Advantages of private health insurance: more benefits, comfort and personalised healthcare
01.06.25
4
Minutes
Katrin Straub
Managing Director at nextsure
Do you want healthcare that is ideally tailored to your needs? Private health insurance (PKV) offers numerous advantages over statutory health insurance. Find out how you can benefit from bespoke tariffs and first-class medical services.
The topic in brief and concise terms
People with private health insurance often benefit from a wider range of benefits, individual tariffs and shorter waiting times for specialist doctors.
Premiums in private health insurance are based on age at entry, health status and the chosen plan, not on income.
For civil servants, self-employed people and high earners, private health insurance (PKV) can be particularly attractive due to its specific advantages. [6,3]
Overview: The key advantages of private health insurance
Private health insurance (PKV) offers a range of benefits that often goes beyond that of statutory health insurance (GKV). A key advantage is the individually customisable insurance cover. You can choose tariffs that are precisely tailored to your needs, for example for dental prosthetics or alternative treatments. Many tariffs include treatment by the chief physician and accommodation in a single or double room in hospital. In addition, privately insured people often benefit from shorter waiting times for specialist appointments. These aspects contribute to more comfortable and often more comprehensive medical care. The ability to customise your insurance cover is a key advantage. Premium rates at a young age can also be attractive.
Practical: Tailored benefits and contribution structure
A major advantage of private health insurance (PKV) is the lifetime guarantee of the benefits agreed once. Unlike in statutory health insurance (GKV), where benefits can be reduced by changes in the law, your contractually guaranteed entitlements remain in place in private health insurance. When premiums are set, your age at entry and state of health play a role, not primarily your income as in statutory health insurance. Many private health insurance tariffs also offer the possibility of a premium refund if no benefits are claimed over a certain period, often several hundred euros per year. Another practical advantage is the often straightforward coverage of medication costs without co-payments, provided no excess has been agreed. The cost structure of private health insurance therefore differs fundamentally from that of statutory health insurance. These individual customisation options are a decisive factor for many.
In-depth expertise: free choice of doctor, innovative treatment methods and options abroad
As a privately insured person, you generally have free choice of doctor and hospital, including specialists who do not accept statutory health insurance. This gives you access to a broader range of medical experts. Access to innovative treatment methods and the latest medicines is often faster and more straightforward. Many plans also cover treatment by alternative practitioners and enhanced visual aids. For stays abroad, most private health insurance plans offer comprehensive cover that often goes beyond that of statutory health insurance. Our expert tip: when choosing a plan, pay attention to the exact conditions for travel health insurance abroad and any possible exclusions of benefits. The differences from statutory health insurance are particularly clear here. This flexibility and access to top-class medicine are compelling arguments.
The benefits often include:
Free choice of doctor and hospital, including private clinics.
Coverage of costs for single or double rooms.
Consultant treatment is offered as standard in many plans.
Access to modern and alternative treatment methods that go beyond the statutory health insurance catalogue.
Faster appointment allocation with many specialists, often within a few days.
Individual plan design according to personal needs and priorities.
Premium refunds in the absence of claims can amount to several hundred euros.
Worldwide health insurance cover is often included or optionally available.
Target groups in focus: For whom is private health insurance particularly worthwhile?
Private health insurance (PKV) is not accessible to everyone, nor is it the best choice for all, but for certain groups it offers clear advantages. Civil servants often benefit significantly, as their employer covers a large share of medical costs through the subsidy scheme (usually 50 to 80 percent). [6,3] The PKV then covers the remaining costs, often on more favourable terms than voluntary statutory health insurance (GKV) membership. [5] Self-employed people and freelancers can take out private insurance regardless of their income and benefit from individual tariff design. Employed people must exceed the annual earnings threshold to switch to the PKV (2024: 69,300 euros). [5] Young, healthy high earners can often enter with comparatively low premiums while still receiving a high level of benefits. For retirees with appropriate provision, the PKV can also be an option. The decision depends heavily on the individual life situation and financial means.
Expert tips: Optimise your tariff choice and benefit in the long term
Choosing the right private health insurance plan is crucial for long-term satisfaction and financial predictability. Compare not just the price, but above all the benefits and terms and conditions carefully. [5] Pay attention to the amount of the excess; a higher excess can reduce monthly premiums, but means greater out-of-pocket costs in the event of illness. [3] Our expert tip: Check the provisions for aids and appliances, alternative practitioner services and psychotherapy, as there can be major differences between plans here. Find out about options for keeping premiums stable in later life, such as ageing provisions and optional premium relief plans. [1] A supplementary health insurance policy can be an alternative if a complete switch is not desired. Careful selection ensures you obtain the benefits you want.
Important aspects when choosing a plan include:
Level and scope of cost reimbursement for outpatient treatment.
Benefits for dental treatment and dentures (percentage of reimbursement).
Inpatient benefits: single or twin room, treatment by the chief physician.
Rules on premium adjustments and options for keeping premiums stable in later life.
Scope of cover abroad.
Coverage of costs for remedies and aids as well as alternative medicine.
Options for premium refunds when no claims are made.
Plan flexibility as your life circumstances change.
Important considerations: contribution development and family insurance
Although the advantages of being privately insured may outweigh them, there are aspects that should be considered. Contributions in private health insurance can rise over time, even though ageing reserves are built up to cushion this. [3] A careful review of the long-term contribution trend is therefore advisable. [1-] Unlike in statutory health insurance, there is no free family cover in private health insurance; each family member requires their own contract and contribution. [3,6ü] This can lead to higher overall costs, especially for families with several children. [5] A switch back to statutory health insurance is also only possible under certain conditions and is often made more difficult, particularly from the age of 55. [4.] These points should be taken into account in your decision for or against voluntary health insurance in private health insurance. Comprehensive advice can help you find the right solution.
Choosing private health insurance offers many opportunities for high-quality and personalised medical care. The benefits range from an extensive range of benefits and free choice of doctor to shorter waiting times. The ability to tailor cover precisely to your own needs is a key argument. However, also consider premium developments and the situation for families. [1-,3] Careful consideration and a detailed comparison of different tariffs are essential. If you value first-class medical care and individual flexibility, private health insurance may be the right choice. Understanding what health insurance is and what options are available is fundamental. Let us find your ideal solution together.
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More useful links
Wikipedia offers a comprehensive overview of private health insurance.
Private Health Insurance (PKV) provides information and arguments for private health insurance.
Federal Ministry of Health offers official information on private health insurance.
Destatis provides statistical data on health expenditure by funding source.
Destatis provides information in a press release on current health expenditure in Germany.
Federal Agency for Civic Education (bpb) explains expenditure and financing of the health system in Germany.
Private Health Insurance (PKV) is the central information platform of the Association of Private Health Insurers.
Association of Substitute Health Insurance Funds (vdek) provides data on insured persons in statutory health insurance.
Destatis offers an overview page on health expenditure in Germany.
Private Health Insurance (PKV) publishes a study on the value added of private health insurance.
FAQ
What are the main advantages of private health insurance?
The main advantages usually include a better range of benefits (e.g. consultant treatment, single room), free choice of doctor and hospital, shorter waiting times for appointments and individually customisable tariffs.
Who is private health insurance particularly suitable for?
Especially for civil servants (because of the subsidy scheme), self-employed people, freelancers and employees with an income above the annual earnings threshold, PKV can be advantageous. [1,6,3]
How are premiums calculated in private health insurance?
Contributions depend on the age at entry, the state of health at the time the contract is concluded and the chosen scope of benefits. They are independent of income. [1,5]
Are the benefits in private health insurance guaranteed?
Yes, the contractually agreed benefits in private health insurance are generally guaranteed for life and cannot be unilaterally reduced by the insurer.
What happens to the contributions in old age?
To offset premium increases in later life, ageing reserves are built up. In addition, certain premium components cease to apply from the age of 60, which can provide relief. [1,2..]
Can I choose my doctors and hospitals freely?
Yes, with private health insurance, you generally have free choice among resident doctors, dentists and hospitals, often also private clinics.
