Private health insurance in Germany for doctors: the 2027 numbers

Private health insurance in Germany is open to doctors only above the income threshold: €77,400 in 2026 and €84,150 in 2027 (draft). Under the municipal hospital agreement TV-Ärzte/VKA, a resident's base salary reaches the 2027 threshold only from step 5 (€85,900.44 a year); specialists start at €90,626.28. Scheduled on-call pay counts, overtime doesn't. Doctors in private practice may choose regardless of income (as of October 2026).

Private health insurance for doctors in Germany: the threshold decides

About 71,480 doctors working in Germany are foreign nationals – 16% of all practising doctors at the end of 2025 (German Medical Association). For health insurance, nationality plays no role. What counts is whether you are employed or self-employed and, as an employee, whether your regular gross salary exceeds the income threshold (Jahresarbeitsentgeltgrenze). Below it you are publicly insured by law; above it you may choose.

That is why the answer changes during a medical career. Residents in their first years are usually in public insurance; specialists, senior physicians and doctors in private practice usually have a choice. The jump of the threshold to €84,150 in 2027 – including a one-off €300 a month – moves the line again.

Resident doctors: pay grades vs the 2026 and 2027 thresholds

Most hospital doctors are paid under collective agreements negotiated by the Marburger Bund. The agreement for municipal hospitals (TV-Ärzte/VKA) has no annual special payment, so the regular salary is simply twelve monthly salaries plus regular on-call pay.

Two details matter for 2027. First, a resident at step 4 who is already privately insured on 31 December 2026 needs €80,550 in 2027 – the base salary is €395.04 short of that. Second, in an existing job you can only leave public insurance at the end of a year in which your salary also exceeds the next year's threshold (§ 6 (4) SGB V). University hospitals (TV-Ärzte TdL) pay slightly more and have agreed a 2.45% increase from 1 September 2027; private hospital groups have their own tables. Your exact switch date: income threshold checker.

On-call duty and overtime: what counts towards the threshold

For doctors, on-call duty (Bereitschaftsdienst) can make the difference. According to the GKV-Spitzenverband's principles, pay for contractually scheduled on-call duties counts as regular pay. Overtime pay is irregular and doesn't count, unless it is a fixed allowance. Family-related allowances are ignored.

• To pass €84,150 in 2027 at step 4 you need regular on-call pay of about €333 a month on top of the base salary; at step 3 about €734, at step 2 about €966 (own calculation from the VKA table).
• The forecast is made in advance, often based on the previous year. Planned changes – a new step, parental leave, part-time – can be taken into account.
• Your employer's payroll and the health insurance fund decide. Ask for their assessment in writing before you sign a private contract.

Specialists, senior physicians and doctors in private practice

From the specialist grade (Ä 2) the base salary is above both thresholds; senior physicians (Ä 3) start at €9,459.56 a month under the VKA table. Doctors who set up their own practice are self-employed and may choose private insurance whatever they earn – in public insurance they would pay on all their income up to the ceiling, without an employer share: up to €1,402.50 a month in 2027 (childless; €1,345.13 with a child; own calculation, scenario). For them, sick pay insurance (Krankentagegeld) and cover for practice costs become central topics.

Once private insurance is open to you, it offers doctors clear advantages:

• Premium independent of income: moving up the pay steps, a senior position or a bonus does not raise your private premium; in public insurance the contribution grows with your salary up to the ceiling of €6,375 a month in 2027 (+9.7%, draft).
• Benefits you choose: chief physician, single or double room, glasses and high-quality dental work – depending on the tariff. Public insurance pays for what is “sufficient, appropriate and economical” (§ 12 SGB V).
• Benefits secured by contract: the insurer cannot cancel a full private policy by ordinary notice (§ 206 (1) VVG); public benefits can be cut by law – the 2026 savings law raised co-payments by 50% and cut the fixed dental subsidy from 60% to 50%.
• Your employer pays half: up to €613.22 a month in 2026 and about €672.56 in 2027 (scenario).

Doctors' tariffs: what insurers offer

Several private insurers market tariffs or special conditions for doctors – among them Allianz, AXA/Deutsche Ärzteversicherung, Hallesche, INTER, SDK and Continentale. They differ in outpatient and dental benefits, sick pay options and price. One insurer's own example: SDK quotes €683.72 a month for a 28-year-old resident in the second year, including long-term care and sick pay; the employer pays half, so the own share is €341.86 (insurer's own example, as of January 2026). Stiftung Warentest found full-cover tariffs for 35-year-olds from €649 to €1,137 a month (Finanztest 3/2025). Any real offer depends on your age, the tariff and the health questions in the application.

Detailed comparisons of doctors' tariffs, in German: PKV for doctors (in German).

Part-time, parental leave and sick pay

Hospital careers are rarely linear. According to the German Medical Association, 28% of doctors worked part-time in 2024. That matters for health insurance in two ways:

• Part-time or parental leave: if your regular salary falls below the threshold, you usually become compulsorily insured in public insurance again – under 55. If you are privately insured, there are exemption options with tight deadlines; plan this before you reduce your hours.
• Sick pay: as an employee you first receive continued pay from your employer. After that, public insurance pays sick pay (Krankengeld) of 70% of your earnings, capped at about €135.63 a day in 2026 (own calculation from the contribution ceiling). In private insurance you need a separate sick pay tariff (Krankentagegeld) that usually starts after the employer's continued pay – and you choose the daily amount yourself.
• Pension scheme: doctors are compulsory members of their regional medical pension fund (Ärzteversorgung). It replaces the statutory pension for most, but it doesn't change your health insurance choice.

Compare like with like: a private premium without sick pay is not comparable with a public contribution that includes it.

Moving to Germany as a doctor: what else matters

Checklist for doctors new to Germany

• Find your pay table and step – and ask HR how scheduled on-call duty is paid.
• Compare your regular salary with €77,400 and €84,150 (draft); for existing jobs check both years.
• Below the threshold: choose a public fund before your first working day.
• Above it: weigh family, age and how long you stay – see public vs private health insurance.
• Comparing employment terms in general? Read private health insurance for employees.

The free 60-second decider gives you a clear, personal result for your situation – without health questions. A specialised expert from our partner network then compares doctors' tariffs with you free of charge.

Frequently asked questions

This article provides general information on health insurance in Germany (as of 14 October 2026). It does not replace individual advice. Which solution suits you depends on your personal situation, e.g. age, health, income, family and length of stay. Despite careful review we cannot guarantee completeness and accuracy; laws and tariffs change. It is not immigration advice: whether your insurance is sufficient for a visa or residence permit is decided by the German mission abroad or your immigration office. Publisher: German-PKV.de. German-PKV.de is not an insurance broker and does not provide insurance, legal or tax advice; individual advice is provided exclusively by specialised cooperation partners licensed under § 34d GewO.