How to Switch from GKV to PKV in Germany — Step by Step

Switching from Germany's public health insurance (GKV) to private insurance (PKV) is one of the most financially significant decisions an expat can make. Done correctly, it can save you €200-500 per month. Done poorly, it can leave you locked into the wrong plan or, in the worst case, without coverage.

This step-by-step guide walks you through the entire process, including the deadlines most people miss.

Step 1: Confirm Your Eligibility

Before anything else, confirm you meet the eligibility requirements:

• Employees: Your gross annual income must exceed €77,400 in 2026, and you must have been above the JAEG threshold in the previous year as well (or be starting a new job above the threshold).
• Self-employed/freelancers: You can switch at any income. See our freelancer guide for the specifics.
• Civil servants: You are generally free to choose PKV at any point due to the Beihilfe system.

Use our eligibility quiz for a quick check, or proceed to a broker consultation where they will verify eligibility as a first step.

Step 2: Find a Licensed Broker

Working with a licensed insurance broker is strongly recommended when switching to PKV. The broker's job is to compare offers across multiple insurers on your behalf. Importantly, their fee is paid by the insurer (as a commission), not by you. From your perspective, the advice is free.

When choosing a broker, look for:

• A valid §34d GewO license (German insurance intermediary license)
• Access to a broad panel of PKV insurers (not just one or two)
• Demonstrable experience with expats and foreign-national clients
• English communication (you will need to understand complex insurance terms)

Avoid single-insurer agents (called Vertreter), who are tied to one company. You want an independent broker (Makler) who can compare the whole market.

Get matched with a licensed broker here.

Step 3: Complete the Health Questionnaire

Every PKV application requires a detailed health questionnaire (Gesundheitsfragebogen). Insurers ask about medical conditions, treatments, medications, and hospital stays, typically for the past five to ten years depending on the condition type.

Key points:

• Answer honestly and completely. Omissions or false answers constitute insurance fraud and give the insurer the right to cancel your policy retrospectively, including denying claims for conditions you thought were covered.
• Minor conditions rarely mean rejection. A past fracture, treated allergy, or resolved back problem typically results in a small exclusion or a minor premium surcharge, not rejection.
• Serious conditions may limit your options. Chronic conditions, diabetes, heart disease, or recent cancer treatment can lead to significant surcharges or rejection. In these cases, staying in GKV may be the right choice.
• Anonymous pre-screening is possible. A good broker can approach insurers anonymously with your health history to get preliminary underwriting guidance before you formally apply. This avoids creating a record of rejected applications.

Step 4: Compare Quotes and Choose Your Plan

Your broker will present quotes from multiple insurers. When comparing, do not focus only on the monthly premium. Evaluate:

• Coverage scope: What exactly is covered? What are the reimbursement percentages for outpatient, hospital, and dental? Are there waiting periods for dental procedures?
• Hospital access: Does the plan give you the right to choose your own chief physician (Chefarztbehandlung) and a private room?
• Historical premium increases: How much has this insurer raised premiums over the past 10-15 years? A cheaper plan today that raises 8% per year will overtake a more expensive stable plan within a decade.
• Financial strength: Check the insurer's solvency ratios and ratings. The German Association of Actuaries (DAV) publishes data, and rating agencies like Morgen und Morgen assess insurer quality.
• Customer service: English support availability matters for expats. Check online reviews for claims experience.
• Deductible option: Setting a voluntary annual deductible can reduce your monthly premium. Typical options are €300, €600, €1,200 or higher. Only choose this if you have the savings to cover the deductible in a bad year.

Step 5: Give Your GKV Fund Notice

Once you have signed your PKV contract and have a start date confirmed, you must cancel your GKV membership. The rules are strict:

Some GKV funds accept notice until November 30 if you have already signed a PKV contract and can show proof. Do not rely on this, though. October 31 is the safe deadline.

Your GKV fund cannot prevent you from leaving if you meet the eligibility requirements. They are legally obligated to process your cancellation and issue a confirmation letter (Austrittsbescheinigung).

You will need to provide the GKV with proof that you have alternative PKV coverage starting from your intended cancellation date. The PKV insurer will typically provide a coverage confirmation letter for this purpose.

Step 6: Manage the Transition

Between giving notice and your PKV start date, you remain covered by GKV. Keep your GKV card active until the switch date. Do not let any gap in coverage occur.

On the switch date (typically January 1):

• Your PKV card or coverage documentation is valid from that date
• Notify your employer's HR department so they adjust payroll (employer contributions and GKV deductions stop, replaced by your PKV contribution)
• Inform your GP, dentist, and any regular specialists that you are now a private patient
• As a private patient, you will receive invoices rather than having the provider bill the insurer directly. Keep all invoices and submit them to your PKV for reimbursement

Common Mistakes to Avoid

• Missing the October 31 deadline: The most common mistake. If you miss it, you are locked into GKV for another full year.
• Choosing on price alone: The cheapest plan is often cheapest because it has high deductibles, low reimbursement rates, or a history of aggressive premium increases. Compare value, not just cost.
• Not telling your employer: Your employer will continue deducting GKV contributions unless you notify HR. The overpayment can be reclaimed but creates unnecessary complexity.
• Underestimating family costs: If you have a spouse or children who are not earning, each person requires their own separate PKV policy. GKV includes free family coverage; PKV does not. Factor this into your total cost comparison.
• Assuming you can easily switch back: Returning to GKV after switching to PKV is genuinely difficult. Employees can only return if their income drops below the JAEG for three consecutive years. Do not switch to PKV expecting to "try it and switch back."
• Omitting medical history: As described above, this is the most serious mistake with the worst consequences.

Ready to start the process? Connect with a licensed English-speaking broker who will guide you through each step at no cost to you.