheap tariffs could lead to private health insurance becoming unaffordable in old age. But ottonova’s private health insurance tariffs are made to last and have various mechanisms built into the tariffs, that will help reduce your premiums in old age:

• The ottonova tariffs are calculated in a particularly sustainable way, as they are based on a realistic actuarial interest rate (considering the current financial market and the investment regulations of BaFin).
• Private health insurance builds up a financial cushion for you with aging reserves to keep your premiums stable in old age.
• You can also lower the premium you pay in retirement today by adding our premium relief component to your premium (“BEK/Beitragsentlastung”): This allows you to reduce your contribution by, for example, € 200 per month from the age of 67.
• Mechanisms to reduce contributions in old age: From the age of 60, the 10 % statutory surcharge no longer applies, which will lower your contribution. Also, the daily sickness allowance ceases with the beginning of your retirement.
• There is a statistical distribution of risk in private health insurance, which means that the healthy pay for the sick. In statutory health insurance, the young pay for the old or high earners pay for low earners. Due to the increasing number of older people in Germany (demographic change), the system of public health insurance is becoming more and more problematic. In contrast to this, premiums in private health insurance are independent of demographic change.

You can never switch back to public health insurance?  

It’s always said that you can never get out of private health insurance, but that’s not true! And more importantly, why would you even want to switch back to public health insurance? Considering the rising costs of premiums in the public system as well as the risk of reduced coverage and less service, private health insurance can be much more beneficial.

• Whether you can switch back to public health insurance depends mainly on your age and your occupation.
• If you’re over 55 years old, it’s almost impossible to switch back to public health insurance.
• However, if you are under 55 years old, you can still switch. You even might have to switch back to public health insurance if your salary falls below the income threshold. If you're self-employed you can switch back if you start working as an employee again.

The switch is not worth it?  

By calculating your premium independently of your income, you could save more than 300 € per month compared to public health insurance and at the same time receive a higher range of benefits for your health! 

• Those who earn well share a maximum contribution of around 1,261.31 € per month (2026, childless, incl. additional contribution and long-term care insurance) in public health insurance with their employer - or bear the costs alone as a freelancer or self-employed person.
• In private health insurance, you could save up to € 4,371 per year, because your contribution is calculated independently of your income.  
• In private health insurance, you can benefit from better coverage for your health: e.g. dental treatments incl. teeth cleaning, acupuncture, treatments by alternative practitioners and chiropractors to a much greater extent, dental prostheses, subsidy for glasses, chief physician treatment, preventive medical checkups without age limits, and more
• Your contribution depends on your health status, the desired scope of benefits and your age of entry: the earlier you decide to switch to ottonova’s private health insurance, the lower your monthly premiums will be.

It is not worth it with a family?

You think private health insurance is not worth it for families? That's not true!
Even with up to three children, you could still save money with ottonova. But what about coverage? For sure you only want the best for your loved ones. With private health insurance, you enjoy excellent medical coverage as a family, which is far above the level of public health insurance.

What benefits can children access with private health insurance?

Privately insured children can access exactly the same benefits as their parents. Here’s a selection:

• They will be seen quickly by specialist doctors and always receive the best treatment. At ottonova, you can even speak to a doctor whenever you need via video call – even in the evenings or on the weekend.
• Need medication? We’ll reimburse you for all prescriptions.
• If you’d rather turn to naturopathic treatments, private health insurance is the best choice.
• Your child needs to stay in hospital? Private insurance makes this exceptional situation far easier and less stressful, as many private tariffs include free rooming-in, allowing you to stay at your child’s side.
• Parents always want to do everything right – and double check whenever they’re unsure. The private insurance system allows you to get a second opinion free of charge.
• Straight teeth and clear vision are part and parcel of private health insurance: you will be reimbursed up to € 500 every 2 years for visual aids (depending on the chosen tariff) and up to 100 % of the costs of orthodontics.

Private health insurance kicks you out when you get sick?

Not true!

The myth that your private health insurance in Germany kicks you out if your health expenses are high or if you become sick quickly after the start of your contract is a persistent one.
BUT: no German private health insurance can kick you out just because you get sick or have an accident. As long as the insured person stated everything correctly when applying (health questions), the contract is considered concluded and cannot simply be cancelled by the insurance company.  
And don't worry, your individual premium will not be increased by private health insurance simply because you may cause increased costs due to a sudden illness. Especially if you get sick, ottonova is there for you!
In general, premium adjustments (both in public and private health insurance) do take place due to rising health costs, but never for an individual customer. Premium adjustments are subject to strict legal requirements.
 

It is not worth it for women?

Private health insurance used to be a male domain and in the bisex tariffs women paid more than men. Since the introduction of unisex tariffs, however, this is no longer the case and as a woman you can benefit from private health insurance just as much as a man. 

Here is an overview of selected benefits of ottonova's private health insurance for women: 

• More preventive health benefits than in public health insurance - and generally not dependent on age. 
• Reimbursement of costs for prenatal classes, pregnancy and postnatal exercises
• More prenatal diagnostics 
• Treatment by a chief physician during a hospital stay  
• Faster access to a specialist: those with public health insurance wait an average of around 25 days for an appointment with a specialist, those with private health insurance only 12. 
• Treatment in private practices 
• Up to 100% coverage of dental bills 
• Old-age provision: With private health insurance, you make provisions for your old age with your contribution and thus protect yourself from excessive costs in old age. Unlike with public health insurance, you are less dependent on demographic change and rising health costs.

Premium health insurance for little money.

You can save a lot of money if you sign up with ottonova, and still get much better coverage compared to public health insurance. Non-EU Expats can save even more, by joining our special expat tariff.

Which two tariffs would you like to compare?

Selected: 0/2

First Class Expats

€196

€500 deductible

Deductible

0 %

• for Non-EU Expats only
• Accommodation in private room
• Dental prostheses: 90%
• World-wide coverage up to 2 months

Select tariff for comparison

Business Class

€321

€500 €1,250 deductible

Deductible

0% 10% 25%

max €500 per year

max €1,250 per year

• Accommodation in double room
• Dental prostheses: 80%

Select tariff for comparison

Business ClassPro

€331

€0 deductible

Deductible

0 % 10 % 25 %

• Contribution refund
• Accommodation in double room
• Dental prostheses: 80%

Select tariff for comparison

First Class

€333

€500 €1,250 deductible

Deductible

0% 10% 25%

max €500 per year

max €1,250 per year

• Accommodation in single room
• Dental prostheses: 90%

Select tariff for comparison

First ClassPro

€358

€0 deductible

Deductible

0% 10% 25%

• Contribution refund
• 9 months premium-free while on parental leave
• Accommodation in single room
• Dental prostheses: 90%

Select tariff for comparison

Premium Economy

€284

€1,000 €500 deductible

Deductible

10 % 50 %

• Accommodation in double room
• Specialist via ottonova concierge
• Dental prostheses: 60%

Select tariff for comparison

Stiftung
WarentestNote 1,0

You selected the following tariffs:

Exemplary monthly rate for employees Employee contribution for a 32-year-old based on our recommended plan options	Public insurance Basic insurance protection €648 monthly	Experts' recommendation €500 deductible Experts' recommendation First Class Expats Best coverage for Expats €196 €196 Change €500 deductible	€500 €1,000 deductible Premium Economy Good coverage with lowest premium €284 €284 * mtl. 10% 50% Selbstbehalt €284 Change €500 €1,000 deductible Deinen Beitrag berechnen	€500 €1,250 deductible Business Class Good price-performance ratio €321 €321 * mtl. 10% 25% Selbstbehalt €321 Change €500 €1,250 deductible Deinen Beitrag berechnen	€0 deductible Business Class Pro Great performance without deductible €331 €331 * mtl. Ohne Selbstbehalt €331 Change €0 deductible Deinen Beitrag berechnen	€500 €1,250 deductible First Class Excellent coverage €333 €333 * mtl. 10% 25% Selbstbehalt €333 Change €500 €1,250 deductible Deinen Beitrag berechnen	€0 deductible First Class Pro+ Outstanding coverage without deductible €358 €358 * mtl. Ohne Selbstbehalt €358 Change €0 deductible Deinen Beitrag berechnen
	Public insurance €648 €648 monatlich n/a placeholder	First Class Expats €196 €196 monatlich 500 € Deinen Beitrag berechnen	Premium Economy €284 €284 monatlich €284 Change €500 deductible €1,000 deductible Deinen Beitrag berechnen	Business Class €321 €321 monatlich €321 Change €500 deductible €1,250 deductible Deinen Beitrag berechnen	Business Class Pro €331 €331 monatlich €331 Change no deductible Deinen Beitrag berechnen	First Class €333 €333 monatlich €333 Change €500 deductible €1,250 deductible Deinen Beitrag berechnen	First Class Pro+ €358 €358 monatlich €358 Change no deductible Deinen Beitrag berechnen
	Public insurance	Tariff First Class Expats	Tariff Premium Economy	Tariff Business Class	Tariff Business Class Pro	Tariff First Class	Tariff First Class Pro+
Deductible Adjust your deductible according to your individual needs.	Now simply personalize:	10% 10% max €500 per year	10% 50% 10% 50% max €1,000 per year max €500 per year	0% 10% 25% 0% 10% 25% max €500 per year max €1,250 per year	0% 10% 25% 0% 10% 25% No deductible selected	0% 10% 25% 0% 10% 25% max €500 per year max €1,250 per year	0% 10% 25% 0% 10% 25% No deductible selected
No-claim bonus
Deductible	up to €10 co-payment for medicines, remedies and aids as well as per day in hospital, max. 2% of income, 1% for chronically ill patients	10% per invoice and max €500 per year	10% per invoice and max €500 per year 50% per invoice and max €1,000 per year	10% per invoice and max €500 per year 25% per invoice and max €1,250 per year	No deductible	10% per invoice and max €500 per year 25% per invoice and max €1,250 per year	No deductible
Monthly contribution	€648	€196	€284	€321	€331	€333	€358
No-claim bonus	none	none	none	none	up to 1 annual average monthly premium	none	up to 1 annual average monthly premium
Savings compared to statutory health insurance*		€364 mtl.	€327 mtl.	€317 mtl.	€315 mtl.	€290 mtl.
*For 32-year-old employees with the following plan options: €150 daily sickness benefit starting on the 43rd day and €200 in premium relief starting at age 67, with no risk surcharge.
How much is your personal contribution? Your age, daily sickness benefits, premium relief in old age, and your health condition determine your individual premium. Calculate individual premium Get comprehensive advice
Outpatient services
Appointment booking through our Concierge
Directly to the specialist, access to private doctors			via ottonova concierge
Corrective lenses, e.g. glasses/contact lenses		up to €300 in 2 years	up to €150 in 3 years	up to €300 in 2 years	up to €300 in 2 years	up to €500 in 2 years	up to €500 in 2 years
Elective Vision Correction Surgery (for example, LASIK)			up to €1,000	up to €2,000	up to €2,000	up to €3,000	up to €5,000
Alternative practitioners		up to €1,000	up to €500	up to €1,000	up to €1,000	up to €1,500	up to €2,000
Inpatient services
Free choice of doctor (including head of department)
Accommodation	Multi-bed room	Private room	Double room	Double room	Double room	Private or double room	Private room
Assumption of costs for treatment in private clinics
Dental services
Dental treatments	0 - 100 %	100%	100%	100%	100%	100%	100%
Dental prostheses	10 - 65 %	60 - 90%	60%	80%	80%	90%	90%
Professional dental cleaning	small subsidy possible	100% 2x per insurance year, max. €125 per treatment	100% 1x per insurance year, max. €125 per treatment	100% 2x per insurance year, max. €125 per treatment	100% 2x per insurance year, max. €125 per treatment	100% 2x per insurance year, max. €125 per treatment	100% unlimited reimbursement
Other services
Bonus for preventive health care	potentially
Worldwide coverage and repatriation
Preventive medical checkups without age limits
Coverage guaranteed for a lifetime
Contribution-free during parental leave	potentially						(up to 9 months when receiving parental allowance)
This list does not represent a conclusive comparison between the scope of the public health insurance coverage and the scope of coverage of the ottonova tariffs. The coverage details described are an excerpt from the tariff benefits and highlight differences. For comprehensive advice, please contact our experts. Please find a summary of the coverage details of the ottonova tariffs here. And for full descriptions of the ottonova tariffs click here. The terms and conditions of the individual insurance contract shall prevail and apply. The English translation is a non-binding version for your information only and has no legally binding character. The contract language will be German only.

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Public insurance First Class Expats Premium Economy Business Class Business Class Pro First Class First Class Pro+

Please select 2 Tariffs

Choose a tariff to compare

First Class Expats Best coverage for Expats

from €196

Deductible

max €500 per year

0 %

First Class Expats Best coverage for Expats

from €196

Deductible

max €500 per year

0 %

Premium Economy Lowest premium

from €284

Deductible

max €1,000 per year

max €500 per year

10% 50%

Premium Economy Lowest premium

from €284

Deductible

max €1,000 per year

max €500 per year

10% 50%

Business Class

Pro

Great price-performance ratio

Great price-performance ratio

Great performance without deductible

from €321

Deductible

max €500 per year

max €1,250 per year

without 10% 25%

Business Class

Pro

Great price-performance ratio

Great price-performance ratio

Great performance without deductible

from €331

Deductible

max €500 per year

max €1,250 per year

without 10% 25%

First Class

Pro+

Excellent coverage

Excellent coverage

Outstanding coverage without deductible

from €333

Deductible

max €500 per year

max €1,250 per year

without 10% 25%

First Class

Pro+

Excellent coverage

Excellent coverage

Outstanding coverage without deductible

from €358

Deductible

max €500 per year

max €1,250 per year

without 10% 25%

Compare now

Personal advice, that really helps you out.

Sign up for a free consultation with our English-speaking insurance experts to find the best tariff for you.

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Who can benefit from an expat health insurance plan in Germany?

The laws in Germany only allow residents with a limited residency permit to sign up for expat health insurance plans.

• If you are an expat here on a limited permit (Non-EU citizens with temporary visa working in Germany) and plan to stay in Germany less than five years – or simply not sure how long you'll be here - you can benefit from our expat health insurance plan: First Class Expats.
• If you are an EU citizen or plan on staying in Germany for longer than five years (no matter if EU- or Non-EU citizen), you can choose between our different long-term full-insurance options at ottonova: Premium Economy Class, Business Class and First Class.

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Why private insurance with ottonova is worthwhile for you

Top-notch health benefits

including reimbursement of visual aids, dentures and private medical bills

Your savings potential

up to € 4,371 per year compared to public insurance

English-speaking support

in real time

Zero paperwork

digital services in one app

Worldwide coverage

up to 6 months

High customer satisfaction

according to independent KUBUS study

Appointments with English-speaking doctors

booked for you

Fulfils all legal requirements for your visa

according to § 257 SGB V

Time-saving digital services
– all in one app.

We offer you everything you need to skip the paperwork and make your health insurance as easy as possible.

We'll do the work for you.

• Appointment service Our Concierge service arranges your medical appointments.
• Health advice Answers all your health and medical insurance questions
• Service abroad Fast, reliable & digital at your side for help.

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Digital doctor’s visit

• Video Consultations with our Partner TeleClinic Don’t want to leave your home? No problem! TeleClinic doctors are available to provide you with digital consultations 24/7, including Sundays and public holidays.
• Save Time Receive medical certificates and prescriptions through telemedicine consultations. As fully insured ottonova-member, you’ll often benefit from priority consultations within 30 minutes.
• Second Opinion Wondering if a procedure is really necessary? We’ll help you get a well-founded second opinion.

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Our app - a real multi-talent

• Keep track Find all the tariff information in your profile at a glance and change it if necessary.
• Fast refunds of your invoices Upload your invoice via app - receive money back within a few days.
• Perfectly organized, without paperwork We sort your documents and events chronologically in your app.

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FAQ

How can I sign up?

To help you with our online sign-up process, we'll set up an appointment to chat on the phone. We can answer any questions you might have, and guide you through the steps, one at a time.

Get a Consultation now!

What happens to my contract if I leave?

You're free to go! No wiggling out of a tricky contract, no matter which health insurance tariff you choose. If you leave Germany sooner, simply contact us and attach your deregistration form from the German Immigration Office - an Abmeldungsbescheinigung. We'll close your contract and wish you the best of luck on your journey. Promise!

Which tariff should I choose?

We have different full-insurance options at ottonova. All tariffs are solid and built to last. If you plan on staying in Germany for longer than five years, you can choose between Premium Economy Class, Business Class and First Class.

If you are here on a limited permit and plan to stay in Germany less than five years – or simply not sure how long you'll be here - we also offer a special Expat tariff, which provides premium coverage to keep you healthy and happy throughout your stay in Germany. For a full overview of the services offered in our Expat tariff, click here.

We help you find the best option for your personal needs – start with getting a consultation with our English-speaking experts now!

Why is the Expat tariff cheaper?

Normally, private insurance plans help you to save for your future - you'll pay more now, so that your premiums don't rise later. But if you're only planning on staying in Germany for a short time - less than 60 months - then there's no need to set this extra money aside.

Get a Consultation to get started!

Why is the Expat tariff only available for non-EU expats?

The laws in Germany only allow residents with a limited residency permit to sign up for expat plans. Unfortunately, this means we can only offer this special tariff to expats who are here on a permit, and not those who can live in Germany without any type of visa.

How often do premiums increase?

As a regulated health insurance, we cannot just increase premiums any time we want. Premiums can increase when actual health costs in general differ more than 5% from what we calculated. This can only happen due to inflation and rising medical costs.

However, this will never happen for single individuals but rather for all insured people at the same time. Specifically, we cannot increase your premiums because you get sick or because you get older. We also cannot terminate your contract for those reasons. We guarantee you coverage for a lifetime when you sign up.

Can I sign up from abroad?

You can start your sign-up process from abroad. As soon as you arrive in Germany, we will organize a general check-up with an English-speaking nurse for you. When we receive the results, we will be able to finalize your policy.

Does ottonova help with my visa application?

Definitely! ottonova is a fully licensed German health insurance and fulfills all regulatory requirements, unlike other providers such as Mawista, Cigna or Allianz Worldwide Care.

We are regulated in § 257 SGB V, which is necessary for your visa applications. This also includes the Expat tariff.

How can I cancel my current insurance?

We can help you write your cancellation letter for your current insurer and send it to you by email. Piece of cake!

Can I have top-up insurance with ottonova?

If you’re insured in the public system, we can also offer you one of our top-up insurances. We can offer Dental Top-Up and Hospital Top-Up tariffs. You can give us a call and we will help you find the best option for you!