Private health insurance costs: premiums, levers and the comparison with statutory health insurance

Unlike statutory health insurance, private health insurance does not base the premium on income but on the insured risk. The plan premium is calculated in the same way as life insurance (§ 146 VAG). Age at entry, scope of benefits and state of health at the time of application determine it. Your later income plays no role.

On top of this comes the statutory surcharge of ten percent. It is charged up to age 60 and goes into the ageing reserve. With pre-existing conditions, a risk surcharge of typically ten to 30 percent is common. The deductible you choose also affects the premium you pay.

The following guide values show the order of magnitude for a plan with strong benefits. They are benchmarks. The actual premium depends on age, state of health, choice of plan and insurer.

Employees pay only half of this themselves. In 2026, the employer contribution is up to €508.59 per month towards health insurance and €104.63 per month towards long-term care insurance. From 2027 it is expected to be up to €557.81 and €114.75, according to the cabinet decision. Self-employed people pay the premium alone. Self-employed people without children who are voluntarily insured in the statutory fund pay up to €1,261.32 per month there.

Besides age, your status decides. Employees in effect pay half, because the employer covers half of the premium. Self-employed people pay the premium alone and should pay special attention to sufficient Krankentagegeld (i)KrankentagegeldPrivate sick pay: a daily allowance from private insurance while you are unable to work. It replaces lost income from an agreed day of illness.More about Krankentagegeld → cover. Civil servants are the special case with the lowest premiums. The Beihilfe of the public employer usually covers half or more of the medical costs. Only the rest is insured privately, often for well under €300 per month.

A few guide values from practice. A 35-year-old employee pays an employee share from approx. €197 in an entry-level plan and from approx. €350 in a top-tier plan. A 35-year-old civil servant pays from approx. €273 in an entry-level plan and from approx. €398 in a top-tier plan. A 35-year-old self-employed person pays the full premium, from approx. €372 in an entry-level plan and from approx. €751 in a top-tier plan. As a guide value, children cost between €130 and €200 per month in an entry-level plan and €200 to €300 per child in a comfort plan. Students pay about €80 to €150, depending on the plan.

The most important cost fact for families comes right with it. Private health insurance has no free family insurance like the statutory fund. Each person pays their own premium. Premiums for children are, however, much lower than for adults. To put the overall level in context: according to the Association of Private Health Insurers, the average premium of all privately insured people is around €529 per month.

For a comparison between private and statutory health insurance to hold up, always look at the net savings. For employees, the employer contribution halves the premium. For self-employed people there is none. If you only put the gross premiums side by side, you will systematically overestimate the savings you hope for compared with the statutory fund.

At entry, age decides. Every year of delay raises the starting premium and shortens the saving phase. Once you are insured, choice of plan and deductible are the ongoing levers. An internal plan change under § 204 VVG can lower the premium considerably without changing insurer.

In old age, the ageing reserves dampen the increase. The industry has set aside €351 billion for this, around €38,800 per insured person according to the Association of Private Health Insurers. If you know the levers of each stage, you steer your premium over decades instead of simply accepting it.

Each topic has its own page with the details, the relevant legal sections and our recommendations:

• Private health insurance in old age: premium development and all relief mechanisms from 60
• Risk surcharge: amount, calculation and ways to have it removed
• Deductible: levels, effect and who it pays off for
• Employer contribution: calculation and maximum amounts for employees
• Premium stability: how to recognize an insurer with stable calculation
• Top-tier plans: when first-class benefits pay off
• Beitragsbemessungsgrenze (i)BBG · BeitragsbemessungsgrenzeThe contribution ceiling of statutory health and long-term care insurance. Income above this amount is not used to calculate contributions.More about BBG →: how it caps the maximum contribution and the employer contribution
• Annual prepayment: premium discount and tax lever of paying once a year
• First premium and subsequent premium: first payment, ongoing premiums and the consequences of late payment
• Premium due date: dates, deadlines and payment methods
• Patient charges: out-of-pocket shares that remain despite insurance
• Standard maximum rate: GOÄ multipliers and what they mean for reimbursement
• Acquisition costs: commission, offsetting and legal caps
• No-claims refund and health bonus: refunds for claim-free years and bonuses for health-conscious behavior

Yes, to a large extent. The basic share of the premium, typically around 79 percent, is fully deductible as a provision expense under § 10 EStG. Comfort elements such as a single room do not count.

Rather the opposite. From 2006 to 2026, premiums in private health insurance rose by 3.4 percent per year according to the Association of Private Health Insurers, contributions in statutory health insurance by 3.9 percent. The statutory maximum contribution alone rose by 55.3 percent from 2017 to 2026. Increases in private health insurance only come in steps and are therefore more noticeable.

The plan premium is the same as for employees. Only the employer contribution is missing. As a guide value, a self-employed person who joins at around 35 pays approx. €510 per month. That is well below the maximum contribution that self-employed people without children pay in the statutory fund. The premium does not depend on profit, which makes it easy to plan when your income fluctuates.