Myths about private health insurance in Germany

Updated:
05.10.2026

Medical insurance is an important part of taking care of your health and wellbeing. However, when it comes to private medical insurance, many people encounter conflicting information and myths that cause concern. Is private medical insurance really only available to wealthy people, and what happens to its cost as you get older? Let’s clear up these and other popular misconceptions.

In brief: the truth and myths about PKV (private health insurance)

There are many fears surrounding private health insurance in Germany, and most of them are oversimplifications. PKV is not just “for the rich”: it can be beneficial for the self-employed, civil servants, and single-earner families. Contributions do not rise uncontrollably in old age — part of the payment goes into a reserve, which later reduces the cost. And yes, returning to the GKV (statutory health insurance) is possible in certain cases. Below, we debunk the 8 most common myths one by one.

All articles about private health insurance in Germany:

Health insurance in Germany

Health insurance in Germany is compulsory. You can choose a public (GKV) or private (PKV) provider:

GKV — gesetzliche Krankenversicherung. Statutory health insurance: contributions are calculated as a percentage of income, but no more than €1,017.19 per month at the average supplementary rate of 2.9% (2026); with a fund that charges a higher supplementary rate, the maximum is higher. Let’s not forget the contribution to long-term care insurance (Pflegeversicherung) as well, which always goes hand in hand with health insurance.

PKV — private Krankenversicherung offers a personalised approach, expanded coverage, and faster, more comfortable service. The premiums depend on the insurance coverage and the insured’s medical risks. Age alone does not push the premium up, but it is adjusted when treatment costs rise: in 2026 for about 60% of policyholders, by 13% on average.

Each type of insurance has its pros and cons, but it is precisely around PKV that numerous myths and stereotypes exist.

Myth 1. Private medical insurance is only for the rich

This is only partly true. Since public health insurance depends on income, it is often more cost-effective than private insurance. For people with high incomes, however, PKV is often more advantageous, as insurance plans do not depend on income and you can choose comprehensive cover (including for all family members) with lower contributions than in the public system for a comparable level of earnings. Plus, additional savings are possible through the refund of part of the contributions, in accordance with the insurance contract.

Private medical insurance can be taken out by:

international students
entrepreneurs (self-employed and freelancers)
Civil servants - for them, private health insurance (PKV) can be more cost-effective than state health insurance
employees earning more than €77,400 gross per year (as of 2026)
high-earning professionals

Myth 2. Once you have taken out PKV, it is impossible to return to GKV

There is a certain income threshold. If you are under 55, employed and your earnings fall below this figure, you can rejoin the GKV. This figure changes every year; in 2026 the threshold is €77,400 gross. Your level of income may decrease if you move from full-time to part-time employment or if you become unemployed and receive Arbeitslosengeld I (unemployment benefit); with Grundsicherungsgeld (basic income support) there is no way back.

However, of course, constantly “switching” back and forth between private and state insurance won’t work. This is because a specific procedure and justification are required each time. Moreover, after the age of 55, this becomes even more difficult. But it is not entirely out of the question either.

Myth 3. If I have diagnosed medical conditions, I will not be able to take out private insurance

Regardless of their state of health, every person in Germany must have insurance (public or private). If you already have previously diagnosed conditions, you can still take out PKV, but they may also be the reason for rejection. Chronic illnesses are not necessarily a reason for rejection. In this case, you will have a risk surcharge and possibly some benefits excluded or reduced. However, certain conditions can indeed be grounds for refusal of insurance.

It is important to honestly complete the questionnaire when entering into a contract.

You will find details about private medical insurance in our article

More details

Myth 4. In old age, monthly contributions will be very high

Right at the start, when taking out the insurance, you will pay both the insurance premiums and the portion that is set aside in the ageing reserve (Alterungsrückstellung). This is the so-called safety cushion for old age. The earlier you start paying, the more you will have put aside for old age within your private health insurance. From 60 the 10% surcharge falls away, and on retirement so does the Krankentagegeld (daily sickness allowance); the employer’s subsidy is replaced by a subsidy from the pension insurer. Therefore, long-term planning and the correctly chosen tariff are important in this matter.

If you decide to take out private health insurance too late, the monthly contributions automatically become higher to allow you to build up that financial buffer in time for the future. This should be taken into account, and at some point, switching to PKV simply won’t be financially viable anymore.

Myth 5. Private health insurance is constantly getting more expensive

Insurance contributions undoubtedly increase over time. The reason is the increase in the life expectancy of the population. But this also happens with public health insurance. Age alone does not push the premium up, but it is adjusted when treatment costs rise: in 2026 for about 60% of policyholders, by 13% on average. Based on our practice, we can note that contributions to statutory health insurance grow even slightly faster than in the private sector.

Myth 6. Without private medical insurance, I do not have access to enhanced benefits and better care

You can get similar service packages by taking out supplementary health insurance on top of your GKV.

Myth 7. Private insurance is not cost-effective for families with children

Of course, with state insurance, as we all know, the whole family can be insured without any additional contributions. But to ensure the desired package of services, you “top up” the basic plan with additional insurances. And this is precisely where the price works in favour of private health insurance. Because in the end, you get a higher quality of service for less money. And from 2028 even the “as we all know” needs correcting: the member will pay a surcharge of 2.5 % of their income for a spouse unless there is a child under 12 in the household – on €5,000 a month that is €125. Children in the GKV are still insured free of charge.

Myth 8. Private health insurance covers all medical expenses

Actually, the insurer only pays for what is insured. Therefore, you should carefully read the terms of your policy rather than just looking at its price.

We have debunked eight popular myths about private health insurance in Germany. We hope that it will now be easier for you to make an informed decision. After all, life is a long and multifaceted journey, and health and well-being are among the most precious gifts you can give yourself.

Our consultants are always ready to help you find the optimal insurance solution tailored to your individual needs. Contact us in any way convenient for you, and we will be happy to provide a free consultation so that you can make a choice with confidence and a full understanding of all the options.

Frequently asked questions about PKV (private health insurance)

Is it true that private health insurance (PKV) is only for the rich?

No, the contribution to PKV does not depend on income, but on age, health and the chosen range of services. For high earners, the self-employed and civil servants, it is often cheaper than GKV with more comprehensive coverage. It is not a matter of wealth, but of status and life situation.

Is it true that you cannot return from private health insurance (PKV) to statutory health insurance (GKV)?

Not quite. It is possible to return to the state system if your income drops below the compulsory insurance threshold and you are an employee. It becomes more difficult after the age of 55 — at that point, returning is practically barred by law.

Will I be refused PKV if I have a chronic illness?

Not necessarily. Diagnoses affect the conditions: the insurer may raise the premium or add a loading, but outright refusal isn’t the only outcome. Much depends on a well-crafted anonymous inquiry to several insurers before submitting an application.

Is it true that PKV contributions will become unaffordable in old age?

No. By law, a 10% surcharge is added to the contribution for the old-age reserve — this surcharge is waived at the age of 60, thereby reducing the cost. In addition, there are tariffs offering the option of reduced premiums in retirement (Beitragsentlastungstarife).

Is it true that PKV is constantly getting more expensive?

Contributions really are reviewed, just like in the GKV, due to rising medical costs and life expectancy. But a sharp and permanent increase is a myth: built-up reserves cushion the rises, and the tariff can be optimised.

Is it true that good treatment is not available without private health insurance?

The enhanced service (consultations with the chief physician, a single room, shorter waiting times for appointments) is about convenience, not the difference between life and death. Basic, high-quality care is also provided by GKV; PKV adds comfort and choice.

Is it true that private health insurance is not worthwhile for families with children?

It depends on the situation. In the GKV, children and a non-working spouse are often insured for free, whereas in the PKV everyone is paid for separately. From 2028, the GKV charges a surcharge of 2.5 % of the member’s income for a spouse unless there is a child under 12 in the household; children stay free. However, if one high-earning parent works while the second parent and the children remain in the GKV, the combination can be advantageous.

Is it true that PKV covers literally all costs?

No. Only what is set out in your policy is covered. Therefore, it is important to understand in advance which services are included, whether there is an excess and limits—there is no such thing as a universal policy for everything.