What does private health insurance cost?

What does private health insurance cost?
Patrick Ott
Martina Martinez
Expert for insurance and finance
2. June 2023

The cost of private health insurance (PHI) depends mainly on the desired benefits and the age of the insured person when the contract is concluded. However, there are price differences between different insurance providers. We will now show you what private health insurance costs you should expect and what you should look out for in your private health insurance.

What does private health insurance cost: How are private health insurance premiums calculated?

How much you have to pay for your private health insurance does not depend on your income - unlike in the case of statutory health insurance. Rather, the insurer determines your private health insurance premium primarily based on the following points:

  • Age at the time of contract conclusion
  • Health status at the time of contract conclusion
  • Benefits included in your chosen private health insurance tariff.

This means that although you cannot influence your age and state of health at the time of signing the contract, you still have a say in determining your PKV costs. After all, the range of benefits included in your private health insurance - unlike in statutory health insurance - is not prescribed by law.

You decide for yourself which benefits you would like to receive from your private health insurance. The more comprehensive your chosen tariff, the higher your private health insurance costs and the lower the cost risk in the event of illness.

The assessment of the private health insurance costs in detail

The cost of private health insurance varies from person to person. The following will give you an idea of how the insurer calculates the premium based on individual factors:

  • Health status: There are many comparison calculators on the Internet that show you the approximate costs of your private health insurance. However, the prices shown are not reliable, as they only apply to people in good health. The insurer checks your current state of health before concluding the contract by means of various health questions and takes the result into account when calculating the premium.

As part of the health check, you must provide information about allergies, lifestyle habits, previous illnesses and other health problems. The questions help the insurer to estimate your expected actual health costs

  • Age: Your age has an influence on the premium amount. This is because your premiums are intended to cover your actual health care costs. In order to determine what costs are likely to be incurred for your care, the insurer consults statistical values.
    The disadvantage of older insured persons is that, statistically speaking, they receive more medical treatment. In addition, they often have to undergo costly treatment - for example, due to chronic illnesses. This is why older policyholders pay a higher monthly premium.
  • Scope of benefits: The greater the scope of benefits you want from your private health insurance, the higher the monthly costs. However, you should not be lured by particularly low rates. Check carefully which services you have to do without in a particularly favorable tariff - after all, you don't want to risk being insured worse than in the statutory health insurance.

Although it is not possible to say in general how much insured persons pay for their private health insurance, a rough guideline can be used:

Salaried employees: For a high-performance PKV tariff, a 35-year-old employee pays about 500 to 700 euros. However, the employer pays half of the costs of private health and long-term care insurance. Note, however, that he only has to make a monthly contribution of a maximum of 403.99 euros.

Self-employed: Self-employed persons must finance their PKV contribution completely out of their own pocket. They have to expect (at an entry age of 35) costs of 460 to 640 euros per month.

Both groups can claim their own contribution paid as a tax deduction.

Different PKV costs for different occupational groups

What you have to pay for your private health insurance depends, among other things, on whether you are employed, self-employed or a civil servant. For different occupational groups, different regulations apply around the PKV, which can affect the costs of private health insurance for you:

  • PKV costs for employees: If you can opt for private health insurance as an employee due to your high income, you will receive a cost subsidy of 50 percent for private health and long-term care insurance from your employer. However, the employer's contribution to private health insurance is capped at a maximum of 403.99 euros per month.

This means: If your private health insurance costs 500 euros per month, your employer will pay a subsidy of 250 euros per month.

  • PKV costs for civil servants: If you are a civil servant, you receive a so-called allowance from your employer. This means that you only have to pay a small part of your PKV costs out of your own pocket. How much you are entitled to depends on your employment relationship and place of employment.
  • PKV costs for self-employed and freelancers: Most self-employed and freelancers do not receive any allowances or employer subsidies. They have to pay the costs of their private health insurance completely out of their own pocket. The costs incurred are independent of the income earned and depend primarily on the desired insurance benefits.
  • Private health insurance costs for children and students: Private health insurance does not recognize family insurance. This means that your children need their own insurance contract. You must finance the costs for this yourself - but you will also receive a subsidy of 50 percent from your employer.

    If you are a civil servant, on the other hand, you can usually insure your children for about 40 euros per month. If you are not a civil servant, the insurance will cost you about 100 euros per month.

    For students, there are special PKV tariffs starting at about 90 euros per month.
  • PKV costs for pensioners: Pensioners receive a subsidy of 50 percent to finance their private health insurance costs from their pension insurance provider. However, the subsidy is capped at a maximum of 8.1 percent of the total pension entitlement.

How private health insurance costs develop in old age

In younger years, private health insurance is often cheaper for high earners than statutory health insurance. However, you shouldn't just spend the contributions you save. There is a simple reason for this: the premium costs for your private health insurance increase over the years. If you have a lower income in retirement, you must be able to continue to finance your private health insurance costs.

However, your private health insurer also helps you to finance your premium costs in old age: It sets aside a portion of the premiums you pay as so-called age reserves. The money saved is later used to cushion and moderate premium increases.

For you, this means that if you enter private health insurance at a young age, you have plenty of time to build up age reserves. The younger you are when you take out the contract, the greater the premium relief in old age.

This is how you can reduce the costs of private health insurance

If you can no longer afford the costs of your private health insurance, you have the option of reducing them. On the one hand, you have the option of changing your private health insurance tariff and opting for a similar, but cheaper tariff from your provider.

If the costs of the PKV cannot be reduced by a tariff change, a change into the legal health insurance or (if you do not fulfill the conditions for the change) into the basis or standard tariff can be a way out. The basic tariff can only be a way out if you receive unemployment benefit I.

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