Altersrückstellungen: aging reserves in German private health insurance

German private insurance is priced on a level-premium principle, similar to life insurance. Your premium is calculated so that, in early years, a meaningful share, often around a third, flows into reserves rather than current claims. On top of that, the law adds a statutory 10 percent surcharge (gesetzlicher Zuschlag) on premiums from the calendar year after your 21st birthday until the year you turn 60, for contracts concluded since 2000. At 60 the surcharge drops away and your premium falls; from retirement age the accumulated funds dampen increases. This is also why entry age drives your premium: the younger you enter, the more low-cost saving years you get, at conditions no later entry can buy back.

Aging reserves are not a personal savings account. German courts have confirmed that they belong to the insured collective: they cannot be paid out when you cancel, cannot be refunded when you leave Germany, and are not inheritable. Whatever you have built up either travels with you under the rules above or stays behind. That makes the switching decision asymmetric: an internal tariff change preserves everything, while leaving your insurer late in life can forfeit decades of savings. It is the main reason we model insurer choice as a long-term decision from day one, and check Bestandsschutz carefully before any move.