Cost of private health insurance: Your comprehensive guide for 2025
30.05.25
6
Minutes
Katrin Straub
Managing Director at nextsure
The cost of private health insurance is a crucial factor when choosing the right health cover. Many factors influence the monthly premiums, from your age to the level of cover you want. This article explores the cost structure and helps you find the best solution.
The topic in brief and concise terms
The cost of private health insurance depends largely on age at entry, health status and the chosen scope of cover and can range from €200 to over €800 per month.
Long-term cost stability is sought through ageing reserves; nevertheless, premium adjustments due to rising healthcare costs are common.
Through tariff optimisation, choosing excesses and reviewing risk surcharges, private health insurance premiums can often be significantly reduced.
Analysing the cost factors of private health insurance in detail
The monthly costs of private health insurance are determined by several key factors. Age at entry is an essential point: younger policyholders often pay lower premiums, as statistically fewer healthcare services are used. A 30-year-old, for example, can expect premiums from around 300 euros, while a 50-year-old often pays 500 euros or more.
Your state of health at the time of signing the contract also plays a major role. Pre-existing conditions can lead to risk surcharges of 30 per cent or more, or even to exclusions from benefits. That is why taking out cover early, while in good health, is often advantageous. The scope of benefits chosen is the third important factor. A basic tariff that meets the statutory minimum requirements is cheaper than a premium tariff with treatment by the chief physician and a single room, which can quickly exceed 800 euros. You must take these aspects into account when calculating your Costs of private health insurance. Careful consideration of these factors is crucial for cover that remains affordable in the long term.
Contribution amount: Understanding PKV versus GKV
A direct cost comparison between private and statutory health insurance is complex. In the GKV, contributions are calculated as a percentage of income, up to the contribution assessment ceiling of 5,512.50 euros per month (as of 2025). The general contribution rate is 14.6 per cent, plus an insurer-specific additional contribution averaging 2.5 per cent in 2025. For high earners, the maximum GKV contribution can therefore exceed 900 euros per month.
In the PKV, contributions are independent of income. For young, healthy high earners, the PKV can therefore often initially be cheaper than the GKV. A 35-year-old employee could expect to pay around 380 euros per month in a starter PKV tariff, whereas the GKV contribution would be higher for a corresponding income. However, the PKV is not a pure savings model in the long term, as contribution adjustments are possible. Average PKV contributions in 2022 were around 529 euros per month for adults without entitlement to subsidies. The benefits of private insurance should therefore not be assessed solely from a cost perspective. The decision depends heavily on the individual life situation and priorities.
Predict contribution development over time and with age
The cost of private health insurance is subject to adjustments over the years. On average, PKV premiums have risen by around 3.1 per cent per year over the past ten years. For 2025, an average premium increase of around twelve per cent was recorded. These increases are attributable, among other things, to medical progress and the general rise in healthcare costs.
To keep premiums stable in old age, PKV builds up so-called ageing reserves. A portion of the premiums paid by younger policyholders is set aside to offset the higher healthcare costs in old age. Despite these reserves, premiums can continue to rise in old age, albeit often more moderately. There are special health insurance policies for pensioners and premium relief options that can help reduce costs in retirement. Forward planning is essential here. The development of premiums should therefore be an important aspect when choosing the right plan.
Identify and make use of savings potential in private health insurance costs
There are various ways to optimise the cost of private health insurance. One option is to choose a tariff with an excess. An annual excess of, for example, 1,000 euros can noticeably reduce the monthly premium, often by ten to 30 per cent. This is particularly interesting for healthy policyholders who rarely need medical services.
Other ways to save include:
Waiving additional benefits that are not absolutely necessary, such as treatment by the chief physician or a single room.
Checking premium refunds in the event of no claims; some insurers refund up to three monthly premiums.
An internal tariff change with your own insurer in accordance with Section 204 VVG can often lead to more favourable conditions without losing any accumulated ageing reserves.
Reviewing and, if necessary, removing risk loadings if your health has improved since the contract began.
Our expert tip: Have your existing policy reviewed regularly by an independent party to identify potential optimisations. Sometimes switching to the basic tariff is also an option, whose benefits are comparable with those of GKV and whose contribution is capped. The issue of sick pay is another aspect that should be considered when choosing a tariff. Careful tariff selection and adjustment can significantly reduce the financial burden.
Know the legal framework and your rights as an insured person
Private health insurance is subject to clear legal regulations. The Insurance Contract Act (VVG) and the Insurance Supervision Act (VAG) form the legal basis. These laws regulate the rights and obligations of insurers and policyholders. Since 2009, there has been a general requirement to have health insurance in Germany.
Important aspects for policyholders are:
The right to switch to another internal tariff under Section 204 VVG.
The insurer’s obligation to offer a basic tariff whose benefits are similar to those of statutory health insurance (GKV).
The build-up of ageing reserves to stabilise premiums in old age.
The insurer’s inability to terminate the contract when the insurance obligation is fulfilled (exception: serious breaches of contract).
The Federal Financial Supervisory Authority (BaFin) monitors compliance with these regulations. For children, a separate premium must be paid in private health insurance; there is no free family cover like in statutory health insurance. The question private or statutory insurance for a child is therefore relevant for families. A sound understanding of the legal framework strengthens your position as the policyholder.
Expert tips for long-term cost control in private health insurance
A private health insurance policy that remains affordable in the long term requires forward-looking planning and regular review. One important expert tip is to choose a tariff with solid ageing reserves from the outset. These help to soften premium increases in later life, even if they slightly raise contributions in younger years – often by around 20 per cent.
Check the option of premium relief tariffs. These special tariffs make it possible to reduce contributions in retirement further by making additional savings contributions at a younger age, in some cases by up to 500 euros per month. Our expert tip: When choosing a tariff, pay attention not only to the current price, but also to the provider’s financial strength and long-standing premium stability. Compare the private health insurance contributions for civil servants or the terms for private health insurance in retirement, if this is relevant to you. Independent advice can help you find a future-proof tariff and keep the costs of your private health insurance under control in the long term. At nextsure, we will be happy to help you review your insurance situation free of charge and receive concrete optimisation suggestions.
Request an individual risk analysis now: Have your insurance situation reviewed free of charge and receive concrete optimisation suggestions.
More useful links
The Association of Private Health Insurance offers detailed statistics and key figures on private health insurance in Germany.
Current press releases and data on private health insurance can be found at the Association of Private Health Insurance.
The Federal Ministry of Health provides comprehensive information on private health insurance, including legal foundations and framework conditions.
A detailed explanation of contributions in private health insurance is provided by the Federal Ministry of Health.
The Federal Statistical Office (Destatis) supplies official data and statistics on illness costs and healthcare expenditure in Germany.
The Consumer Advice Centre provides information on premium increases in private health insurance and gives advice on how to proceed.
Practical tips on switching to a cheaper private health insurance tariff are available from the Consumer Advice Centre.
FAQ
How are the costs of private health insurance made up?
The costs comprise the base premium for the selected benefits, any risk surcharges due to health status, the statutory surcharge of ten per cent (up to the age of 60) for ageing reserves, and premiums for any additional modules.
Is private health insurance always more expensive than statutory health insurance?
Not necessarily. For young, healthy high earners, PKV can initially be cheaper. In the long term, costs depend on premium development in both systems and individual factors. GKV is income-based, while PKV is risk-based.
What happens if I can no longer pay my private health insurance premiums?
If there are payment difficulties, the insurer will first issue a reminder. If no payment is made, the contract can be transferred to the emergency tariff, which covers only emergency treatment. Contribution arrears accrue. Switching to the basic tariff or social assistance may be options.
What role does the deductible play in private health insurance costs?
An excess lowers the monthly premium. The higher the excess (e.g. 1,000 euros per year), the lower the premium. In the event of illness, costs up to the amount of the excess must be borne by the policyholder. A reduction in the monthly premium of ten to 30 per cent is possible with a medium excess.
Can children and partners be co-insured under private health insurance?
In private health insurance (PKV), there is no free family cover. Every person, including children and non-working partners, needs their own policy and pays their own contribution. For children, contributions are often between €100 and €200 per month.
What are ageing provisions and how do they affect costs?
Age-related provisions are savings components in private health insurance premiums, which help to cushion the rising healthcare costs associated with ageing and keep premiums more stable in later life. Younger policyholders pay a slightly higher premium for this.
