Last reviewed: 13 September 2026
Some figures in this guide are not yet officially confirmed for the current year and are marked as such; always check the linked official source (BAMF / Make-it-in-Germany) before you rely on them.
Health insurance is mandatory in Germany, and most employees end up in the public system by default. Some people can choose private insurance instead, and the two work very differently: one prices by income, the other by risk.
This guide explains who is allowed to go private, how the public (GKV) and private (PKV) systems compare, and what each actually costs. To see numbers for your own situation, use the health insurance cost calculator; this guide explains the reasoning behind the figures it shows.
Who can choose private?
💶 The private-insurance threshold (2026)
Below this, employees stay in the public system (GKV) by default. The self-employed and civil servants can generally choose private insurance regardless of income.
How the two compare
| Public (GKV) | Private (PKV) | |
|---|---|---|
| How the price is set | A percentage of your gross salary | Risk-based: your age, health and chosen cover |
| Family members | Covered at no extra contribution (co-insurance) | Each family member insured, and priced, separately |
| As you age | Premium tracks your income, not your age | Premium tends to rise as you get older |
| Who it suits | Most employees, especially those with a family or below the private threshold | Higher earners, the self-employed, and civil servants who value tailored cover |
What public insurance costs
Public (GKV) contribution rates (2026)
- General rate: 14.6% of gross salary, split evenly between you and your employer (7.3% each).
- Each health fund also charges a supplementary contribution (Zusatzbeitrag), averaging 2.9% in 2026, also split between employee and employer.
- Long-term care insurance (Pflege): 1.8% each side. Childless members aged 23 and over pay an extra 0.6% (employee only). From the second child onward, the employee's care-insurance rate falls by 0.25% per child, up to five children. In Saxony, the employee pays an additional 0.5%.
- Contributions apply up to an income ceiling of €69,750 per year (2026); the employer pays about half of the total.
Private (PKV) premiums are not a fixed rate
Private premiums are risk-based, set from your age, health and the cover you choose, and vary by provider. An illustrative range is about €250 to €700 per month, but this is never a quote: only an individual offer from an insurer gives you a real figure.
The trade-off
Public insurance suits most people well, especially anyone with a family, since spouses and children are covered at no extra cost. It also scales with income rather than age, which makes it predictable for younger earners and families.
Private insurance can offer more tailored cover and is often cheaper for young, healthy, single people early on, but it prices each family member separately and premiums tend to climb as you age. Switching back to public insurance later in life is also restricted once you’re established in the private system, so it’s worth thinking beyond just this year’s numbers.
Before you rely on this
Contribution rates, income thresholds and the private-insurance eligibility limit are set annually and can change. The PKV range above is illustrative only, never a quote. Confirm the current figures against a primary source:
Disclaimer: This calculator provides estimates only and is not financial, tax, or legal advice. Figures are general in nature and may not reflect your circumstances. Verify against official sources or a qualified adviser before making decisions.