Once you have private health insurance, switching to statutory health insurance is only possible under certain conditions. We explain what these are.
There are many reasons why someone would want to switch from private health insurance (PKV) to statutory health insurance (GKV). Switching means: you want to change the system for the first time or you were previously insured under statutory health insurance and are now looking to go back. Often the family or professional situation may have changed – and with it often the financial situation too.
Read the guide in detail to find out who can switch from private health insurance to statutory health insurance and under what circumstances.
No matter what the reason is that makes you consider switching from private to statutory health insurance, there are two numbers you should definitely know.
Firstly, there is the so-called compulsory insurance limit, also known as the annual wage limit (JAEG). This refers to the gross salary per year that determines whether you can change your health insurance system or not. Secondly, your age is important.
- Compulsory insurance limit: It increases by a few percent each year and will reach 69,300 euros Gross income. Anyone who works as an employee and earns less than this limit falls into the so-called compulsory insurance scheme – a statutory health insurance company must therefore accept you as an insured person.
- Age: In the statutory health insurance system, the contribution depends on income. Pensioners in particular benefit because they often pay significantly less than their medical care probably costs. To ensure that no one can take advantage of this, the legislator normally only allows a change to the solidarity system up to the age of 55 years before.
- Also read: Back to the statutory health insurance scheme over 55 years of age – these exceptions apply
- Advantages and disadvantages: Private health insurance or statutory health insurance – which is better?
If you want to return from private to statutory health insurance and you have not yet celebrated your 55th birthday, the change is relatively easy. Depending on whether you are self-employed or employed, you have several options.
If you are self-employed, your path to statutory health insurance will normally involve a permanent position. The new job must be your main job, i.e. it must make up the majority of your weekly working hours and earnings. If you are self-employed, you can still work part-time.
In your employment, you must earn more than 538 euros per month, so a mini-job is not enough. At the same time, you must not exceed the annual salary limit of 69,300 euros for 2024. Broken down to a monthly salary, this corresponds to a gross salary of 5,775 euros. It cannot be more than that.
Please note: Health insurance companies check whether you have really looked for a job. In many cases, it may not be enough if you get a job from a family member.
There is one exception to what has just been said: If your spouse or registered partner has statutory health insurance, you can be covered under family insurance. In this case, however, you must give up your self-employment completely and are only allowed to earn a small amount of additional income.
In 2024, you are not allowed to earn more than 608 euros per month – the income limit of 505 euros per month is supplemented by a flat rate of 102.50 euros for advertising expenses. Your income also includes rental income or capital gains. Alternatively, you could take on a mini-job. You will receive 538 euros per month.
Employees who have previously been members of statutory health insurance and now want to return have several options.
The simplest option would be to stay in your current job but reduce your working hours and therefore your salary – and bring it below the annual salary limit. For example, you could temporarily go part-time (so-called bridge part-time) or take a sabbatical, i.e. take a year off.
In addition, parental leave or family care leave may be an option, provided it suits your family situation. The latter allows you to take a leave of absence from work for a maximum of 24 months to care for a relative.
- Also read: Caring for relatives and retiring early – what you should know
It is important that you stay within the earnings limit for a full year. This is because you are then required to have insurance and a statutory health insurance fund must accept you. Once you are a member of the statutory health insurance fund again, you can then earn more and have voluntary statutory health insurance.
If the options mentioned above are not an option and you urgently need to switch to statutory health insurance, there are two other, albeit rather drastic, measures you can take: give up your job completely and register as unemployed. Or: move abroad temporarily.
- Declare unemployment: This option only works if you are also entitled to unemployment benefit I. It is particularly important that you have paid into unemployment insurance for at least twelve months in the 30 months before becoming unemployed. For the self-employed, this means that you must have done so voluntarily.
- Moving to another European country: You must choose a country where insurance is compulsory, such as Sweden or the Netherlands. In order to be accepted into the foreign health insurance system, however, you must generally live abroad and earn money there. If you return to Germany later, you can apply for admission to a statutory health insurance company. However, the company can also refuse. Those younger than 45 generally have better chances.
If one of the above options applies to you, you should make sure that you do everything correctly, even formally.
Anyone who has private health insurance must cancel their insurance. Anyone who moves to another European country must generally observe a deadline for cancellation. Check your contract for this. If you return to Germany later, you must voluntarily take out insurance with the GKV within three months.
- Also read: These health insurance companies will increase the additional contribution in 2024
If your gross salary as an employee falls below the applicable annual wage limit, you can cancel your private health insurance as soon as your employer – or, in the case of unemployment, the Federal Employment Agency – certifies that you are required to take out insurance. You have a maximum of three months to cancel your private health insurance.
With the certificate of compulsory insurance, you have two weeks to choose which statutory health insurance fund you apply to join. After that, your employer may decide for you. You will then only have another opportunity to change regularly after 18 months.
