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Step 03 · Health

Health insurance: understand GKV and PKV.

Health insurance covers medical costs and is compulsory in Germany. Statutory health insurance (GKV) and comprehensive private health insurance (PKV) differ in access, contributions, billing and contractual benefits, so changing systems should be considered over the long term.

Compulsory insuranceGKV and PKVLong-term review

Why does health insurance exist?

Diagnostics, treatment, medication or a hospital stay can generate high costs. Health insurance spreads this risk and provides access to medically necessary care.

Statutory health insurance (GKV)

GKV is based on solidarity and generally uses the benefits-in-kind principle.

  • Contributions largely follow assessable income.
  • Medically necessary medical, dental and psychotherapeutic treatment is included within the statutory framework.
  • Medicines, remedies, medical aids, hospital treatment, home nursing and rehabilitation are covered according to law.
  • Non-contributory family insurance may be possible if statutory conditions are met.

Comprehensive private health insurance (PKV)

In PKV, the selected plan and policy conditions define the benefits.

  • Premiums depend in particular on age at entry, health risk and scope of benefits.
  • Bills are commonly paid first and then submitted for reimbursement.
  • Deductibles, reimbursement limits and additional benefits depend on the selected plan.
  • Each family member generally needs a separate policy.

Who can choose which system?

The choice is not unrestricted. Employment status, income and special statutory rules are among the decisive factors.

GKV obligation and right to choose

  • Employees whose regular annual remuneration does not exceed the general annual earnings threshold (Jahresarbeitsentgeltgrenze, JAEG) are generally subject to compulsory GKV membership.
  • As at 2026, the general JAEG is EUR 77,400 per year, or EUR 6,450 per month.
  • Exceeding the figure during ongoing employment does not necessarily permit an immediate switch: statutory timing rules apply and, for an exit at year-end, the following year’s threshold can also matter.
  • Self-employed people, freelancers and civil servants may generally have a choice; special rules can apply.

Limits and long-term questions

  • GKV benefits must be sufficient, appropriate and economical; co-payments may apply.
  • Outside legally regulated access arrangements, PKV insurers may apply risk surcharges or exclusions, or reject applications.
  • PKV premiums are not linked to income and may be adjusted.
  • Returning to GKV is not simply a matter of choice; it generally requires a new statutory route such as compulsory insurance. Additional restrictions often apply from age 55, depending on the person’s prior insurance history.
Illustrative example

Having a choice is not yet a decision.

An employee’s regular annual remuneration exceeds the general JAEG in 2026. This does not by itself permit an immediate switch: the statutory timing requirements, including the threshold relevant to the following year where applicable, must first be met. Once compulsory GKV membership ends, the employee may remain voluntarily insured in GKV or consider a comprehensive PKV plan. Family circumstances, desired benefits, health, deductibles and long-term affordability all matter.

Illustrative example only — not personal advice and not a guarantee of cover, benefits or price.

How MB Finance supports you.

We consider more than the monthly contribution: benefits, conditions and the consequences of a long-term system decision belong together.

Clarify status

We put compulsory insurance, any right to choose and existing protection into context.

Compare benefits

GKV options and contractual PKV benefits are presented clearly.

Include the family

Co-insurance, separate premiums and foreseeable life changes are considered.

Prepare health information

Health questions are organised fully and truthfully for a possible enquiry.

Assess costs

Premium, deductible, benefit limits and long-term affordability are reviewed together.

Provide ongoing support

We remain available after a policy has been taken out if questions arise about cover or circumstances change.

Frequently asked questions about health insurance.

These answers are general guidance; each person’s insurance status must be checked separately.

Who can choose GKV or PKV?

A choice may exist for self-employed people, freelancers, civil servants and employees who meet the statutory income and timing requirements. The general JAEG for employees is EUR 77,400 per year as at 2026; for an exit at year-end, the following year’s threshold can also matter.

Is PKV automatically better?

No. Suitability depends on status, family, health, the selected plan, contributions and long-term plans.

Does supplementary cover turn GKV into PKV?

No. It only adds selected contractual benefits. The person remains in GKV and does not have comprehensive private health insurance.

Next step in health protection

Add selected benefits to GKV: supplementary health insurance.

The next page explains private supplementary policies and why they do not turn statutory cover into comprehensive private health insurance.

Sources and general notice

General information, last updated 31 August 2026. It does not replace personal advice. Insurance status, benefits and contributions are governed by law, status, application, policy schedule and conditions.