Cancelling or switching private health insurance - a guide

Rising premiums in private health insurance (PKV) are giving many policyholders pause for thought: is it worth switching back to statutory health insurance (GKV)? Or are there better alternatives? This guide outlines the options — and the obstacles.

When is it possible to switch from PKV to GKV?

Returning to GKV is subject to strict conditions. The law aims to prevent policyholders from benefiting from low PKV premiums when they are young and then switching to the solidarity-based GKV in old age.

For employees: A switch to the GKV is possible if your gross annual salary falls below the annual income threshold (JAEG). For 2026, this limit stands at €73,800 gross per year. If your salary falls permanently below this level — for example, due to a change of job, a reduction in working hours or unemployment — you will once again be subject to compulsory GKV insurance.

For the self-employed: The way back usually involves taking up employment subject to social insurance contributions with a salary below the JAEG.

The age limit: things get tricky from 55

From the age of 55, switching from private health insurance (PKV) to statutory health insurance (GKV) is generally not permitted — even if compulsory insurance were to apply. The law virtually completely blocks this option.

The only exception: you were compulsorily insured under the GKV for at least two and a half years in the five years prior to turning 55. This scenario is rare in practice.

For anyone over 55 who has to remain in private health insurance, there are alternatives to reduce the burden of premiums.

Alternatives to cancellation: reducing premiums

Before you cancel your private health insurance completely, you should check whether the premiums can be reduced within the private health insurance scheme:

Changing tariffs within private health insurance (Section 204 of the Insurance Contract Act)

You have a legal right to switch to a cheaper tariff with comparable benefits within your insurer — without a new health check and whilst retaining your age-related reserves. Many policyholders are unaware that this right exists.

Switching to the basic tariff

The basic tariff offers benefits comparable to those of statutory health insurance (GKV). The maximum premium is capped at the GKV maximum premium. In the event of financial difficulties, the premium can be halved.

Increase excess

By agreeing to a higher excess, you can reduce your monthly premium. You will then pay more out of your own pocket in the event of a claim, but save on your ongoing premiums.

Take advantage of premium refunds

Many private health insurance plans offer a premium refund if you have made no or only minor claims in a calendar year. This can amount to one to three months’ premiums.

Cancelling private health insurance — what you need to bear in mind

If switching to the state health insurance scheme (GKV) or changing your private health insurance plan is not possible, cancelling your private health insurance may be an option — for example, when switching insurers.

Notice periods:

Important: Never cancel your private health insurance before you have secured replacement cover. In Germany, health insurance is compulsory — anyone without cover must make back payments and risks having benefits excluded.

Special right of termination in the event of a premium increase

In the event of a premium increase, you have a special right of termination. You can terminate the contract within two months of receiving the notification — effective from the date the increase takes effect.

You can also use this right to switch tariffs within your private health insurance policy instead of cancelling it completely.

Frequently asked questions (FAQ)

Can I switch back from private health insurance to statutory health insurance?

Under certain conditions, yes — for example, if your salary falls below the annual income threshold or if you take up employment subject to compulsory insurance. From the age of 55, switching is generally no longer possible.

What happens to my ageing provisions when I switch private health insurance providers?

If you switch to another private health insurance provider, you can take your age-related reserves with you up to the amount of the basic tariff. If you switch tariffs within the same insurer (tariff switch under Section 204 of the Insurance Contract Act), all reserves are retained.

Is the basic tariff a good alternative?

The basic tariff offers benefits comparable to those of statutory health insurance (GKV) at a capped premium. It can be a sensible option if you can no longer afford your current tariff and switching to statutory health insurance is not possible.

How much does it cost to switch tariffs within private health insurance?

Changing tariffs under Section 204 of the Insurance Contract Act (VVG) is free of charge. However, it may be advisable to seek assistance from an independent adviser who can compare all available tariffs.

Can I cancel my private health insurance if premiums increase?

Yes. In the event of a premium increase, you have a special right of termination with two months’ notice. You can terminate the contract with effect from the date the increase takes effect.

This article is for general information purposes only and does not replace individual insurance or legal advice. Private health insurance policies are complex — if in doubt, seek assistance from an independent adviser or specialist solicitor.