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System Analysis

Private Insurance (PKV)

How private health insurance works in Germany — and why it is structurally different from what most people expect.

The equivalence principle

Private health insurance in Germany follows the equivalence principle.

This means that premiums are calculated based on:

  • Entry age
  • Health status
  • Chosen coverage level

Unlike statutory insurance, income does not determine contributions.

Aging reserves

A central component of the private system is the creation of aging reserves (Altersrückstellungen).

Part of each premium is invested and accumulated during younger years.

These reserves are later used to stabilize premiums in older age.

This mechanism transforms private health insurance into a long-term capital-funded system.

Contractual benefit guarantees

Private health insurance operates on a contractual basis.

The medical services defined in the insurance contract remain binding.

Unlike statutory insurance, these benefits cannot simply be reduced through political reform.

This creates long-term planning stability for policyholders.

Individual tariff structure

Private insurance allows policyholders to select the structure of their coverage.

Common adjustable parameters include:

Deductible

€0 to €1,500 annually

Dental modules

Enhanced prosthetics & implants

Hospital

1/2-bed room + chief physician

Sick pay

Customized daily sickness allowance

This flexibility allows coverage to be tailored to individual needs.

Employer subsidy

Employees in Germany receive a statutory employer contribution toward private health insurance.

Employers must pay:

50% of the premium

up to the maximum amount they would have paid in the statutory system.

This subsidy significantly reduces the effective cost of private insurance for employees.

Understand the systems. Now check your eligibility.