Switching back from private to statutory health insurance: requirements and exceptions

In 2026, the Jahresarbeitsentgeltgrenze is a gross annual salary of €77,400. If an employee falls below this threshold, compulsory statutory insurance under § 5 SGB V applies automatically. This can happen, for example, when you reduce your hours to part-time or change to a job with a lower salary.

Only cancel your private health insurance after statutory health insurance has confirmed in writing that you have been accepted.

Family insurance under § 10 SGB V lets you be insured free of charge through your partner with statutory health insurance if your own income is below €565 a month (2026, from 2027: €590). This can apply, for example, during a career break, while caring for relatives or during your studies.

Family insurance is also possible after your 55th birthday, as long as you stay within the income limit.

§ 6 SGB V concerns people who were privately insured for more than half of the last five years. From their 55th birthday, neither new compulsory insurance nor voluntary statutory insurance is possible for them. The background is the protection of the community of insured people in the statutory health insurance funds.

Family insurance remains possible from 55 if the income requirements are met. If you are considering a switch back, you should therefore complete it before your 55th birthday.

From over 5,000 applications with health questions and consultations we have supported, a pattern emerges. People often consider switching back on impulse after a premium increase and underestimate the consequences. The ageing reserves are lost in full when you switch back, and the insurance status in statutory health insurance in retirement was not considered either. We recommend that you first compare the premium burden over your lifetime. Statutory contributions rise with income, while the private premiums in old age are cushioned by the ageing reserves.

For young insured people under 35, the loss is smaller, because they have only built up small ageing reserves. With chronic illnesses and a high premium, statutory health insurance can be much cheaper financially.

Not through voluntary insurance under § 9 SGB V, but through compulsory insurance under § 5 SGB V and only under certain conditions, for example after you give up self-employment and start a job subject to social insurance below the Jahresarbeitsentgeltgrenze (i). If you remain self-employed, you usually have no right to be accepted into statutory health insurance.

Yes. The ageing reserves are tied to the private contract and remain with the insurer when the contract ends. This applies regardless of whether you return through family insurance or through compulsory insurance.

With compulsory insurance because you fall below the Jahresarbeitsentgeltgrenze (i), you choose your fund within two weeks, otherwise your employer registers you with the fund you were last insured with (§ 175 (3) SGB V). With voluntary insurance, there is a deadline of three months to join. If you miss it, you lose the right to join.

No. The switch back is a legal consequence of falling below the Jahresarbeitsentgeltgrenze (i). From the start of compulsory insurance, the employer must pay the employer contribution to statutory health insurance.

Ongoing treatment is billed through private health insurance as long as the private contract is active. Your status as a private patient ends on the effective date of the termination. Follow-up treatment then follows the statutory standard. You should agree on the timing of the termination with the doctor treating you.