Private health insurance explained simply

Private health insurance definition: What is the meaning of PKV?

Private health insurance (German: private Krankenversicherung; short: PKV) is a form of health insurance that exists alongside the statutory health insurance (German: gesetzliche Krankenversicherung; short: GKV) in the German health insurance system. PKV companies offer both comprehensive health insurance and supplementary health insurance. Comprehensive health insurance offers comprehensive health insurance coverage, while supplementary health insurance closes benefit gaps for people with statutory health insurance, i.e. it supplements statutory health insurance.

• Private health insurance offers people who are not subject to compulsory insurance in the statutory health insurance an alternative to cover their medical costs.
• Switching from statutory health insurance to private health insurance rates is therefore only possible for certain groups, but the rates for supplementary insurance are open to those insured under statutory health insurance regardless of income or occupational group. These are primarily civil servants, the self-employed and employees who earn a salary above the annual income threshold as well as students.
• Civil servants are entitled to benefits from their employer, which is why they only have to cover part of their medical costs through private health insurance. In the case of salaried employees, the employer pays about 50 percent of the costs of health insurance through the employer subsidy.
• The premiums for private health insurance depend on the individual health status, age and desired benefits.
• The type and scope of insurance coverage in private health insurance is generally not regulated by law. It depends on the insurance conditions and the agreed tariffs, which are negotiated between the contracting parties.
• In private health insurance, reimbursement of services is based on the principle of cost reimbursement, which means that insured persons must first make financial advance payments.
• Unlike statutory health insurance, there is no non-contributory family insurance in private health insurance. Each family member takes out their own tariff.
• However, benefits are also contractually fixed and, unlike in the statutory health insurance system, cannot be reduced.