Private health insurance at 35 or 40 as an employee: when switching still makes sense

For our comparison we use the same plan and the same scope of benefits. The basis is two PKV-Welt quote calculations for the ARAG plan ME0 with private Pflegepflichtversicherung (i)PflegepflichtversicherungCompulsory long-term care insurance. Everyone with health insurance in Germany must have it, privately insured people through their private insurer., Krankentagegeld KTV42/170 and the statutory surcharge. Risk surcharges are not included in the calculations shown.

In this specific example, the 40-year-old employee pays €73.14 more per month. Compared with €700.51, this is an extra premium of 10.44 percent. This figure applies to these two calculations and cannot be transferred as a rule to other plans or insurers.

The comparison still shows the mechanism very well. With an identical plan, a later start of cover alone changes the calculation. The association of private health insurers explicitly names age at the start of cover as one factor in calculating the premium.

Private health insurers calculate ageing reserves because average health costs rise with age. According to the association of private health insurers, the calculated premium in younger years is above the average expected costs, while the difference flows into the ageing reserves with interest.

With a later start of cover, there is less time for this build-up. The association of private health insurers therefore states explicitly that with a later switch the monthly payments into the ageing reserves must be higher, which leads to a higher premium.

Up to age 67, a 35-year-old has 32 years on paper and a 40-year-old 27 years. This does not mean that the 40-year-old has to pay five years of missing ageing reserves in one go. Their contract is calculated from the start on the basis of the higher entry age.

The higher starting premium does not mean that switching at 40 inevitably leads to unaffordable premiums at retirement age. The higher premium already takes into account that the ageing reserves are built up over a shorter period of insurance.

The association of private health insurers also explains that individual ageing itself may not lead to a premium increase. Premium adjustments, by contrast, can become necessary if values relevant to the calculation change, such as insurance benefits or life expectancy.

For the decision at 40, today's premium is therefore not the only relevant point. We check whether the plan also fits your income, your retirement provision and your planned life situation financially if premiums develop over the long term.

The difference in entry age shows especially clearly with an additional premium relief plan. Here you pay an additional premium today so that your health insurance premium falls by a fixed amount from an agreed age. The association of private health insurers describes these plans as an additional way to relieve premiums in old age.

In our practical calculation, the private premium is to be reduced by €300 per month from age 67. The 35-year-old pays €87.90 per month for this. For the 40-year-old, the same relief costs €105.00.

For the same relief, the 40-year-old pays €17.10 or 19.45 percent more in this calculation. The main reason is the financing period until age 67, which is five years shorter.

For employees, the premium for a premium relief plan can qualify for the employer contribution within the legal limits. If enough employer contribution is available and half of the premium is covered, the employee initially keeps €43.95 of €87.90 and €52.50 of €105.00. Whether the full half contribution is actually available must be checked against the whole private premium and the maximum contribution that applies.

The tax effect comes on top and depends on your personal situation and on the share of the premium that can be taken into account for tax. We therefore do not calculate with a flat net saving.

Entry age is only one part of the decision. Your state of health when you sign the contract also influences whether an insurer accepts the application on standard terms, asks for a risk surcharge or rejects the application.

Five more years of life can mean more doctor visits, diagnoses or treatments. This does not have to be the case for a specific person. For us it is still a reason to prepare your health history especially carefully before a later switch.

A switch should therefore not be postponed only because you are waiting for a supposedly better moment. If private health insurance fits you professionally, an earlier start with the same scope of benefits can have advantages for the premium and for the health questions.

At 40 you have 15 years left until age 55. This limit matters for a later return to statutory health insurance, because § 6 (3a) SGB V excludes compulsory insurance after your 55th birthday under certain conditions.

The statement that a return to statutory health insurance is impossible without exception from 55 would, however, be wrong.

For a 40-year-old employee, 55 is still closer than for a 35-year-old. If you want to keep a later change of system open, understand this point before switching to private health insurance and do not wait years to check it.

At 40 we look more closely at long-term financing than with a very early start. A premium advantage today is not enough for the decision. We calculate the premium including long-term care insurance, Krankentagegeld (i) and possible additional premium relief.

Just as relevant are family planning, state of health and the question of how likely a later switch back to statutory health insurance really is. If you already know today that you only want to be privately insured for a few years, your starting point differs from someone who plans private health insurance as their health insurance system for good.

Switching at 40 can therefore still fit. It should be a conscious long-term decision, though, and not be sold with the argument that five years of age difference hardly matter in private health insurance.

Practical example 2026: Joining five years later raises the total premium in the same plan from €700.51 to €773.65. For the same relief of €300 from 67, the additional premium rises from €87.90 to €105.00.