Private Krankenversicherung (PKV) is an alternative to Germany's statutory GKV for eligible groups, including employees whose regular annual pay exceeds the 2026 Jahresarbeitsentgeltgrenze of €77,400, qualifying self-employed people and civil servants.
A €78,000 employee example
Elena earns €78,000 regular annual employment income in 2026. That is €600 above the general €77,400 threshold, so she may have a choice of GKV voluntary membership or PKV, subject to the relevant year-boundary and employment rules. A colleague on €76,000 generally remains GKV compulsory through the income threshold unless another exemption applies. Neither income alone tells them which cover is cheaper or better: provider, chosen tariff, deductible, dependants, employer contribution and health conditions matter.
Why age reserves matter
Private contracts build Alterungsrückstellungen to smooth age-related claim costs. A switch to another tariff within the same insurer generally carries those reserves in full. For a contract begun in 2009 or later, a transfer to another insurer carries a statutory Basistarif-equivalent transfer value; not necessarily the full old reserve. Health Ministry guidance explains the rule. Individual premiums do not follow one standard age-30-to-80 curve.
Returning to GKV after 55
The age-55 barrier is conditional, not an absolute lifetime lock: BMG explains the combination of age, no statutory cover in the previous five years and insurance-free/exempt/self-employed status for at least half that period. Do not reduce income or terminate a policy on a generic promise of returning to GKV. Ask the insurer and statutory fund for a written eligibility/status decision.
