Contents (9 sections)
- Who may switch from public to private health insurance in Germany?
- When employees can switch: new job or turn of the year
- How to switch from public to private: the right order
- Leaving your public fund: the two-week rule and cancellation
- The private side: application, health questions, start date
- Switching in late 2026: the threshold trap
- Freelancers: switching when you start or while self-employed
- Five pitfalls when switching to private
- After the switch: what changes in everyday life
- Employees may switch only above the income threshold: €77,400 in 2026 and €84,150 in 2027 (draft: Federal Cabinet decision of 7 October 2026, Bundesrat approval pending).
- In an existing job the switch is possible at the turn of the year at the earliest, and only if your salary also exceeds next year's threshold (§ 6 (4) SGB V); a new job above the threshold allows private cover from day one.
- When compulsory insurance ends, your fund continues it as a voluntary membership unless you declare your exit within two weeks of its notice and prove your private cover (§ 188 (4) SGB V).
- A voluntary member can cancel to the end of the month after next; the twelve-month binding period doesn't apply when you leave public insurance altogether (§ 175 (4) SGB V).
- Always get the private insurer's written acceptance first – then leave public insurance.
To switch from public to private health insurance in Germany as an employee, your regular salary must exceed the income threshold – €77,400 in 2026, €84,150 in 2027 (draft). In an existing job the switch works at the turn of the year at the earliest. Get the private insurer's written acceptance first, then declare your exit within two weeks of your fund's notice (§ 188 (4) SGB V) or cancel a voluntary membership to the end of the month after next (as of October 2026).
Who may switch from public to private health insurance in Germany?
Your status decides – not your nationality:
Employees
Only with a regular gross annual salary above the income threshold (Jahresarbeitsentgeltgrenze, JAEG). Below it, public insurance is compulsory.
Freelancers
Whatever they earn. They leave public insurance by cancelling their voluntary membership.
Civil servants
Usually private with the state allowance (Beihilfe); special opening conditions apply within six months of appointment (PKV association).
Whether you should switch is a different question. Family, length of stay and age often speak for public insurance even above the threshold. Read the disadvantages of private health insurance and let the 60-second decider check your situation before you start.
When employees can switch: new job or turn of the year
| Situation | Earliest switch | Condition |
|---|---|---|
| New job with a regular salary above the threshold | First working day | Above €77,400 (start in 2026) or €84,150 (start in 2027) |
| Pay rise in your existing job during 2026 | 1 January 2027 | Above €77,400 in 2026 and above €84,150 for 2027 |
| Pay rise in your existing job during 2027 | 1 January 2028 | Above €84,150 and above the 2028 threshold (not yet known) |
| Freelancer, voluntary public member | End of the month after next | Cancellation with proof of private cover |
The turn-of-the-year rule (§ 6 (4) SGB V) trips up many people in 2026: with €82,000 you are above this year's threshold but below next year's, so compulsory insurance does not end on 31 December 2026. Your exact date: income threshold checker.
First job in Germany?Then you are free to start in either system. Public insurance stays open to you for three months after the start of the job, even above the threshold (§ 9 (1) no. 3 SGB V). More for employees: private health insurance for employees.
How to switch from public to private: the right order
The order of steps protects you from two expensive outcomes: being without cover, or paying for both systems.
1. Check eligibility and the date
Confirm that your regular salary exceeds the threshold and from which date. Freelancers check their fund's notice period.
2. Compare full-cover tariffs
Look at benefits, long-term care insurance, sick pay, the deductible and what happens if you leave Germany. The price is only one part.
3. Apply – and answer every health question
The insurer prices your health based on the questions in the application. Answer completely and truthfully (§ 19 VVG). With health issues, an anonymous pre-check comes first.
4. Wait for the written acceptance
Check the start date, any surcharge or exclusion. Only then leave public insurance.
5. Leave your fund in time
Two weeks after the fund's notice if compulsory insurance ends – or by cancellation as a voluntary member. Always with proof of private cover.
6. Tell your employer
Hand in the insurer's certificate so the employer contribution is paid with your salary.
Leaving your public fund: the two-week rule and cancellation
How you leave public insurance (gesetzliche Krankenversicherung, GKV) depends on your membership type – the difference is a matter of days.
When compulsory insurance ends: two weeks
If your compulsory insurance ends – for example at the turn of the year because of your salary – your fund does not simply let you go. By law it continues your insurance as a voluntary membership (obligatory continuation insurance, obligatorische Anschlussversicherung). To go private instead, you must declare your exit within two weeks after the fund has informed you about this option, and prove that you have other cover (§ 188 (4) SGB V). According to the GKV umbrella association, what counts is when your declaration reaches the fund; the exit then takes effect from the day after your compulsory insurance ended.
As a voluntary member: cancellation
If you are already a voluntary member – as a freelancer, or because you missed the two weeks – you leave by cancelling. The membership ends at the end of the month after next, counted from the month of your cancellation, and only if you prove other cover within that period (§ 175 (4) SGB V). The usual twelve-month binding to a fund does not apply if you leave public insurance altogether. If you chose an optional tariff (Wahltarif), for example for sick pay, a longer binding period can apply (§ 53 (8) SGB V) – ask your fund.
| Your membership | How you leave | Deadline |
|---|---|---|
| Compulsory insurance ends (e.g. salary above threshold, new job) | Exit declaration + proof of private cover | Two weeks after the fund's notice |
| Voluntary member (freelancer, missed exit) | Cancellation + proof of private cover | End of the month after next |
| Example: cancellation in March | Membership ends | 31 May |
TK, AOK or any other fund – the rules are the same, because they are set by law, not by the fund's terms. Send your declaration in a way you can prove and keep a copy.
The private side: application, health questions, start date
The private insurer decides after its health questions whether and on which terms it accepts you – without a surcharge, with a risk surcharge, with an exclusion, or not at all. The basic tariff (Basistarif) works differently: insurers must offer it and may not charge risk surcharges, but access is limited and the premium is capped at the public maximum. What you need to know about this process, without any health questions here: private health insurance and pre-existing conditions.
- Answer completely. You have to disclose everything the insurer asks about in text form until you sign (§ 19 VVG). Incomplete answers can cost you your cover years later.
- Apply in time. If you apply within two months after your public insurance ends, your public insurance time counts towards the private waiting periods (§ 197 VVG).
- Withdrawal right. You can withdraw from a new contract within 14 days in text form; the period starts once you have received the policy, the terms and the instructions (§ 8 VVG).
- No gap. The private start date must be the day after your public insurance ends.
Switching in late 2026: the threshold trap
New jobs that start in November or December 2026 need extra care, because the threshold rises sharply on 1 January 2027. People who are exempt and privately insured on 31 December 2026 get a lower 2027 limit of €80,550 (§ 6 (8) SGB V as amended; draft value). Two model cases:
- New job from November 2026 at €82,000, private from day one: exempt in 2026; above €80,550 in 2027 → usually stays exempt.
- New job from November 2026 at €79,000, private from day one: exempt in 2026, but below €80,550 → compulsorily insured again from 1 January 2027. You may be able to apply for an exemption within three months (§ 8 SGB V) – it binds you to private insurance.
Going private for two months and then falling back into public insurance – or tying yourself to private through an exemption – is rarely a good idea. If your salary is close to these limits, talk to a broker before you sign, and check your case with the threshold checker.
Freelancers: switching when you start or while self-employed
If you move from a job into self-employment, your compulsory insurance ends with the job. Your fund then continues it as a voluntary membership, and the two-week exit rule applies (§ 188 (4) SGB V). If you are already a voluntary member as a freelancer, you can switch at any time by cancelling to the end of the month after next. Remember that as a freelancer nobody pays half of your private premium, and that sick pay is a separate private contract. Before you decide, read health insurance for freelancers in Germany – especially if you might take a salaried job again.
Five pitfalls when switching to private
- Cancelling public cover before the acceptance. If the insurer then declines or adds a high surcharge, your options shrink.
- Counting on a pay rise that is not yet regular. One-off bonuses usually don't count towards the threshold.
- Ignoring the 2027 jump. Being above €77,400 is not enough for a switch on 1 January 2027.
- Forgetting the family. In private insurance every family member pays – see private health insurance with a family.
- No exit plan. Outside the EU/EEA a German private policy usually ends when you move, and the way back to public insurance is restricted. Read switching back to public before you leave.
After the switch: what changes in everyday life
You receive an insurance card from your private insurer, but doctors usually send the bill to you. You pay it, submit it – often via the insurer's app – and get the money back according to your tariff. As an employee, the employer contribution appears on your payslip: half of the premium, up to €613.22 a month in 2026 (employer contribution explained). Keep all confirmations from your fund and your insurer – you may need them if you leave Germany or return one day.
A German-language guide to the same steps: Wechsel in die PKV (source in German).
Frequently asked questions
When can I switch from public to private health insurance in Germany?
As an employee with a new job above the threshold, from the first day. In an existing job, at the end of the calendar year in which your regular salary exceeds the threshold – but only if it also exceeds the next year's threshold (§ 6 (4) SGB V). For 1 January 2027 you need more than €84,150 (draft). Freelancers can switch at any time with the notice periods of their fund.
How do I switch from TK to private health insurance?
The same way as from any other fund. Get the private acceptance first. If your compulsory insurance ends, declare your exit to TK within two weeks of its notice and send proof of your private cover (§ 188 (4) SGB V). If you are already a voluntary member, cancel to the end of the month after next and prove your private cover within that period (§ 175 (4) SGB V).
What happens if I miss the two-week deadline?
Your public insurance continues as a voluntary membership. You can still leave by cancelling – the membership then ends at the end of the month after next, and only if you prove other cover in that period (§ 175 (4) SGB V). For a short time you may pay both.
Can the private insurer reject me when I switch?
Yes. Except in the basic tariff, a private insurer may accept you with a risk surcharge or an exclusion, or decline your application, depending on its health questions. That is why you should only leave public insurance after a written acceptance – and use an anonymous pre-check through a broker if you have health issues.
Can I switch back to public health insurance later?
Only in certain cases. Under 55 usually through a new compulsory insurance, for example a job below the threshold, or through family insurance. From 55 the way back is usually closed if you were not publicly insured in the previous five years (§ 6 (3a) SGB V).
Sources
- § 6 SGB V – exemption from compulsory insurance (income threshold, turn of the year)
- § 188 SGB V – continuation as voluntary member, exit within two weeks
- § 175 SGB V – cancellation of membership
- GKV-Spitzenverband: principles on the obligatory continuation insurance (§ 188 (4) SGB V) – 24 July 2023
- § 19 VVG – duty to disclose
- § 197 VVG – waiting periods
- § 8 VVG – right of withdrawal
- § 257 SGB V – employer contribution
- Federal Government: contribution ceilings 2027 (Cabinet decision) – 7 October 2026, Bundesrat pending
This article provides general information on health insurance in Germany (as of 10 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.