What are private costs

Private health insurance

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What makes good private health insurance?

Services are individually adapted

The ideal private health insurance is tailored to you and your personal situation. In contrast to statutory health insurance, private health insurance gives you the option of customizing the scope of benefits according to your wishes. A good private health insurance should offer at least the same services as the statutory health insurance and ideally Additional Services cover that the statutory health insurance would not take over. You can find an overview of this in the “Services” chapter.

The most important advantages of private health insurance at a glance:

  • Individual scope of services
  • Contributions not dependent on income

Good private health insurance doesn't have to be expensive

Private health insurance does not have to be expensive - on the contrary: in some cases it is cheaper than the statutory insurance. For a 30-year-old employee without previous illnesses, good private health insurance costs between 150 euros and 350 euros in the month. In the GKV this employee would against it 480 euros pay in the month. You can find out exactly how the costs are made up in the section "Costs and prices".


These are our recommendations for good private health insurance

Our Experts | for private health insurance recommend the following providers. Find out more about the exact tariffs and services on our website. But the subject of private health insurance is very individual. So let yourself always a free and personal tariff comparison created by our experts. Please use that for this Free form for the tariff comparison on this page.

Compare the best private health insurance providers now

The test winners2021 from Stiftung Warentest, Ökotest and Focus Money in comparison.

What does private health insurance cost?

The amount of the contributions is calculated individually for each insured person. Basically Private health insurance costs from € 150 per month (in the entry-level tariff).

Sample calculation: This can cost private health insurance

Sample customer:

  • Employment relationship: employee
  • Entry age: 30 years
  • Gross annual income: 65.000 €
  • Pre-existing illnesses or other health restrictions: No
  • Services in the hospital: at least twin room, head physician treatment
  • Dental treatments: Takeover of at least 60%

For comparison: Our sample customer would pay 468.04 euros per month with his income in the state of Berlin for statutory health insurance (minus the employer's share and including the compulsory long-term care insurance).


Further Examples of costs


What are the costs of private health insurance based on?

In contrast to statutory health insurance, the costs of private health insurance are not calculated on the basis of income. Rather, the following factors play a major role:

  • Tariff and scope of services (which additional services are important for you?)
  • Employment relationship (Employed, self-employed, civil servant, student)
  • Entry age (The younger, the cheaper)
  • health status (Chronic illnesses, previous illnesses)

Compare the costs of private health insurance here

The test winners2021 from Stiftung Warentest, Ökotest and Focus Money in comparison.

Retirement provisions affect costs

Because the illness and treatment costs increase in age, insurers allow their customers to share in the increasing costs in old age. For this reason, older insured persons have to pay higher insurance premiums than young customers. This relationship does not apply to statutory health insurance because the insurance premium is not influenced by the age or the state of health of the insured person.

So that the contributions do not rise excessively in old age, so-called Aging provisions educated. They are intended to help keep the contributions in old age for the individual insured person stable. The insurer uses for the retirement provisions 10 percent of the monthly fee, hence they are also called the 10 percent surcharge.

Expert tip:

“Health insurance contributions can be reduced by choosing a deductible. There is also a module "Reduction of contributions in old age", Where you first pay a little more and from the age of 65 or 67 the contribution decreases noticeably."

Private health insurance benefits

In the entry-level PKV tariffs, the benefits are initially comparable to those of the statutory insurance. In addition, however, there are numerous services that are usually not covered by the statutory health insurance fund. As a rule, privately insured persons benefit from better remedies and aids as well as higher quality treatments.


Free choice of services

In private health insurance, unlike statutory health insurance, there is no catalog of benefits that stipulates which benefits are paid for. The privately insured can choose yourselfwhat services he needs and wants to pay for. For example, he can choose whether he wants to be accommodated in a single or double room in the hospital or whether the treatment by the chief physician is particularly important to him.

Overview of possible services

  • Payment of the treatment costs
  • Insurance coverage abroad
  • Single or twin room in the hospital
  • Takeover of cures, rehab, psychotherapy, etc.

Which services are really important and which are not?

Which services you should choose in your private health insurance tariff and which ones make less sense is of course also a personal question. Nevertheless, we have one for you below Overview created about essential services, important services and other useful services. Take the overview as a orientation and adapt this to your individual needs at.

Essential services

  • Reimbursement of the maximum rate of the medical fee ordinance (3.5 times the GOÄ / GOZ)
  • Unrestricted takeover of medicines and aids

Important achievements

  • Maximum coverage for psychotherapy and other treatments by therapists
  • Services also abroad (EU / non-EU)
  • Assumption of transport costs
  • Takeover of cures and rehab

Additional services


Daily sickness allowance - especially important for the self-employed

Policyholders should make sure that their insurance company offers them in the event of a prolonged illness pays a sufficiently high daily sickness allowance. This is especially true for the self-employed who, in addition to their living expenses, have to cover the running costs of the business. Statutory sick pay is only available to those with statutory health insurance. In private health insurance, the equivalent is the daily sickness allowance. In some PKV tariffs this is often already included, in others it has to be insured separately by a private supplementary health insurance.

Find out more about daily sickness allowance

Expert tip:

“In contrast to the GKV, with a private health insurance the Customize insurance coverage. So you can choose different modules, such as loss of earnings, cure, high performance in the dental area, head physician treatment, etc., in order to build the right insurance cover. What options there are should be discussed with one of our consultants. "

Private health insurance tariffs

Which Services are actually taken over by the insurer and in what amount, depends on the chosen tariff. The tariffs of the private health insurance are often divided into entry tariffs, comfort tariffs and premium tariffs. The individual tariff levels can, however, with Additional modules or additional individual services can be adapted to personal needs. Below you will find an overview of the tariff levels without any additional services.


Entry-level tariffs

Private health insurance entry tariffs correspond in their scope of benefits roughly to the level of statutory health insurance and are accordingly cheap. The costs are reimbursed up to the maximum rates of the GOÄ or GOZ. 80 percent of the services provided by alternative practitioners are covered; there is a 100 euro grant every 3 years for visual aids. In the hospital, treatment takes place in shared rooms and by ward doctors.

Combined tariffs

Comfort tariffs are similar to entry-level tariffs in some points, but some services already correspond to the premium level and provide a good average, depending on personal needs . Comfort tariffs also cover treatment costs up to the maximum rates of the GOÄ or GOZ. At the naturopath, 100 percent of the costs are covered, the allowance for visual aids increases to 260 euros every 2 years.

Premium tariffs

In the case of premium tariffs, the Scope of services open to the top - accordingly also the costs. Premium tariffs usually reimburse above the maximum rates of the GOÄ or GOZ. There is no family doctor principle here, but the free choice of doctor. Treatment in the hospital takes place in a single or double room and is provided by the chief physician.


Here's how you go about graduation

  1. Determine which Services and additional services are particularly important to you and which you really need.
  2. Receive Aid from the employer? Find out what amount.
  3. Make a thorough and individual Tariff comparison and compare the private health insurance providers in terms of costs, benefits and service.
  4. Set the Request on insurance cover in the private health insurance and get exempt from the statutory health insurance.
  5. Fill in the Health examination out.
  6. Let yourself be carried away by our experts the private health insurance. Please use the form for the tariff comparison.

Which tariff would you like to take out? Compare the test winner tariffs now for free

The test winners2021 from Stiftung Warentest, Ökotest and Focus Money in comparison.

PKV tariffs for financial emergencies

If contributions can no longer be paid in full, there is certain tariffs for financial emergencies in which contributions and benefits reduced are.

Standard tariff

The standard tariff is only relevant for those who before 2009 have joined. The benefits generally correspond to those of the statutory health insurance.

Base tariff

The basic tariff is aimed at people who from 2009 on joined the insurance, over 55 years of age and in accordance with social law needy are. This tariff still covers all services, but doctors can no longer charge 2.3 times the fee rate.

Emergency tariff

The emergency tariff is intended for those insured who are currently financial bottleneck experience. This tariff only covers acutely necessary treatments from.

Tips and advice on private health insurance

Below you will find our tips and information on private health insurance. You can, for example, receive private health insurance benefits abroad and benefit if you insure yourself as a married couple or family. However, always pay attention to hidden deductibles.

This is how reimbursement works in private health insurance

Most of the services you will have to take advantage of first pay yourself. Hospital bills are excluded because the hospital bills your insurance company directly.

1. Pay the bills to the doctor and pharmacist

Get an outpatient care from a doctor, dentist or alternative practitioner, you will receive one invoice. Sometimes you have to be in Advance payment sometimes you have a few weeks to settle the bill. Medicationthat you order by prescription are paid for directly at the pharmacy.

2. Submit invoices to the PKV

The bills for treatments or medication pass You then with your private health insurance a - either by post or online.

3. Get your contribution back

Your private health insurance provider will check the bills and reimburse you depending on the Reimbursement rate the costs. Some insurers offer services that allow you to see in advance how much of the costs you will get back. This is beneficial because not all invoices are “worth” submitting them.

As the Submit invoices with private health insurance in detail works, you can find out on our separate page on the subject:

Submit invoices to the PKV

What if the insurance company doesn't pay?

Occasionally it comes to Litigationif the insurance company and the policyholder disagree about whether a certain benefit should be reimbursed by the insurance company or not. Clear wording in insurance conditions can prevent such disputes. Ask if something is worded too vaguely.

However, should problems arise, the independent Insurance Ombudsman or a specialist lawyer for insurance law can help. You can find out more about this in the corresponding section in our Loss Glossary: ​​Problems with the health insurance company - who helps those privately insured?

What you can still do if the private health insurer does not pay, read here:

The insurance does not pay - what to do?

This is how you can reduce the cost of the private health insurance tariff

There are a few ways you can reduce the cost of your private health insurance:

Eliminate risk surcharges

Anyone due to an illness Risk premiums has agreed in his contract and is healthy again, can agree to cancel these additional contributions.

The PKV tariff can also be used within of the offer of the private health insurance provider. It should be noted, however, that cheaper tariffs usually go hand in hand with lower services. You can read more about the change options here: Change PKV.

Arrange a deductible

A Deductible significantly reduces the contribution. However, it should be borne in mind that part of each treatment has to be paid for out of pocket.

Adjust services

For example, you can influencehow much the daily sickness allowance or the reimbursement of dentures should be. You can also determine whether you always need a head physician treatment, or you can agree on a family doctor with the health insurance company and thus save contributions.

Don't get sick or take within an insurance year no benefits, there is often a refund of the contributions. As a rule, the usual preventive medical check-ups or vaccinations are excluded from the calculation of the reimbursement. You can find out more about this here: Premium refunds in private health insurance.

Let experts advise you

Choosing private health insurance is often a lifelong decision. Find the right insurer and the best tariff that suits your situation right from the start. Our experts in private health insurance know the market and can support you with it. Make an appointment now for a free consultation.