At the end of 2025, 8.79 million people in Germany had comprehensive private health insurance. That is around 50,000 more than a year earlier, an increase of 0.5 percent. The number of insured people has now grown for the third year in a row, after twelve years of decline down to a low of 8.705 million in 2022.
Behind the calm industry figure lie very different individual trends. According to an analysis by VersicherungsJournal based on the annual reports, 20 of 30 companies increased their number of people with comprehensive cover, and ten lost customers. The 30 companies cover around 99 percent of the market.
Who gained in 2025
| Insurer | People with comprehensive cover, end of 2025 | Trend |
|---|---|---|
| Debeka | 2,554,768 | plus 8,275 |
| HanseMerkur | 334,332 | plus around 20,700, about 7 percent |
| Barmenia | 329,619 | five-digit increase |
| ARAG | 124,401 | around 16.7 percent |
| Ottonova | 14,314 | around 58 percent |
Two points belong with this table. The Barmenia figure refers to Barmenia Krankenversicherung, not to the merged group BarmeniaGothaer. Gothaer is listed separately in the same analysis and is losing customers.
And the most striking percentage is also the least meaningful one. Ottonova grows by around 58 percent, but this brings it to 14,314 people with comprehensive cover. That is a good 5,000 more people on a very small base. Debeka hardly grows in percentage terms and still gains 8,275 insured people, so clearly more people.
Who lost
| Insurer | People with comprehensive cover, end of 2025 | Trend |
|---|---|---|
| DKV | 652,290 | minus 14,056, around 2.1 percent |
| Continentale | 362,935 | minus 6,935, around 1.9 percent |
| Landeskrankenhilfe | 155,299 | around 2.0 percent |
| Gothaer | 114,703 | around 2.4 percent |
| Münchener Verein | 61,363 | around 2.5 percent |
Here, too, a second look pays off. The decline at Continentale concerns comprehensive cover. Across all lines of business, the insurer reports 1.3 million insured people for the same period and an increase of 2.0 percent, driven by supplementary insurance. A decline in comprehensive cover is therefore no sign of crisis for the company.
Why these figures tell you little for your decision
Growth in customer numbers is often used in advice as proof of quality. It is not suitable for that, and there are three sober reasons.
Growth measures sales, not benefits. Strong growth can point to attractive terms. It can just as well come from high sales commissions, a broad cooperation with brokers or an aggressively calculated entry premium. From the outside, these cases cannot be told apart.
A low entry premium attracts new customers and becomes expensive later. We see exactly this pattern regularly when we review existing contracts. A plan that was at the top of comparisons years ago now has a premium that nobody would take out voluntarily anymore. If you want to know how an insurer calculates, look at the premium development over the last ten years, not at last year’s new customers.
A decline in customer numbers, on the other hand, is no warning sign. It can mean that an insurer deliberately gives no discounts for new business, or that its pool of insured people is shrinking for reasons of age. For an existing contract, this is often better news than fast growth.
How to actually measure an insurer
| Criterion | What you check |
|---|---|
| Terms | What is binding in the contract wording, not in the benefits overview. |
| Premium stability | How the premiums in the specific plan have developed over ten years. |
| Calculation | Was the calculation cautious, or was the entry premium strikingly low. |
| Financial strength | Do the ageing reserves carry the costs in old age. |
| Fit | Does the plan cover your work situation, your family planning and your health history. |
In practice, the last point decides most often. A plan that is the right choice for a 32-year-old employee can be the wrong one for a self-employed woman who wants fertility treatment, regardless of how strongly the insurer grew last year.
A look at the industry as a whole
The other figures of the Association of Private Health Insurers for 2025 put the growth in context:
- 40.8 million insurance policies in total, of which 31.98 million supplementary policies, an increase of 2.2 percent
- €54.4 billion in premium income in health and long-term care insurance, plus 7.3 percent
- €42.1 billion in benefits paid out, plus 7.1 percent
- €355.4 billion in ageing reserves, plus 3.8 percent
So benefits are growing faster than the number of insured people. This is the real cost pressure behind premium adjustments, and it affects growing and shrinking companies alike.
Conclusion
Private health insurance is growing again, moderately and for the third time in a row. For the question of which insurer you should choose, this is no answer.
A market analysis based on growth in customer numbers or on a well-known brand name falls short. What counts are the terms, the premium history of the specific plan and the question of whether this plan fits your own life situation. If you want to check this, base your comparison on these criteria and not on last year’s ranking.
