What is the difference between public and private health insurance in Germany?

Public health insurance in Germany charges ~14.6% plus Zusatzbeitrag of your gross income and covers non-working family members for free. Private health insurance is priced by age, cover and health instead of income, which is why high earners, self-employed professionals and healthy newcomers usually get noticeably better care for a lower premium. Switching back to public is rarely possible after age 55, so get advice before you decide.

Is private always better than public?

For those who qualify, private health insurance usually wins on cover, access and often on price. Public remains the better fit for single-earner families and anyone below the income threshold. We tell you honestly which side you are on, the consultation is free.

Is public health insurance free?

No. It's funded by income-based contributions split with your employer. Statutory does cover non-working family members for free, however.

Not as primary insurers. You can hold a private supplemental policy on top of public, common for dental, hospital and travel.

Who can choose private health insurance?

Employees earning above the income threshold of €77,400 a year (2026), the self employed and freelancers, civil servants and students can opt for private health insurance. Employees earning below that threshold are required to stay in public health insurance.

How do I switch from public to private?

First you need to qualify, by earning above the income threshold, being self employed, or being a civil servant. Then you choose a tariff and give your public insurer notice, usually two months. A free consultation walks you through eligibility and the paperwork so nothing slips.

Can I switch back from private to public?

It is difficult, and after age 55 it is usually not possible. Before 55 you generally need your income to fall below the threshold for a sustained period, or start employment that makes you publicly insured again.

Is private cheaper than public?

Often, yes. Private premiums are based on age and health instead of income, so younger high earners and the self employed regularly pay less for noticeably more coverage. For single-earner families with children, public is usually cheaper because family members are covered for free.

Can I cover my family?

Public health insurance covers a non working spouse and children for free through family insurance. With private health insurance, every family member needs their own contract and premium.

What happens to my health insurance when I retire?

In public health insurance your contributions follow your pension income. In private health insurance the premium is income-independent, but aging reserves built from day one, a pension-fund subsidy and options like a tariff change keep it manageable. We model your premium into old age in every consultation, free of charge.

Do I lose private health insurance if my income drops?

As an employee, falling below the €77,400 threshold (2026) normally makes you publicly insured again unless you apply for an exemption. Self-employed clients keep their private cover regardless of income swings. Short-term dips can often be bridged with a deductible or tariff adjustment.

How long does switching from public to private take?

Plan for two to three months end to end: the private application and health declaration take one to three weeks, and your public fund requires two full calendar months of notice after you cancel. Our switching guide has the exact timeline.

How does paying for treatment work in private health insurance?

In private cover you often pay the doctor's invoice first and claim the amount back from your insurer, usually within days via an app. Organised people barely notice the extra step, but it is worth knowing before you sign. Many tariffs also settle hospital bills directly with the clinic.

Do pre-existing conditions matter when I switch to private?

Yes. Private insurers assess your health when you apply and may add a premium loading, exclude a condition or decline the application, while public health insurance takes you at the standard income-based rate regardless of your health. With a significant pre-existing condition, public cover is often the stronger choice, and we will tell you so honestly in a free consultation.

What changes in 2027?

The income threshold for choosing private health insurance is projected to rise to roughly €84,600 per year in 2027. The final figure will be confirmed by federal ordinance in late 2026. Public contributions for high earners also rise as the contribution ceiling moves up. See our 2027 income threshold guide for details.

Young couple comparing two health insurance offers side by side at a Berlin loft dining table

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TrustScore 4.8 · 89 reviews · Rating as of September 2026

Public vs. private

Public vs. private health insurance in Germany

Free consultation

Excellent

TrustScore 4.8 · 89 reviews · Rating as of September 2026

Two parallel systems, but not equal ones. If you qualify for private health insurance, you usually get better care, faster access and often a lower premium. Here is the honest comparison.

The standard system

What is public health insurance?

Public health insurance is the statutory system that covers around 90% of people in Germany. Your contribution is a fixed percentage of your gross income, roughly 14.6% plus a provider top up that has risen steadily for years. In return, everyone receives the same legally defined standard of care: panel doctors, multi-bed hospital rooms and subsidised dental work. Non working family members are covered for free.

It is a solid default if you cannot choose. But high earners pay the maximum every month regardless of how much care they use, while the benefits stay at the legal standard. Read the full guide on our public health insurance page.

Recommended when you qualify

What is private health insurance?

Private health insurance prices your premium on your age and the cover you choose, not on your income. For younger, higher earning professionals and the self employed in good health, that regularly means broader cover for a lower premium. And unlike the public catalogue, which lawmakers can trim, your benefits are guaranteed by contract for life.

You can see any doctor in Germany, skip referrals, get faster appointments, and choose single hospital rooms and chief physician treatment in higher tariffs. See the full picture on our private health insurance page.

Five differences that actually matter

How premiums are priced
Public: ~14.6% + Zusatzbeitrag of gross income, so every raise also raises your premium. Private: based on age, tariff and health, your salary is irrelevant.
Who's covered
Public: family insurance covers a non-working spouse and children for free. Private: each person has an own contract, children from around €120 with benefits above the public standard.
Choice of doctor
Public: panel doctors only. Private: any doctor in Germany, plus chief-physician treatment and single hospital rooms in higher tariffs.
Switching back
Public → private: straightforward once you qualify, and we handle the paperwork. Private → public: hard after age 55, which is why we stress-test every switch beforehand.
Retirement
Public: contributions follow your pension. Private: aging reserves, a pension-fund subsidy and tariff options keep the premium manageable for life.

Health insurance advisor reviewing public and private options with a client in a bright German office

Estimate your private premium in 60 seconds

Age, income and employment status are enough for a realistic first number. No contact details needed to see the result.

Coverage tier

Who needs coverage?

Profession

Age

Annual income

€

Estimated monthly premium

Enter your age and income to see your estimate.

Estimate based on a healthy applicant. Actual private health insurance premiums depend on your individual health declaration, chosen tariff, deductible, and provider.

Get a free quote

Estimates based on typical 2026 tariff data. Your exact premium depends on insurer, tariff and health declaration.

Public vs. private at a glance

Public

Private

Cost

Premium

~14.6% + 2.9% Zusatzbeitrag of gross

Age, tariff, health

Income cap

Yes, contributions are capped at the assessment ceiling

n/a

Family insurance

Free for non-working spouse + children

Separate contracts

In retirement

Falls with your income

Continues, cushioned by the ageing reserves you build up

Choose a plan to compare

Premium~14.6% + 2.9% Zusatzbeitrag of gross

Income capYes, contributions are capped at the assessment ceiling

Family insuranceFree for non-working spouse + children

In retirementFalls with your income

What you actually pay in 2026

Four typical situations, same person in both systems. Realistic 2026 estimates including long-term care insurance.

Public health insurance

Income-based contribution

Income-based

Income-independent

Private health insurance

Priced by age, cover and health

from €380/mo

Monthly cost examples

Employee, €80,000 salary, age 35

Around €650 per month as your share

Typically €220 to €280 after the employer share

Self-employed, €60,000 profit, age 35

Around €1,000 to €1,100, fully self-paid

€450 to €550 gross for solid mid-level cover

Single earner, partner and two children

No extra cost, family is covered free

Own contract per person, children typically €120 to €200 each

In retirement

Contributions follow your pension income

Income-independent, softened by aging reserves and relief components

Choose a plan to compare

Priced by age, cover and health

Employee, €80,000 salary, age 35Typically €220 to €280 after the employer share

Self-employed, €60,000 profit, age 35€450 to €550 gross for solid mid-level cover

Single earner, partner and two childrenOwn contract per person, children typically €120 to €200 each

In retirementIncome-independent, softened by aging reserves and relief components

Estimates for 2026 including long-term care insurance. Public contributions are set by law as a percentage of income up to a cap. Private premiums depend on insurer, tariff, age and health. Ask us for exact numbers, the consultation is free.

Three real profiles, three different answers

A headline number never settles this decision, so look at three real situations instead.

A 32-year-old software developer on a permanent contract at €82,000, single and healthy, pays close to the public maximum every month. Private cover often gives this person more for a comparable premium, and signing up young locks in a favourable rate for life.

A 38-year-old freelance designer earning around €70,000 pays the full public contribution alone, with no employer share. Private cover is usually better value here, but freelance income is uneven, so the premium has to stay affordable in lean years too.

A 41-year-old sole earner on €90,000 supporting a partner and two children faces the opposite maths. Public health insurance covers those dependents for free, while private cover prices each person separately. Free family insurance often wins this one.

The time dimension matters as much as the monthly figure: public premiums rise and fall with your income, while private premiums are independent of your salary but should be planned for the long run. Judge any plan on how it will feel at 60, not just at 30. For current figures, see our cost breakdown.

The family question

Free family cover is the public system's strongest card, and we say so openly. But it wins in a narrower set of cases than most families expect, and one detail many people miss can flip the maths: your employer's subsidy is calculated on your whole private coverage, not just your own premium. Here is how the family question really breaks down.

Your employer co-pays the whole family
As a privately insured employee, your employer pays half of your premium up to a fixed monthly cap, around €613 in 2026 (€508.59 for health plus €104.63 for long-term care). That cap is a single shared pot for you and your privately insured children, so if your own tariff sits below it, the unused headroom helps carry the children's contracts too. Even with a non-working partner and a child, private can still come out ahead.
Noticeably better cover for your children
Children typically cost €120 to €200 a month each in private, and for that they get benefits well above the public standard: shorter waits, direct specialist access and stronger dental cover. Their premium never depends on your income.
Free public cover, and when it genuinely fits
A non-working partner and children are insured for free in the public system. For a single earner with several children and no plan to go private, that is the stronger option, and we will tell you so plainly.
We model both routes for you
One rule families miss: if the privately insured parent earns more and sits above the threshold, children usually cannot join the free public cover. We plan this before the first child and calculate both systems for your exact situation, free of charge.

See the family guide

What changes in retirement

Retirement is where private planning quietly pays off. Public contributions fall with your pension, but the rate itself keeps climbing for everyone still paying in, and the standard of cover is whatever the law allows that year. In private, the aging reserves you build from day one are designed for exactly this moment: they cushion your premium for life, and you keep several levers to bring it down further.

Your premium is cushioned, not climbing
Part of every premium you pay before 60 is set aside as an aging reserve that pays your cost down later. A statutory 10% surcharge between 21 and 60 builds an extra cushion on top. It is money working for your future self.
A pension-fund subsidy takes over from your employer
As a privately insured pensioner you receive a subsidy from the statutory pension fund toward your premium, stepping in for the employer share you had throughout your career.
Levers you actually control
A tariff change at the same insurer under section 204 VVG keeps all your reserves and can cut the premium noticeably. A premium-relief component locks in a fixed reduction from age 65. You are never stuck with one number.
Public isn't free in retirement either
Pensioners in the public system pay contributions on their pension and most other retirement income, at a rate that has only risen. Private simply hands you tools to shape that cost that public members never get.

How aging reserves flatten your premium

The same private cover, with and without the aging reserves you build from day one. The gold line is what you actually pay. The navy line is what pure age-based pricing would cost without that cushion.

Without aging reserves

Your premium with reserves

Get a free personal projection

Illustrative example for a healthy applicant on 2026 tariff logic. Your actual figures depend on insurer, tariff, entry age and health. Ask us for a personal projection, the consultation is free.

Switching between the systems, step by step

Check your eligibility

Employees need more than €77,400 gross per year (2026)
Self-employed and freelancers qualify from around €40,000 annual income
Below the threshold, public health insurance remains your route

Secure the private policy first

An anonymous risk pre-check protects you from recorded rejections
Sign only once acceptance and conditions are confirmed in writing
Never cancel your public fund before the new policy is secured

Cancel your public fund

Two full calendar months of notice, or an exemption application when you cross the threshold
Your broker handles the paperwork and the timing
Coverage switches seamlessly on the agreed date

Know the way back before you go

Returning to public is only possible in specific scenarios, and rarely after age 55
For employees, falling below the threshold reopens the public door
We stress-test your decision for the next 20 years, free of charge

Broker comparing public and private health insurance side by side with a young couple on a laptop

Which one is right for you?

For most people who can actually choose, private health insurance is the stronger deal: high earners, the self employed, civil servants and young healthy professionals get broader cover, faster access and often a lower premium. Public health insurance remains the sensible choice if you earn below the threshold or a non working partner and children depend on a single income.

Not sure where you stand? Take our free eligibility check or book a free consultation and we will compare both systems for your exact situation.

Check if you qualify

Common questions

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Read why clients trust us with their healthcare needs. Discover authentic testimonials highlighting our excellent service and support.

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Prathap A.

July 12, 2025

Exceptional Service – Truly Deserving of 6 Stars!

I had an outstanding experience working with Bettina and her team. From the very first contact, they were quick to respond, incredibly helpful, and always professional. Every question I had was met with clear and easy-to-understand explanations, which made navigating the world of medical insurance much less overwhelming. Bettina and her team took the time to understand my individual needs and provided thoughtful, tailored options without any pressure. Their knowledge, patience, and transparency gave me full confidence that I was making the right decisions. Honestly, if I could give 6 stars, I absolutely would—but since 5 is the maximum, they'll have to settle for that! I highly recommend Bettina and her team to anyone looking for reliable and responsive insurance support.

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May 03, 2025

Outstanding service in Health…

I have a family of 3. I am communicating with Bettina and Iris for more than 1 year now. Had come across many of challenges mentioned below 1. New in Germany. (Not aware about Process) 2. Transfer health insurance to private from public. (Based on my requirements and cost effective) 3. Getting money back from public insurance ( Starting my stay in Germany for 1 year, was using public insurance) 4. Dental insurance for my family. Going through a period of having a baby now. I highly recommend people to connect with Bettina and team for healthcare and support. It’s a blessing for me to have them.

Randy V.

May 14, 2025

My wife and I have just moved to…

My wife and I have just moved to Germany to work for CANYON Bicycles. ExPat friends living here had suggesting exploring private health insurance, but navigating through both the companies, process and our current lack of German was more than challenging. Luckily I found Bettina. She quickly and efficiently helped us look at options, settling on the best one for us. In only a matter of days, we have been accepted and have smoothly solved what could have been a tough challenge. Bettina was great.

Sachin M.

June 24, 2024

Great experience and support provided

Michael provided detailed comparison between various health insurance plans and helped to choose the best one.

Gopal D.

May 01, 2024

I changed my health insurance from…

I changed my health insurance from public to private through Michael and it was great experience with him. He walked me through advantages and disadvantages of private insurance over public insurance very well. He is quick while responding and provided me proper guidance and help, when needed. I really recommend Michael as Health insurance broker.

Jordi M.

June 26, 2025

Bettina guided me to choose the right…

Bettina guided me to choose the right private health insurance for myself in Germany. She was very patient with my questions and explained everything in detail with full transparency. I would strongly recommend Bettina and her team for private health insurance related services. Her team's support even after you sgin, is excellent.

L. S.

June 27, 2025

From the initial call and throughout…

From the initial call and throughout the onboarding process, my experience with Michael has been straightforward and positive. He was very transparent about the different insurance plans, ensuring I understood all the options available. His responsiveness stood out, as he promptly answered all my questions, no matter how many I had. Additionally, he offered valuable advice regarding my current plan and what I would need in the future, helping me make informs decisions. Based on my experience, I highly recommend him as an insurance advisor.

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May 01, 2025

Clarity in German Insurance

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March 01, 2024

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The process was smooth from the beginning to the end. Starting with getting to know my current situation and offering different options in detail and starting the process with minimal effort required from my side till starting my new insurance and getting my card. They are also available after getting your new insurance for questions and consultation and all is for free.

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March 24, 2024

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June 23, 2024

A really professional team and very…

A really professional team and very helpful for people that have zero experience with this topic.

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June 22, 2024

Best Experience

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June 10, 2024

Exceptional Service and Support from My Healthcare Broker

I recently used My Healthcare Broker to find private health insurance in Germany, and I couldn't be happier with their service. Bettina and her team provided exceptional support, guiding me through every step of the process with their deep knowledge and friendly approach. They were incredibly responsive to all my queries and made a potentially daunting task straightforward and stress-free. I highly recommend My Healthcare Broker for anyone needing professional and reliable insurance assistance in Germany. Thank you, Bettina, for your outstanding service!

Jordi M.

April 30, 2025

Bettina guided me to choose the right…

A K.

April 01, 2025

I couldn’t be more happy with their…

I couldn’t be more happy with their service, Bettina has been completely fantastic. She has provided the best advice for choosing the PKV and she is there for every inquiry you could have.

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June 06, 2025

I had the chance to work with Michael…

I had the chance to work with Michael Kammerer when I was figuring out my health insurance in Germany. Honestly, I was expecting a headache, but Michael made everything super straightforward. He knows all there is to know about health insurance here and found me a deal that was just right for what I needed and could afford. Michael was always there to answer my questions, big or small and made sure I understood everything. It was like having a friend in the insurance business.

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July 10, 2025

Even months after signing the contract

Even months after signing the contract, I can call Michael anytime. This personal care is rare nowadays.

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July 01, 2025

All important documents were provided…

All important documents were provided in both German and English. Made everything so much easier to understand.

Prathap A.

July 12, 2025

Exceptional Service – Truly Deserving of 6 Stars!

Amit P.

May 03, 2025

Outstanding service in Health…

Randy V.

May 14, 2025

My wife and I have just moved to…

Gopal D.

May 01, 2024

I changed my health insurance from…

L. S.

June 27, 2025

From the initial call and throughout…

Mohamed H.

March 01, 2024

Free, smooth and easy process

Ikarus L.

June 10, 2024

Exceptional Service and Support from My Healthcare Broker

Jordi M.

April 30, 2025

Bettina guided me to choose the right…

Alice B.

June 06, 2025

I had the chance to work with Michael…

Keep reading

Related guides

The pages that come up most often when people are choosing between the two systems.

Public vs. private health insurance in Germany

What is public health insurance?

What is private health insurance?

Five differences that actually matter

How premiums are priced

Who's covered

Choice of doctor

Switching back

Retirement

Estimate your private premium in 60 seconds

Public vs. private at a glance

Public

Private

Cost

Care

Dental & vision

Mental health

Switching

What you actually pay in 2026

Public health insurance

Private health insurance

Monthly cost examples

Three real profiles, three different answers

The family question

Your employer co-pays the whole family

Noticeably better cover for your children

Free public cover, and when it genuinely fits

We model both routes for you

What changes in retirement

Your premium is cushioned, not climbing

A pension-fund subsidy takes over from your employer

Levers you actually control

Public isn't free in retirement either

How aging reserves flatten your premium

Switching between the systems, step by step

Check your eligibility

Secure the private policy first

Cancel your public fund

Know the way back before you go

Which one is right for you?

Common questions

Our customers love what we do

Exceptional Service – Truly Deserving of 6 Stars!

Outstanding service in Health…

My wife and I have just moved to…

Great experience and support provided

I changed my health insurance from…

Bettina guided me to choose the right…

From the initial call and throughout…

Clarity in German Insurance

Free, smooth and easy process

Great team with good communication

A really professional team and very…

Best Experience

Exceptional Service and Support from My Healthcare Broker

Bettina guided me to choose the right…

I couldn’t be more happy with their…

I had the chance to work with Michael…

Even months after signing the contract

All important documents were provided…

Related guides

Private health insurance in Germany

Public health insurance in Germany

Am I eligible for private?

30-year cost comparison

How to switch, step by step

Calculate your premium