Private Health Insurance – Who can and who should change?

Who can insure privately?

Who can insure privately?

First of all, there are legal requirements that regulate who is allowed to insure privately and who does not. However, the same rules do not apply to all groups of companies.

Civil servants – Civil servants have the choice whether they want to insure themselves privately or legally. The employer makes a contribution to the medical expenses of at least 50 percent, but only for private health insurance. As a rule, officials and other beneficiaries thus conclude a so-called residual cost insurance with a private health insurer. Anyone who has been permanently employed and has no major health problems should therefore be privately insured. The secured income and the high subsidy protect against the financial disadvantages of PKV.

Self-employed – Anyone who works full-time on their own can also choose whether to take out private or voluntary insurance. Because the choice of insurance is not tied to earnings for the self-employed. An exception to this rule applies to freelancers who pursue an artistic or journalistic activity: they may be subject to compulsory insurance in the KSK.

Employees – In an employee relationship, the gross income must be above the so-called annual earnings limit (JAEG) or mandatory insurance limit. Only then does an employee have the choice between statutory or private health insurance. In 2018, this limit is 60,750 euros per year, which corresponds to an average monthly earnings of around 5,063 euros. These include regular payments such as holiday and Christmas bonuses, but not special payments such as profit distributions.

The earlier regulation that employees can only insure themselves privately after three years of earnings above JAEG no longer exists. Instead, the compulsory insurance ends with the year in which the salary first exceeds the annual earnings ceiling, if it is expected to be above the limit for twelve months. In addition, however, the mandatory insurance limit must be exceeded in the new year.

For example, in July 2019 you will receive a salary increase to 62,000 euros per year. This will allow you to have private health insurance from 1 January 2020. However, only if the annual earnings ceiling for 2020 remains below 62,000 euros.

Employees who do not change immediately, but first voluntarily insure themselves in a statutory health insurance, must observe the notice periods of the GKV.

Students – At the beginning of their studies, students can opt for private health insurance. You will then be bound by this decision for the duration of your university education. There are special student rates for them. When the newly-graduated academics start full-time employment for the first time, they can switch back to a statutory health insurance fund. Private health insurance is particularly useful for students who are the children of civil servants, since they receive up to 80 percent of the allowance.