Reviewed by our Expat experts
Last reviewed: March 2026
PKV Costs & Contributions
Understanding how private health insurance premiums are calculated and what you'll actually pay as an expat in Germany.
How PKV Premiums Are Calculated
Unlike GKV (which charges a flat percentage of your income), PKV premiums are based on individual risk factors:
- Age at entry — younger = lower premiums. Locking in at 30 vs 40 can save thousands over your lifetime.
- Health status — pre-existing conditions may lead to surcharges or exclusions
- Coverage level — basic vs comprehensive plans
- Deductible (Selbstbehalt) — higher deductible reduces your monthly premium
Sample Premium Comparison
| Profile | GKV Monthly | PKV Monthly | Annual Savings |
|---|---|---|---|
| 30yo employee, €80k salary, healthy | ~€540 | ~€350 | ~€2,280 |
| 35yo employee, €95k salary, healthy | ~€580 | ~€420 | ~€1,920 |
| 40yo freelancer, healthy | ~€950 (full) | ~€550 | ~€4,800 |
* Approximate figures for illustration. Your actual premium depends on individual factors. GKV figures include employee + employer share.
Employer Contribution (Arbeitgeberzuschuss)
If you're employed, your employer is legally required to contribute to your PKV premium — up to the same amount they would pay for GKV. In 2026, this maximum employer contribution is approximately €403/month.
This means if your PKV premium is €450/month, you only pay €47 out of pocket. The employer pays €403.
Tax Deductibility
PKV premiums are tax-deductible as "special expenses" (Sonderausgaben) in your German tax return. The basic healthcare coverage portion (Basisabsicherung) is fully deductible, while supplementary benefits may have limits.
Aging Provisions (Altersrückstellungen)
A portion of your PKV premium goes into aging provisions — a savings mechanism designed to keep your premiums stable as you age. This is one of the most important factors when choosing a plan:
- Higher aging provisions = more stable premiums in retirement
- Plans with lower upfront premiums may have weaker aging provisions
- Since 2009, aging provisions are partially portable if you switch insurers
Long-Term Planning
The cheapest PKV plan today isn't always the best choice. Focus on insurers with strong financial ratings and robust aging provisions. We help you find the right balance between current affordability and long-term stability.
Premium Increases
PKV premiums can increase over time due to:
- Medical inflation (rising healthcare costs)
- Changes in the claims experience of your risk group
- Regulatory changes
Historically, PKV premiums have increased by about 2-3% annually. Well-managed insurers with strong reserves tend to have more stable premiums.
Reducing Your Premium
Options to lower your PKV cost:
- No-claims bonus (Beitragsrückerstattung) — get months of premiums refunded if you don't file claims
- Higher deductible — accepting more out-of-pocket costs lowers your premium
- Tariff switching (Tarifwechsel) — switch to a different plan within the same insurer, keeping your aging provisions