Rising premiums in private health insurance (PKV) lead many policyholders to consider cancelling their cover or returning to statutory health insurance (GKV). The way back is tied to strict legal requirements. This guide explains when the switch works, which deadlines apply, and which alternatives can lower the premium burden.
When is a switch from the PKV to the GKV possible?
Returning to the GKV is subject to strict conditions. The legislator wants to prevent policyholders from benefiting from low PKV premiums when young and then switching to the solidarity financed GKV in old age.
Employees: salary below the annual earnings threshold
A switch to the GKV is possible if your gross annual salary falls below the annual earnings threshold (JAEG). For 2026 this threshold is 77,400 € gross per year. If your salary falls permanently below it, for instance through a change of job, reduced working hours or unemployment, you become subject to compulsory insurance in the GKV again.
Self-employed: returning via employment
The way back generally leads through taking up employment subject to social insurance with a salary below the JAEG.
| Route back to the GKV | Requirement |
|---|---|
| Salary falls below the JAEG | Compulsory insurance arises |
| Taking up employment (self-employed) | Salary below the JAEG |
| Unemployment with ALG I | Compulsory insurance in the GKV |
| Family insurance | Spouse in the GKV, own income below 565 €/month |
Switching from the PKV to the GKV from age 55
From age 55, switching from the PKV to the GKV is generally excluded, even if compulsory insurance would otherwise arise. The legislator blocks this route almost entirely.
An exception applies only if you were compulsorily insured in the GKV for at least two and a half years within the five years before turning 55. In practice this situation is rare.
If you have to stay in the PKV past 55, the following alternatives can reduce the premium burden.
Alternatives to cancellation: lowering PKV premiums
Before cancelling the PKV entirely, it is worth checking whether the premium can be reduced within the existing contract. Four routes come into question.
Tariff change under § 204 VVG
You have a statutory right to switch to a cheaper tariff with comparable benefits within your own insurer. No new health assessment takes place, and the ageing provisions are fully retained. Many policyholders are not aware that this right exists.
Switching to the basic tariff
The basic tariff offers benefits comparable to those of the GKV. Its maximum premium is capped at the GKV maximum contribution. In case of financial hardship, the premium can be halved.
| Option | Level of benefits | Premium | Ageing provisions |
|---|---|---|---|
| Tariff change (§ 204 VVG) | Comparable to your current tariff | Often considerably cheaper | Transferred |
| Basic tariff | GKV level | Capped | Credited |
| Standard tariff | Between the basic tariff and full cover | Capped | Credited |
Increasing the excess
A higher excess lowers the monthly premium. In return you pay more out of pocket when you make a claim, but save on the ongoing premium.
Using the premium refund
Many PKV tariffs refund part of the premium if you claimed no or only minor benefits in a calendar year. The refund can amount to one to three months premium.
Cancelling the PKV: deadlines and follow-on cover
If neither a switch to the GKV nor a tariff change is an option, cancelling the PKV remains, for instance when switching to another private insurer. Fixed deadlines apply.
| Situation | Notice period |
|---|---|
| Ordinary cancellation | 3 months to the end of the insurance year |
| Special cancellation on a premium increase | 2 months from notification of the increase |
| Special cancellation on a change of benefits | 1 month from notification |
Important: only cancel the PKV once follow-on cover is secured. Health insurance is compulsory in Germany. Anyone left without cover has to make back payments and risks exclusion from benefits.
Special right of cancellation on a premium increase
If the premium is increased, you can cancel the contract within two months of receiving the notification, effective from the date the increase takes effect. Many premium increases are also formally invalid, in which case overpaid premiums can be reclaimed. You can read how we approach this under Reducing a private health insurance premium increase.
The special right of cancellation can also be used to change tariff within the PKV instead of ending the contract entirely.
This article provides general information and does not replace individual insurance or legal advice. PKV contracts are complex. If in doubt, seek support from an independent adviser or a specialist lawyer.
