Advantages and disadvantages at a glance


Lerato Khumalo

Privately insured people are often seen as first-class patients. But private health insurance also has significant disadvantages. An overview.

Anyone who chooses private health insurance (PKV) in Germany enjoys a number of advantages over those with statutory insurance. These include shorter waiting times for doctor’s appointments, treatment by a senior physician and the option of putting together individual services. But PKV also has its downsides – mainly in old age. We summarize the most important disadvantages and advantages.

Civil servants, the self-employed, students and well-paid employees can take out private insurance. But the decision should be carefully considered, because private health insurance is not worthwhile for everyone. These are the disadvantages:

The most important disadvantage of private health insurance is its financial risk. Unlike statutory health insurance, contributions in private health insurance are not income-dependent. In addition to the tariff you choose, they also depend on your age and state of health. As you get older and require more frequent treatment, contributions often rise dramatically, which can represent an enormous financial burden for older people.

Anyone who wants to escape this by switching back to statutory health insurance (GKV) will face high hurdles. Especially if you are older than 55, the chance of switching is extremely small. The legislator wants to prevent people from taking advantage of the low premiums in private health insurance at a young age and then later, when the premiums have become more expensive, switching to the solidarity system of statutory health insurance, into which they have not paid for decades.

In private health insurance, children and spouses or life partners without their own income are not automatically covered. Separate contracts must be concluded for them, which increases the costs considerably.

Acceptance into private health insurance is only possible after a medical examination. Insurers can charge risk surcharges or exclude certain benefits if you have a pre-existing medical condition. In statutory insurance, your state of health is not important.

The disadvantages of private health insurance are offset by several advantages. Here is an overview of the most important ones:

Depending on the tariff you choose, as a private patient you will receive better services such as treatment by a senior physician, a single room in the hospital and usually do not have to wait as long for doctor’s appointments and treatments as statutory health insurance patients.

The private health insurance offers a wide range of tariffs and services that you can put together individually. This also includes services that the statutory health insurance does not provide, such as certain dental treatments or daily sickness benefits.

The tariff selection also allows you to choose a variant with fewer benefits or deductibles, which can sometimes even be cheaper than membership in the statutory health insurance scheme. However, this has disadvantages if you become ill frequently or seriously.

In summary, private health insurance offers more options, but also higher financial risks due to rising premiums and exclusions from benefits, particularly in old age and in the case of pre-existing conditions. A change should therefore be carefully considered.