- Updated:
- 05.10.2026
Private health insurance (Private Krankenversicherung, PKV) in Germany offers a wider choice and individual services compared to public insurance. When choosing such insurance, it is important to understand what exactly it includes and how it covers various aspects of medical care. In this article, we will examine which services are included in the private insurance package, from outpatient and inpatient treatment to dental care and preventive measures.
All articles about private health insurance in Germany:
What is PKV and what is included in private medical insurance
PKV — Private Krankenversicherung — is private health insurance in Germany. Private insurance companies determine the number of tariffs and what is included in them themselves. This allows the insured person to choose the terms and necessary coverage themselves in accordance with their wishes.
Private health insurance covers:
- Doctor’s visit — treatment by doctors and specialists.
- Inpatient treatment — coverage of hospitalisation costs, including single, twin or shared room.
- Outpatient treatment — examinations, tests and procedures.
- Medicines — to the extent of the chosen tariff.
- Prevention: preventive check-ups; vaccinations to the extent of the chosen tariff.
- Dental services — treatment, dental hygiene and prosthetics.
- Ophthalmology — eye tests and vision correction.
- Additional services — alternative medicine (physiotherapy, homeopathy, massage), assistive devices.
However, there is also a mandatory tariff set by law. This is the so-called social tariff (Social tariffs in private health insurance). It is the same for all insurance companies and is calculated centrally.
It is also mandatory to take out Pflegepflichtversicherung (compulsory long-term care insurance) — insurance that covers the costs of long-term care for people who need it due to illness, disability or old age. This includes funding for care at home or in specialised facilities, payments towards the purchase of special aids and home adaptations, and the possibility of financial compensation for relatives providing care at home.
PKV Tariffs
What types of private insurance tariffs are there?
PKV Tariff Plans
Private health insurance offers its customers guaranteed freedom of choice. Policyholders can choose the scope of cover and the tariff themselves — both when taking out the policy and at any time during the policy term. Companies often divide this scope of cover into several tariffs, for which additional modules are also available.
Which private health insurance plan is best suited to you depends on various factors — for example, which services are particularly important to you, whether you are self-employed, whether you wish to have an excess, and so on.
Option to reduce contributions in retirement (Beitragsentlastungstarife)
To ensure that health insurance contributions do not become unaffordable after retirement, there is a scheme to reduce them. This means that, before you retire, you pay slightly more throughout the entire insurance period. After that, your monthly contribution is reduced.
The aim of this tariff is to reduce private health insurance premiums in old age by a fixed amount for life, through monthly savings. This tariff operates in a similar way to savings-based schemes and can be offered without a health or risk assessment.
Contributions under this scheme are split equally between the employee and the employer (provided the maximum subsidy has not already been exhausted). This contribution is tax-deductible. If you and your spouse are planning to divorce, the accumulated funds under this scheme are not subject to division. It is also important to note that contributions continue to be paid after retirement. It may be the case that, in the event of the contract being terminated (due to a change of insurance company or the death of the insured person), the contributions are not passed on to the heirs or transferred to the GKV (statutory health insurance). In other words, you will lose these contributions unless the insurance company’s terms provide otherwise.
PKV Special Tariffs
The following standard tariffs are available for insured persons of all insurance companies:
- Basic
- Standard
- Emergency
Insured persons have various options for reducing the amount of their health insurance contributions — either on a permanent basis or for a limited period.
The Basic Tariff in PKV (Der Basistarif)
The basic tariff is the social tariff in private health insurance. It is suitable for people who are in need and are entitled to social assistance, or who cannot be insured under the state insurance scheme. People who were insured under private health insurance (PKV) after 31 December 2008 may switch to this tariff. For those who have been with a private health insurer for a longer period, switching to the basic tariff is only possible upon reaching the age of 55, upon retirement, or if they are entitled to social assistance.
The maximum contribution under the basic tariff for an individual is €1,017.19 per month in 2026. The long-term care insurance contribution is payable in addition to this. If a person is entitled to social assistance, the basic tariff contribution may be halved. If insured persons in need of assistance are unable to pay this reduced contribution, social services will pay part of the required contribution or cover it in full.
Standard tariff in PKV (Der Standardtarif)
The standard tariff offers services comparable to the benefits of statutory health insurance. It is a relatively inexpensive alternative within long-term private health insurance. Contributions for individuals under the standard tariff are capped at the maximum GKV contribution — no more than €848.62 per month (2026), about €480 on average — plus an additional contribution for long-term care insurance. Family members who would be insured under the GKV can also switch to the standard tariff. Around 53’000 people are insured under the standard tariff.
All persons who were insured under the PKV scheme as at 1 January 2009 may switch to the standard tariff if:
- they had private medical insurance for at least 10 years and
- aged 65 or over, or
- aged at least 55 years and total income does not exceed the GKV contribution assessment ceiling (2026: €5,812.50/month)
- are under 55 years of age and have either been granted or have applied for a pension under the statutory pension insurance scheme or are retiring in accordance with civil service regulations, and their total income does not exceed the GKV contribution limit (2026: €5,812.50 per month)
Emergency tariff in PKV (Notlagentarif)
Insured persons experiencing difficulties with paying private health insurance contributions can agree a potential solution for this period with their insurer. If the inability to pay is temporary, it is possible to arrange with the insurer to defer the contributions. However, the insurer is not obliged to do this.
If an insured person fails to pay their premiums for several months, the insurer may take action against that person (such as taking them to court for the outstanding debts or initiating enforcement measures, such as seizure of assets). This will also happen if, during the period of non-payment, the insured persons have switched to another private insurer or to a state-run insurance company. There is also another option, whereby the insured person will be transferred to an emergency tariff.
The emergency tariff offers a solution in the event of temporary insolvency. It applies for the short term. It is not possible to choose it or switch to it independently. This tariff is designed in such a way that the contribution is very low. Each private health insurance company sets the amount of the payments in this tariff itself. The longer you have paid contributions prior to this, the lower the amount of the payments will be. However, penalties will also be charged for late payment.
During this period, insured persons do not have to pay contributions towards old-age reserves and, as a result, are given an excellent chance to clear their arrears in the shortest possible time and return to their original tariff. This happens automatically once the full amount of the debt has been repaid. Medical services during the validity of the emergency tariff are provided on a minimal scale. Only treatment for acute illnesses, pregnancy and maternity is covered. For children and adolescents, the costs of medical treatment in connection with illness or an accident, preventative examinations and vaccination are covered.
What should be included in the insurance
Hospital services
- Single, double or standard room.
- The attending physician is either the head physician or the doctor on duty.
- Daily hospital allowance (for extra expenses or personal use).
- Free choice of hospital.
Additional payments
- Daily sickness allowance (Krankentagegeld): a payment for every day you are unable to work.
- Short-term additional payments (for a spa, for example).
Outpatient treatment
- Initial consultation.
- Emergency help.
- Payment for medication.
- Massage, physiotherapy, alternative medicine.
- Medical aids (wheelchair, hearing aid, prosthesis).
- Glasses (new, to replace stolen or broken ones, regular replacement even if the previous glasses are intact, contact lenses). Laser vision correction. Early detection of glaucoma.
Psychotherapeutic treatment
Considered individually in the tariffs of each insurance company. The number and cost of sessions with a psychologist depend on the terms of the insurance contract. This can be outpatient, inpatient care, or online consultations. Diagnoses for which private insurance may include treatment: depression, neuroses, phobias, eating disorders, psychosomatic disorders.
Dental treatment
- Dental treatment.
- Professional cleaning.
- Modern fillings.
- Root canal treatment.
- Dental prosthetics (crowns, bridges, implants) have an annual cost limit. In the event of an accident, there are no limits.
- General anaesthesia.
- Orthodontist (there may be an age limit).
General services
- Online doctor.
- Recommended vaccinations.
- Health screening (early detection of cancer, prevention of cardiovascular disease, early detection of high blood pressure, circulatory system diseases and metabolic disorders, doppler sonography).
Medical treatment abroad
- Throughout Europe.
- Worldwide (time-limited).
- Medical repatriation.
Pregnancy and childbirth care*
- Routine check-ups (blood pressure monitoring, weight monitoring, urinalysis), laboratory tests (screening for infections: HIV, hepatitis B, syphilis, rubella), prenatal diagnostics (chromosomal abnormalities, hereditary diseases, Down syndrome) and doctor’s visits are included in the insurance. The cost of the insurance does not increase as a result.
- After birth, the child receives private medical insurance without the need for a medical examination and without exclusions, even if medical risks are discovered.
- 3D ultrasound.
- Antenatal class.
- Natural birth or caesarean section.
- Comfortable postnatal room and supervision by the head physician.
* the service package depends on your tariff
What can be excluded from an insurance policy
- Single room.
- The attending physician is the head physician.
- Daily hospital allowance (for extra expenses or personal use).
- Short-term additional payments (for a spa, for example).
- Spectacles (replacement even if previous spectacles are undamaged).
- Online doctor.
Private Health Insurance (PKV) and Travel Insurance
You have private medical insurance in Germany. Does it “work” abroad or do you need to take out an additional policy? That depends on your chosen insurance tariff. Many policies include cover abroad. But, unfortunately, not all of them do. Therefore, you should check the conditions of your insurance before your trip:
- Does your insurance cover you in countries outside of Europe?
- How long can the journey last?
- Is medical repatriation financially covered?
If necessary, we recommend increasing your existing cover or taking out additional travel medical insurance.
But there is another important point in favour of taking out travel insurance to supplement your main insurance policy. Only tariffs with premium refunds (Beitragsrückerstattung) pay back part of your premiums for years without claims: for example, 4–6 monthly premiums after three years without claims.
However, when travelling abroad, it is difficult to avoid seeing a doctor. Because a change in climate, time zones, unfamiliar food and water, different epidemiological conditions, and insufficient time for acclimatisation increase the risk of an immune system malfunction, tourists often seek help (intestinal infections and poisoning, colds, allergies, migraines, eye diseases, insect bites, and infectious and viral diseases). In this case, it would be wiser to use an additional private insurance option — a travel insurance policy. It can cost around €30 per year per person. Not only will it protect you on your trips, but it will also allow you to receive an annual bonus from your insurer.
Vaccinations for travelling abroad to epidemiologically unsafe regions
Private medical insurance pays for vaccinations for children and adults under the national vaccination schedule to the extent of the chosen tariff. However, additional vaccinations for travelling abroad may not be included. This depends on your insurance company and the policy under which you are insured. If your contract states that preventative vaccinations are also covered, this means the insurer will pay for them. If this is not stated in your policy, but your trip to a country requiring additional vaccination is for professional purposes, you should check this with your insurance company.
Be sure to check the deadlines and necessity of vaccination before your trip. These could include, for example, vaccinations against meningitis, malaria, yellow fever, etc.
Compulsory long-term care insurance (Pflegepflichtversicherung) — prices in the GKV and PKV
Long-term care insurance (due to illness, injury, or old age) is a must for everyone living in Germany. And it does not matter whether you are insured with a state or private company. Every month you will also pay contributions towards the Pflegepflichtversicherung (statutory long-term care insurance). Therefore, it is important to know and understand how much you are paying for this insurance.
If you start comparing the amount of the monthly contributions, bear in mind that on the payslip of someone insured under the public health scheme, this line appears separately and is often overlooked. Therefore, you might only pay attention to the payment amount for the Krankenversicherung. With private insurance, however, this payment is already included in the total sum. In the end, it works out roughly like this:
State insurance
Private insurance
Compulsory long-term care insurance €209.25 (€104.63 each paid by the employee and employer; €244.13 for people without children)
€800 health insurance + compulsory long-term care insurance
Total: ≈ €1,226 (≈ €1,261 without children)
Total: €800
Frequently asked questions
The decisive factor for the contribution amount is, above all, the desired scope of services, your age and your state of health at the start of the contract. The earlier you switch to private health insurance, the lower your medical expenses will be, even in the long term.
Which private health insurance tariff is best suited to you depends on various factors — for example, which services are particularly important to you, whether you are self-employed or a civil servant, whether you want an excess, and so on.
After a free consultation we will be able to advise you on the best option.
Age alone does not push the premium up, but it is reviewed when treatment costs rise: in 2026 for about 60% of policyholders, by 13% on average. Old-age reserves help you avoid significant expenses in later life. An additional contribution of 10% towards these reserves is enshrined in law and builds up your old-age reserve. This contribution ceases from the age of 60, and the cost of private health insurance is reduced. Furthermore, upon retirement, the contribution towards sick pay (Krankentagegeld) is also discontinued.
A deductible policy means that you pay your own medical bills up to a specified annual amount. Only when this limit is exceeded does the insurance company begin to pay the bills. In return, you pay lower monthly premiums. Certain services (preventive check-ups and, where the tariff includes them, vaccinations) are usually excluded from the deductible.
We will be happy to advise you on the services of private insurance companies in Germany. Book a free appointment and find out which insurance is right for you.
Do you need advice?
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