PKV vs GKV: private vs public health insurance in Germany
Germany's once-in-a-career health-insurance choice, explained even-handedly: how GKV and PKV each work, what each costs at your salary (the GKV cost computed to the euro), the JAEG gate, who each suits, and why PKV is hard to undo.
8 min readUpdated June 18, 2026
Germany gives most employees a once-in-a-career choice between two health-insurance systems: gesetzliche Krankenversicherung (GKV, public) and private Krankenversicherung (PKV, private). It's one of the most consequential money decisions you'll make here — and one of the hardest to undo. This guide covers how each works, what each actually costs at your salary, and who each one suits — with the GKV cost computed to the euro and a way to plug in your own PKV quote.
How GKV works
GKV is income-based. You pay a percentage of your gross salary, your employer pays roughly half, and your non-earning spouse and children are covered for free (Familienversicherung). The rate is the same whether you're 25 or 55, healthy or chronically ill — GKV doesn't underwrite, and it can't turn you down. Above the Beitragsbemessungsgrenze (€69,750 gross/yr in 2026) your contribution stops growing.
At €80,000, your GKV employee share is €648 a month if you have no children — and it would be the same at €120,000, because contributions are capped.
How PKV works
PKV is premium-based. Your monthly premium is set when you join — by your age, your health, and the coverage you choose — not by your income. As an employee, your employer pays an Arbeitgeberzuschuss of half your premium, capped at €613/mo in 2026.
On a €600/mo premium, your employer pays €300 and you pay €300.
A young, healthy high-earner can often find a premium well below their GKV contribution — but a cheap premium usually buys thinner coverage, and premiums climb as you age.
Head-to-head at €80,000
| System | Your share / month |
|---|---|
| GKV (public) | €648 |
| PKV (€600/mo premium) | €300 |
On paper PKV looks cheaper at this salary — and for a healthy 30-year-old it can be dramatically cheaper, with some entry tariffs running well under €200/mo. But "cheaper now" is the trap. We can compute your GKV cost exactly; your PKV premium depends entirely on your quote — and unlike GKV, it's yours for life and rises with age.
The JAEG gate
You can only switch to PKV as an employee if your gross is above the Versicherungspflichtgrenze (JAEG) — €77,400 in 2026. Below it, you stay in GKV. Note this is a different number from the €69,750 contribution ceiling — two thresholds people often confuse.
Who PKV suits — and who stays GKV
PKV tends to suit: young, healthy, high-earning employees with no dependents and stable income who want broader coverage (private rooms, shorter waits, specialist access) and won't need to drop back down.
GKV tends to suit: anyone with a family (free cover for a non-earning spouse and kids is a large, recurring saving), anyone who values predictability, anyone who might earn less later (parental leave, a career break, going self-employed), the risk-averse, and anyone with pre-existing conditions — PKV underwrites and prices on health; GKV cannot.
The catch — why it's hard to undo
Self-employed — a different calculus
If you're self-employed there's no employer to pay the Arbeitgeberzuschuss — you carry 100% of the premium, so PKV's biggest cost lever is gone. The exception is the Künstlersozialkasse (KSK): for eligible artists and publicists, the KSK pays a subsidy of about half your premium (capped), exactly like an employer — so a KSK member's PKV maths look like an employee's, not a regular freelancer's. The self-employed calculator models both: regular PKV (full premium) and KSK + PKV (with the subsidy).
Compute your own
The one number we can't compute for you is your premium — it's down to your age, health, and coverage. Get a quote, then plug it in below to see your exact take-home under PKV at your salary, with the employer subsidy credited.
Related guides
- German Net Salary, Explained: How Much of Your Gross You Actually KeepA plain-English guide to how a German gross salary turns into net pay — income tax, solidarity surcharge, church tax, and the four social insurances.
- Freiberufler or Gewerbe? What the Difference Actually Costs YouWhether you register as a Freiberufler or a Gewerbe in Germany barely changes your tax — §35 sees to that. The real decision is classification and paperwork. With live worked examples.
- German Steuerklasse, Explained: Which Class You're In and What It CostsYour Steuerklasse sets your monthly withholding, not your total tax. Here's what each of the six classes means in euros, the real married-couple III/V vs IV/IV decision, and what's changing in 2030 — with live numbers.
- Understanding Your German Payslip: Every Line ExplainedYour first German Gehaltsabrechnung is a wall of abbreviations. Here's every line decoded in plain English — Lohnsteuer, KV, PV, RV, AV — with a live €60,000 example showing exactly how your gross becomes your net.