An Overview of Private Health Insurance in Germany
Around 11% of people in Germany opt for private health insurance (PKV). However, private insurance is not available to everyone, as eligibility depends on specific factors.
Costs of Private Health Insurance
The price of private health insurance is influenced by:
Your age at the time of enrollment
Your health status when applying
The coverage level you choose
Once you are insured, your premiums remain unaffected by changes in your health. Even if you develop a serious illness, your costs won’t increase.
You have flexibility to customize your plan. For example, selecting a higher deductible (Selbstbeteiligung) reduces monthly premiums, while broader coverage increases them. Some insurers also offer discounts if you don’t make claims. If you’re employed, your employer covers half the cost, whereas self-employed individuals pay the full amount.
What Does Private Health Insurance Cover?
Private health insurance provides coverage for all essential healthcare needs and often goes beyond what public insurance offers.
One key advantage is flexibility. You can tailor your coverage to include additional services like advanced dental treatments, glasses, or even laser eye surgery. If you prefer a lower monthly premium, you can opt for reduced coverage or choose a plan with a higher deductible (Selbstbeteiligung).
Private insurance also opens doors to a wider range of healthcare providers, including specialists and therapists who may not accept public insurance. Additionally, privately insured patients often receive priority when booking appointments.
The payment process works differently from public health insurance. With private insurance, you usually pay for treatments upfront and then submit invoices for reimbursement. For costly procedures, the insurer can pay the provider directly. Unlike public insurance, where you simply present your insurance card, private insurance gives you more control and choice in managing your healthcare.
Advantages of Private Health Insurance
01
Faster Access to Doctors
Private insurance often means quicker appointments with specialists. Many doctors prioritize privately insured patients, ensuring shorter waiting times.
02
Customizable Coverage
Private plans can include additional benefits like enhanced dental care, travel insurance, or advanced treatments. You have the freedom to select only the coverage you need to manage costs.
03
Save More with Deductibles
By choosing a plan with a high deductible, you cover small medical costs yourself, resulting in lower monthly premiums. This is ideal for those who rarely visit the doctor, as it can lead to significant savings.
04
No-Claims
Bonus
Some private insurers reward you for not using your insurance by lowering your premiums. Healthy individuals who rarely need medical care can benefit greatly from this feature.
Disadvantages of Private Health Insurance
01
Costs Increase with Usage
The more you use private insurance, the less you save. Deductibles and no-claims bonuses create financial incentives to avoid frequent doctor visits, which may discourage preventive care.
02
Additional
Paperwork
Private insurance involves upfront payment for medical services. You receive an invoice, pay it, and then request reimbursement from your insurer. This process can be time-consuming, especially if you have a deductible. Mostly working with a special app by the provider, with quicker reimbursement.
03
Exclusions for Pre-Existing Conditions
Applicants often undergo a health assessment. Those with pre-existing conditions, such as chronic illnesses, mental health issues, or high-cost medication needs, may face rejection or significantly higher premiums. Once accepted, however, premiums do not increase if your health worsens.
04
Risk of Rising Costs for Families
While private health insurance can be affordable for single individuals, it can become significantly more expensive for families with more then 2 children. Unlike public health insurance, where dependents (spouse and children) are typically covered at no extra cost, private insurance requires separate premiums for each family member. For families with multiple children, these additional costs can add up quickly, making private insurance less attractive for those planning or raising a family. Has to be checked individual.
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