Updated 7 October 2026.
The short answer. A private health insurance (PKV) contract you have already signed can be reviewed in four ways: withdrawal, within 14 days of receiving the contract documents; a tariff change with the same insurer, which keeps your ageing reserve; switching insurer, which carries over only part of it; and termination, with three months’ notice. Which one is right depends on how old the contract is, your age, your health and your current tariff. The only way to find out is to analyse the contract and then compare it with other offers at equivalent cover.
Why a PKV is hard to judge
Many privately insured people took out their contract after being approached, sometimes without it being explained in detail. So the useful question is not “is this contract bad?” but “do I know what is in it, and what are my options?”
A PKV contract is not a standard product. It is a set of choices put together. Two contracts at the same monthly premium can protect very differently. Seven building blocks explain most of it.
What is in a PKV contract
The benefits. In the GKV, the benefit catalogue is the same for everyone. In the PKV, each tariff defines its own: how much of medical fees is reimbursed (some tariffs stop at the official fee schedule, the GOÄ, others go beyond it), whether hospital stays include a single or shared room and treatment by the chief physician, how dental treatment and dentures are reimbursed, sometimes with caps in the first years, and what applies to remedies and medical aids. Comparing means reading line by line, not just looking at the price.
The deductible. A deductible (Selbstbehalt) lowers the monthly premium but shifts the risk to you: the higher it is, the lower the premium, and the more you may have to cover yourself in some years. Some tariffs also refund part of the premium if you submit no claims.
The health questionnaire. At signing, your answers decide whether the application is accepted and whether benefit exclusions or a risk surcharge apply. Inaccurate or incomplete answers can, in certain cases, give the insurer rights over the contract. This deserves particular care before any new contract.
The ageing reserve. The law requires a surcharge of 10% on the annual gross premium, from the calendar year after your 21st birthday to the year you turn 60. It is paid into an ageing reserve (Alterungsrückstellung) that is meant to dampen premium increases in later life. The reserve is tied to the contract with that insurer, which matters a great deal when switching.
Premium increases. An insurer may raise premiums when actual benefits deviate from the calculated ones by more than a set threshold, 10% by default. The insurer’s terms can set a lower threshold, and an independent trustee must approve the increase. How a tariff behaves over the years is therefore part of the offer. Tariffs closed to new customers pool an ageing group of policyholders, which can make increases steeper.
Sickness absence. If you are ill, your employer keeps paying your salary for up to six weeks, a right that starts after four weeks of employment. After that, GKV members receive sickness benefit (Krankengeld) from their fund: 70% of gross salary, capped at 90% of net, for at most 78 weeks within three years for the same illness. The PKV has no Krankengeld. To cover the loss of income from day 43, you need a separate daily sickness allowance (Krankentagegeld). Its amount and start date are set in the contract and affect the price.
The employer contribution. Your employer contributes to your PKV premium by at most half, capped at half of the maximum GKV contribution. In 2026 that cap is €508.59 a month for health cover (long-term care is handled separately).
Four ways to review an existing contract
1. Withdrawal. You can withdraw from a contract within 14 days of receiving the contract documents. After that, this option is gone.
2. A tariff change with the same insurer. The right to change tariff (Tarifwechsel) is set out in § 204 of the Insurance Contract Act (VVG): you can ask to move to another tariff with equivalent cover, and your acquired rights and ageing reserve are credited. The insurer may demand an exclusion or a surcharge only for the part of the benefits that goes beyond your old tariff. This right cannot be waived in the contract. In 2017, the Hamburg consumer advice centre (Verbraucherzentrale) had found delays and unjustified refusals of such requests.
3. Switching to another insurer. This is a different matter: the ageing reserve can be carried over only for the part equivalent to the basic tariff (Basistarif), and only for contracts concluded on or after 1 January 2009. The rest stays with the old insurer, and the new one calculates your premium on your current age and health. The older the contract, the more a switch costs.
Switching can still be the right call: when the contract is young and little reserve has built up, when your tariff is closed to new customers and premiums are climbing, when the cover you want does not exist in any tariff of your current insurer, or when the service is poor. Each of these situations can be put into numbers: what is lost on one side, what is gained on the other.
4. Termination. You can terminate at the end of the first insurance year and then at the end of each following year, with three months’ notice, subject to any minimum term in the contract. If the insurer raises the premium or cuts benefits, a special termination right applies, which has to be exercised within two months of receiving the notification. A policy that satisfies the insurance obligation can also be terminated only if you take out a new compliant contract with another insurer. If someone becomes compulsorily insured in the GKV by law, for example because their income drops below the threshold, they can cancel the private insurance within three months, with retroactive effect.
Ten points to have checked
- The exact name of the tariff, and whether it is still open to new customers.
- The reimbursement cap for medical fees.
- Hospital conditions (room, chief physician).
- Dental care and dentures: percentages and caps in the first years.
- The size of the deductible and any premium refund.
- The daily sickness allowance: amount, start, duration.
- The premium increases of the last ten years.
- The original exclusions and surcharges.
- The ageing reserve built up so far.
- The tariffs you can move to under your right to change with the same insurer.
If another adviser suggests switching
Three questions are enough to frame the conversation. Is it a tariff change (the reserve is kept) or a change of insurer (part of it is lost)? What cover, deductible and daily sickness allowance does the new offer contain compared with the old one? And what does the switch mean for your health assessment: new health questions, new exclusions?
An offer that leaves these three questions open is not a basis for a decision.
Have the contract analysed and compared
An analysis has two steps: first the contract you have (what it covers, what it costs over time, how much reserve has built up), then a comparison with other offers at equivalent cover. Leaving everything as it is can be just as valid an outcome as a tariff change or a switch of insurer.
Feller Financial Advisory works with several insurers, and the analysis puts numbers on what each option gains or costs. The first conversation lasts about an hour and is free. For the original choice between the GKV and the PKV, see the article GKV or PKV: which health insurance is right for you in Germany?. Adrien Feller’s background is on the About page.
This article is general information. It is not personal advice or a product recommendation. Rules change, so always check the current position. For tax questions, a tax adviser (Steuerberater) is the right contact.
Sources
- § 204 VVG, change of tariff
- § 205 VVG, termination
- § 8 VVG, right of withdrawal
- § 19 VVG, duty of disclosure at signing
- § 149 VAG, 10% surcharge
- § 155 VAG, premium adjustment
- § 47 SGB V, amount of sickness benefit
- § 48 SGB V, duration of sickness benefit
- § 257 SGB V, employer contribution
- § 3 EntgFG, continued payment of wages in case of illness
- Ärzteblatt, Tarifwechsel in the PKV (1 February 2017)
Frequently asked questions
Can you change PKV tariff without losing your ageing reserve?
Yes, with the same insurer. The right to change tariff under § 204 VVG credits your acquired rights and the reserve. Switching insurer carries over only part of the reserve, and only for contracts concluded from 2009.
How long do you have to withdraw from a PKV contract?
14 days from receiving the contract documents. After that, the options are a tariff change, switching insurer or termination.
When can you terminate private health insurance?
At the end of the first insurance year and then at the end of each year, with three months’ notice, subject to any minimum term in the contract. Termination takes effect only if you take out a new contract that satisfies the insurance obligation. After a premium increase by the insurer, a special termination right applies, to be exercised within two months of receiving the notification.
Do you have to switch insurer to pay less?
Not necessarily. Switching carries over only part of the ageing reserve, and the new insurer calculates the premium on your age and health at the time of the switch. In some situations it can pay off, for example with a young contract or a closed tariff with rising premiums, but you can only say so once you have a quantified comparison.
Why can two PKV contracts at the same price be so different?
Because each tariff sets its own benefits: reimbursement cap for fees, hospital, dental, deductible, daily sickness allowance. The price reflects those choices, not an absolute quality.
Why do PKV premiums go up?
Because insurers may raise them when benefits actually paid exceed the calculated ones by more than 10%, with the approval of an independent trustee. Tariffs closed to new customers, whose policyholders are getting older, can be hit harder.