Selbstbeteiligung: the deductible in German private health insurance
A higher deductible buys a lower monthly premium. Whether that trade is worth it depends almost entirely on whether you are employed or self-employed. Here is the honest math, in plain English.
How the deductible works
You choose a tier at signup
Common fixed tiers run from EUR 0 through EUR 300, 600 and 1,200 upward. The law caps the combined annual deductible in substitutive private cover at EUR 5,000.
Three models exist
Fixed annual amounts, percentage models (often 10 to 25 percent with an annual cap), and modular deductibles that apply only to outpatient care while inpatient and dental stay fully covered.
The trade-off is structural
Every euro of deductible you accept lowers the monthly premium. The question is never whether it saves premium, but who keeps the saving.
Preventive care is often exempt
Many tariffs waive the deductible for checkups and preventive treatment, so the deductible never discourages prevention. Tariff-dependent, check the wording.
Employees: the three hidden costs of a high deductible
For employees the math is worse than it looks, for three stacked reasons. First, your employer pays roughly half of your premium, up to a monthly maximum of just over EUR 500 in 2026, but pays nothing toward your deductible: a lower premium also lowers the employer share, so only about half of any premium saving is actually yours, while the deductible risk is fully yours. Second, no-claims refunds are calculated on your premium, so a cheaper premium also shrinks the refund you could earn in healthy years. Third, premiums are tax-deductible as special expenses, deductible payments are not. Stack the three and a high deductible rarely pays off for employees. Our usual advice: EUR 0 or a low tier, and let the premium level do the work.
- Employer pays half the premium, but never a cent of the deductible.
- Lower premium = smaller no-claims refund base.
- Premiums are tax-deductible, deductible payments are not.
Self-employed: where a deductible makes sense
Self-employed clients pay the full premium themselves, so the full saving is theirs. The break-even test is simple: a deductible pays off if the annual premium saving is larger than what you realistically expect to spend below the deductible line. For a healthy consultant who sees a doctor twice a year, a mid-tier deductible often wins. Two details before you sign: raising a deductible later is usually easy, but lowering it counts as a benefit increase and normally triggers a fresh health check. And weigh the deductible against no-claims refunds, because many insured self-pay small bills anyway to protect the refund, which stacks with the deductible as out-of-pocket cost.
- Full premium saving stays with you, unlike employees.
- Break-even: annual saving must beat your expected below-deductible spend.
- Lowering a deductible later usually means a new health check.
Common questions about the deductible
Check your situation in
Related guides
Two more pages that come up most often when people are at this stage.
Deductibles, explained
How your excess changes what you pay.