These tricks will no longer work in 2026

Exemption rules tightened

Government closes loopholes for return to statutory health insurance

Older PKV insured people are often considering switching to statutory health insurance due to rising contributions. A change was possible with tricks. Stricter rules will apply in 2026.

The decision to take out private health insurance (PKV) should always be carefully considered. Because: A return to statutory health insurance is almost impossible, especially in old age. In the past, resourceful insured people have used various loopholes to find their way back into the statutory health insurance after the age of 55. But the federal government stopped these options at the turn of the year.

The basic rule is: At the age of 55, the insured person has reached the so-called age limit. This can be found in the fifth Social Security Code (SGB V). It states: A change to the GKV is not possible after the age of 55 if the insured person did not have statutory health insurance in the previous five years.

What may seem unfair at first glance serves to protect the solidarity system. At a young age, those insured with private health insurance usually only pay low contributions. However, as you get older, your risk of illness increases and so do your premiums. Many pensioners find themselves financially overwhelmed by the burden of contributions and have been looking for a way back into the statutory health insurance despite the age limit. So far, two loopholes have been open to them.

Another option for returning to statutory health insurance was to go through family insurance. Requirement: The spouse or registered life partner must be legally insured. In addition, the income of the privately insured person may not exceed a certain income limit (2026: maximum of 565 euros). If these requirements are met, the PKV insured person can take out insurance through the family insurance in the GKV without paying any contributions.