Step-by-step guide: Switching between statutory (GKV) and private health insurance (PKV) in Germany

In Germany, changing from statutory health insurance (GKV) to private health insurance (PKV) and back again is tightly regulated by law. Below you’ll find a detailed and practical guide that you can use as an article on your website: who is allowed to switch, how the process works, and what you must pay close attention to.

1. Switching from statutory health insurance (GKV) to private health insurance (PKV)

Who can switch to PKV?

Generally, only certain groups are eligible to move to private health insurance:

• Employees whose annual gross income exceeds the legal threshold (Versicherungspflichtgrenze), e.g. €69,300 in 2025.

• Self-employed persons and freelancers (Selbstständige / Freiberufler).

• Civil servants (Beamte).

• Students, usually at the beginning of their studies only.

Step-by-step: How to move from GKV to PKV

1. Check your eligibility

• Confirm that your income exceeds the legal annual income threshold
  or that you are self-employed, freelance or a civil servant.

2. Compare private insurance offers

• Request several quotes from PKV companies.

• Compare:

  • monthly premiums,

  • scope of benefits (e.g. hospital comfort, dental coverage),

  • conditions for premium increases with age,

  • deductibles and waiting periods.

3. Health assessment

• Most private insurers require a detailed health questionnaire.

• Depending on your medical history, they may:

  • charge a risk surcharge,

  • exclude certain conditions from cover, or

  • in rare cases, reject the application.

• Sometimes, an additional medical check-up is requested.

4. Apply for PKV

• Submit the application with all health information completely and truthfully.

• Approval may take a few days to two weeks.

5. Cancel your GKV membership

• Only after you receive written confirmation from the PKV (policy or preliminary cover) should you cancel your GKV.

• The notice period is usually two months to the end of a month.

• You must provide your GKV with proof of your new PKV cover, because health insurance is compulsory in Germany.

6. Start of PKV cover

• Your PKV coverage typically begins immediately after your GKV membership ends, i.e. after the notice period.

Important notes on switching to PKV

• Once you have switched to PKV, returning to GKV later is very difficult, especially after the age of 55.

• In PKV, each family member needs a separate contract and pays their own premium – unlike GKV, there is no free family cover.

• PKV premiums depend not on your income, but on:

  • age at entry,

  • health status,

  • and chosen benefit level.

2. Switching from private health insurance (PKV) back to statutory health insurance (GKV)

Switching back from PKV to GKV is considerably more difficult and only possible under specific legal conditions.

When is a return to GKV possible?

1. Falling below the compulsory insurance threshold

• If you move from a high-earning employee (above the Versicherungspflichtgrenze) to a lower-earning employee, you may again become compulsorily insured in GKV.

• In that case, you can re-join GKV as a compulsory member.

2. Change of life or employment status

• Students under 30 years of age may, under certain conditions, switch back to GKV.

• People receiving Bürgergeld (formerly Hartz IV) are normally insured in GKV automatically.

3. Return from abroad

• If you have been living abroad and then re-establish residence in Germany, you may re-enter GKV depending on your new employment situation (e.g. as a compulsory insured employee).

4. Switching to an employment subject to compulsory insurance

• If you move from self-employment to an employee position with an income below the compulsory insurance threshold, you can be insured again in GKV.

Steps to return from PKV to GKV

1. Check legal eligibility

   • Clarify whether you now fall under compulsory insurance in GKV under the Social Code (SGB V), e.g. through reduced income or receiving Bürgergeld.

2. Apply to a statutory health insurance fund

   • Choose a GKV provider (e.g. AOK, TK, Barmer) and submit a membership application.

   • Provide supporting documents such as employment contract, proof of income, benefit decision, or registration certificate.

3. Provide GKV confirmation to your PKV

   • Once you have received the membership certificate from GKV, you can cancel your PKV.

   • The PKV usually requires proof that you will be insured elsewhere in future.

4. Terminate the PKV contract

   • The termination of PKV must follow the contract conditions.

   • In cases of new statutory insurance obligation, PKV often ends at the date this obligation begins.

When is a return to GKV practically impossible?

• For people over 55 years of age who have been privately insured for years and do not become subject to compulsory insurance again, a return to GKV is virtually impossible.

• Only very rare exceptions (e.g. special hardship cases with professional legal advice) may allow a return.

Key German terms

The authors and editorial team of this website strive to provide accurate information based on extensive research and multiple sources. Nevertheless, errors may occur or some details may be incomplete or not fully confirmed. The information in this article should therefore be regarded only as an initial point of orientation. For binding and up-to-date advice, please always contact the relevant authorities, particularly health insurance funds, insurance advisors and official counselling centres.