The difference between statutory health insurance (GKV) and private health insurance (PKV)

The difference between statutory health insurance (GKV) and private health insurance (PKV) in Germany

First: Statutory health insurance – Gesetzliche Krankenversicherung (GKV)

Who is it for?

• Employees whose income is below the annual threshold for private insurance (around €69,300 per year in 2025).

• University students, unemployed people, and those receiving social benefits.

• Retirees and non-earning family members.

Costs:

• A fixed percentage of income (around 14.6% – 15.6% of gross income).

• Spouse and children without their own income are covered at no extra cost (family coverage).

Benefits:

• Broad basic coverage (doctor visits, hospital care, medication, dental treatment).

• Equal access to care regardless of income or illness.

• No medical exam required for acceptance.

Limitations:

• Longer waiting times for specialists can occur.

• Fewer options for certain “comfort” services (e.g., single hospital room).

Second: Private health insurance – Private Krankenversicherung (PKV)

Who is it for?

• Higher-income employees (above the GKV threshold).

• Self-employed professionals and business owners.

• Civil servants (Beamte), who often receive additional state support.

Costs:

• Premium depends on age, health status, and the chosen level of coverage.

• No free family coverage: each family member pays their own premium.

Benefits:

• Faster access to treatment and appointments.

• More choices and premium services (single rooms, senior/lead physicians).

• Depending on the plan, partial reimbursement for treatment abroad.

Limitations:

• Medical assessment is required before acceptance.

• Premiums can rise with age or illness.

• Returning to GKV later can be difficult after years in PKV.

Quick comparison:

Important notes:

• Some self-employed people can choose GKV voluntarily if they register properly early on.

• Students may choose PKV, but GKV is often recommended during studies.

• Zusatzversicherung (supplementary insurance) can be added to GKV to improve services (e.g., full dental coverage or single rooms).

Key German terms:

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