Public vs. private health insurance in Germany

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.