Reviewed by our Expat experts
Last reviewed: March 2026
PKV Guide: Step-by-Step for Expats
Germany has a dual healthcare system: public insurance (GKV) and private insurance (PKV). As a high-earning expat, you have the option to choose private health insurance — and it often makes financial sense. This guide covers everything you need to know.
Looking for a comprehensive overview? Read our complete guide to private health insurance in Germany →
What is PKV?
PKV (Private Krankenversicherung) is Germany's private health insurance system. Unlike public insurance (GKV), where premiums are a percentage of your income, PKV premiums are based on your age, health status, and chosen coverage level.
For high-earning professionals — especially those who are young and healthy — PKV typically offers significantly better healthcare at a lower cost than public insurance. Benefits include shorter wait times, direct specialist access, private hospital rooms, and comprehensive dental and vision coverage.
About 11% of Germany's population (roughly 8.7 million people) is privately insured. It's particularly popular among self-employed professionals, high-earning employees, and civil servants.
Explore the Guide
Who Qualifies for PKV?
Income thresholds, employment types, and eligibility criteria explained for expats.
How to Switch to PKV
Step-by-step process from eligibility check to enrollment. Timeline and documents needed.
Costs & Contributions
How PKV premiums are calculated, employer contributions, tax deductions, and aging provisions.
PKV for Freelancers
Special considerations for self-employed expats: no income threshold, full premium responsibility, and smart strategies.
More Tools & Resources
Quick Eligibility Check
You likely qualify for PKV if any of the following apply:
- You're an employee earning more than €77,400/year (2026 threshold)
- You're self-employed or a freelancer (no income threshold)
- You're a civil servant (Beamter)
- You're new to Germany and not yet enrolled in GKV
Frequently Asked Questions
Yes, but it becomes more difficult after age 55. You can switch back if your income drops below the threshold (€77,400 in 2026) or if you become unemployed. Self-employed individuals can switch back by taking up employment below the threshold.
No. The brokers we connect you with provide full English-language support throughout the entire process — from initial consultation to claims handling.
The process typically takes 2–4 weeks. Your broker handles all paperwork. Coverage can start as early as the 1st of the following month after your application is approved.
PKV premiums can increase with age and medical inflation, but insurers build aging provisions (Alterungsrückstellungen) to stabilize costs. Starting young means lower premiums and larger reserves built over time.