Statutory or private health insurance? A decision for the long term

Private health insurance (private Krankenversicherung) can be worthwhile, but not for everyone. Here you can read who is allowed to switch, what the differences are and which questions you should ask yourself first.

Uygar Vural, SIGNAL IDUNA insurance in Cologne · Updated: 13 October 2026

Who can take out private health insurance

• Employees whose regular annual salary is above the compulsory insurance threshold (Versicherungspflichtgrenze). Regular extra payments such as holiday and Christmas bonuses count towards it. In 2026 the threshold is 77,400 euros. After a pay rise, you can usually switch at the end of the year; with a new job, often straight away.
• Self-employed people and freelancers, however much they earn. Exceptions apply, for example, to members of the artists’ social insurance fund (Künstlersozialkasse).
• Civil servants. They receive a healthcare subsidy (Beihilfe) from their public employer and insure the rest privately.
• Students can apply to be exempted from compulsory insurance at the start of their studies. The exemption applies for the whole course of study and cannot be revoked.

The key differences

In statutory health insurance (gesetzliche Krankenversicherung), the contribution depends on your income. The benefits are set by law and can be changed by the legislator.

In private health insurance, the premium depends on your age when you join, your health and the plan you choose. The benefits are written into the policy. The insurer cannot simply cut them. Depending on the plan, they include, for example, treatment by a senior consultant (Chefarztbehandlung), a single room or higher reimbursement for dentures and crowns.

What to consider before you switch

• Family: in a statutory health insurance fund, children and a spouse with no or only a low income of their own are often covered free of charge. In private insurance, each person pays their own premium. If the higher-earning parent switches to private insurance, the children often can no longer stay in the statutory fund free of charge.
• Age: private premiums can rise too. Insurers build up reserves for old age (Alterungsrückstellungen). Still, include your retirement years in your planning.
• Going back: returning to statutory health insurance is only possible in certain cases and is usually ruled out from age 55.
• Health: before you take out the policy, you answer health questions. Acceptance and premium depend on them.

A middle way: supplementary insurance

Would you like to stay with your statutory health insurance fund but have better cover? With supplementary insurance, for example for teeth, hospital stays or glasses, you add exactly what you need to your statutory cover.

How I can help

We look at your situation together: income, family, plans for the future. Then you receive a recommendation that you can review at your own pace. Even if that recommendation is to stay with your statutory health insurance fund and add targeted extras.

This article gives a general overview. Exactly what is covered is set out in the terms and conditions of the plan. I am a tied insurance agent (gebundener Versicherungsvertreter) and exclusively arrange products of the SIGNAL IDUNA Group.