7 Myths about private health insurance

When it comes to private health insurance, it's easy to make hasty statements that aren't at all true. We'll clear up the most common private health insurance myths for you. Here you can find out, for example, what happens when you leave Germany and whether private health insurance really becomes unaffordable in old age.

Myth 1: Private health insurance is 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:

Testimonial Image

“With its old-age provisions, private health insurance offers sustainable, intergenerational financing and affordable premiums in old age.”

Heribert Private health insurance expert at ottonova

Beware of cheap rates!

Compare the tariffs carefully before taking out private health insurance. Especially with regard to how much you are saving for old age. This is because very cheap bait offers mean that premiums are quickly adjusted and become much more expensive.

In private health insurance, there are also premium increases, but insurers cannot set these arbitrarily. However, your premiums cannot increase just because you get older or ill.

But premiums in statutory health insurance (gesetzliche Krankenversicherung or short GKV) are also rising continuously - even more than in private health insurance (private Krankenversicherung or short PKV). An analysis by the Wissenschaftliches Institut der PKV (WIP) shows that private health insurance premium income rose by 3.1% between 2004 and 2024, while statutory health insurance recorded an increase of 3.8% in the same period. This means that private health insurance performs better in a direct comparison.

development of premium in public and private health insurance

Myth 2: It only makes sense to have private health insurance if you know you leave soon

A lot of Expats think that private health insurance is only worth it when you take it out for a short amount of time. But that's not true. If you plan to stay longer than 5 years in Germany, private health insurance still can offer a savings potential.

By calculating your premium independently of your income, you could save up to 200 € per month compared to public health insurance and at the same time receive a higher range of benefits for your health!

premiums private vs public health insurance

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Myth 3: I can never switch back to public health insurance

People always say that you can never get out of private health insurance, but that's not true at all! Whether you can switch back to statutory health insurance depends mainly on your age and your professional status or income.

  1. If you are over 55 years old, it is almost impossible to switch back to statutory health insurance.
  2. If you are under 55, you can switch to statutory health insurance if your professional status and income change:

Example:

You have become self-employed, are under 55 and would like more job security after a few years because the uncertain order situation as a self-employed person is too risky for you. So you decide to take on a permanent position again. In your new job, you earn e.g. 65,000 euros - i.e. below the current annual income threshold of 73,800 euros. This automatically makes you subject to compulsory insurance again and you even have to switch back to statutory health insurance.

Myth 4: Private health insurance is not worth it with a family

You think private health insurance is not worth it for families? That's not true!

Even with two 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:

Private health insurance vs. statutory health insurance - what savings potential do you have with a family?

More benefits sounds good, but what about the financial aspect? Our sample calculation for a family with one child shows you how much you could save on premiums.

Book a consultation now to find out whether private health insurance could also be worthwhile for your personal family situation.

 

Public health insurance

incl. additional contribution
and long-time nursing care

ottonova

Tariff:
Business Class Pro

ottonova

Tariff:
First Class Pro+
Father1.141 €732 €786 €
Mother1.141 €704 €757 €
Child0 €196 €211 €
Total contribution2.282 €1.632 €1.754 €
Employer's share1.141 €816 €877 €
Premium/Month1.141 €816 €877 €
Annual premium savings compared to statutory health insurance3.902 € pro Jahr3.172 € pro Jahr

Calculation example for: Father (34 years old, over the statutory retirement age, employed), mother (32 years old, over the statutory retirement age, employed) and child (4 years old), with daily sickness benefit of € 120 / day from the 43rd day and premium relief at retirement age of € 200 per month from 67 (private health insurance), rounded values

Myth 5: Private health insurance kicks you out when you get sick

That's definitely 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 private health insurance company can kick you out just because you fall ill or have an accident. As long as everything was stated correctly when you applied (health questions), the contract is considered concluded and cannot simply be terminated by the insurance company because you fall ill.

And don't worry, your premium cannot be increased by the private health insurance company just because you may incur higher costs due to a sudden illness.

Generally speaking, premiums are adjusted (both in private and statutory health insurance) due to rising healthcare costs, but never for an individual customer. Premium adjustments are subject to strict legal requirements and may not be made arbitrarily.

So if you are suddenly diagnosed with an autoimmune disease such as type 1 diabetes, for example, your private health insurance company cannot kick you out or directly increase your premium because you are now incurring higher treatment costs. Ultimately, your health insurance is there to support you if you fall ill and to cover the costs of treatment so that you can concentrate on your recovery.

Testimonial Image

"Benefits that were contractually agreed at the time of conclusion are guaranteed and cannot be reduced in the future.

Heribert Private health insurance expert at ottonova

Incidentally, it's also not true that you generally can't switch to private health insurance if you have a pre-existing condition.

Chronic illnesses do not automatically lead to rejection. Even with a pre-existing condition, you often have the option of taking out private health insurance. Before you can take out a policy, the insurer will ask about your state of health and decide whether a risk surcharge is due.

However, as every illness is different and the assessment is individual, there is no guarantee that your application will be accepted. In the case of more serious pre-existing conditions, it may not be possible to take out private health insurance.

Still unsure whether private health insurance is the right choice for you?

Our insurance experts will be happy to advise you free of charge and without obligation and answer all your questions about private health insurance and ottonova.

Myth 6: With private health insurance, I always have to pay the bills myself first

This is true: With private health insurance, you receive your bills directly from your doctor or therapist and then submit them to the insurance company.

But: If you opt for digital private health insurance that also has a well-functioning app, you can simply take a photo of the bill, upload it and have your money back in your account before it has to go to the doctor.

For particularly expensive treatments or a hospital stay, doctors' surgeries or hospitals can even settle the services directly with your private health insurance so that you don't have to pay the bill yourself.

Myth 7: Private health insurance 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: 

ottonova Magazin Autor
WRITTEN BY Marie-Theres Rüttiger

Marie-Theres is online editor for health and insurance topics at ottonova. She researches and writes mainly about private health insurance, (e-)health and digital innovation that make life better.

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