Private Health Insurance (PKV) can be an attractive option for many people, often providing better access to medical services and more personalized rates. However, when considering the future as a retiree, concerns frequently arise that premiums may become unaffordable in old age. This leads to statements like: “I won’t be able to pay PKV premiums as a retiree” or “Switching back to statutory health insurance (GKV) is impossible.” But how much truth is there to these claims, and what does the reality look like for PKV policyholders in old age?

An Overview of Private Health Insurance in Old Age

One of the most important aspects to consider is the difference in premium structure between PKV and GKV. In PKV, premiums are calculated based on individual factors such as age, health status, and chosen plan, whereas in GKV, premiums are a percentage of income.

Key Information at a Glance:

  1. Employer Contribution and Subsidies: For retirees, the employer’s contribution to health insurance is eliminated. However, former employees can apply for a subsidy from the pension insurance.
  2. Sick Pay: As retirees, sick pay is no longer applicable, which reduces the costs in PKV.
  3. Preventive Care Surcharge: The preventive care surcharge of 10%, which is used to stabilize premiums from the age of 65, is waived from the age of 60.
  4. Tariff Change: Within PKV, it is possible to switch to cheaper plans, which saves costs in old age.
  5. Premium Increases: Due to medical advancements, there are premium increases in both GKV and PKV. The myth that only PKV premiums increase significantly is not true.
  6. Cost Reduction: When signing up for PKV, measures to reduce costs in old age should be considered, such as a premium reduction tariff or an additional private pension insurance.

Subsidy for Retirees in PKV

In retirement, the employer’s contribution to PKV is eliminated for former employees. However, a subsidy can be applied for from the pension insurance. This subsidy corresponds to half of the GKV contribution rate, currently (2024) 8.15% of income, but not more than 50% of the PKV premium. The subsidy is granted regardless of the pension amount, PKV tariff, or assets, provided the following conditions are met:

  1. Pension Receipt: The insured person receives a statutory pension.
  2. Residence: The residence is within the EU.
  3. Insurance Supervision: The private health insurer is subject to German insurance supervision or an EU supervision.

Reduced Costs for Retirees in PKV

Upon retirement, the premium for sick pay in PKV is usually eliminated. Additionally, the statutory preventive care surcharge of 10% on the normal premium is waived from the age of 60, which is used to reduce premiums from the age of 65.

Tariff Change and Premium Relief

To reduce costs in old age, PKV offers the option to switch to a cheaper plan. By switching tariffs within the insurer, premium increases can be mitigated. The switch is risk-free and often offers better benefits.

Another way to reduce costs is through premium reduction tariffs, which allow higher premiums at a younger age to lower costs in old age. A smart alternative can also be the combination with a fund-based Rürup pension, which serves as a private retirement provision.

Switching Back to GKV

A persistent myth is that switching from PKV back to GKV is impossible. For employees, a switch is possible if the income falls below the annual earnings threshold or in the case of unemployment. For self-employed individuals, options include an employee relationship, the spouse’s family insurance, or the Artists’ Social Fund.

For people over 55, switching is more difficult but not impossible. A switch is possible if one has been insured by GKV for at least 1 day in the last 5 years and the income is below 505 euros.

Conclusion: What Does PKV Cost in Old Age?

The costs for private health insurance in old age can be reduced through subsidies, the elimination of sick pay, and the elimination of the preventive care surcharge. A tariff change within the insurer and measures such as premium reduction tariffs or private retirement provisions can further reduce costs.

In PKV, you pay for the best possible medical care, which can be especially valuable in old age. Therefore, when deciding on PKV, the focus should be on health rather than short-term savings.


  1. Subsidy: Retirees can apply for a subsidy for PKV from the pension insurance.
  2. Tariff Change: It is possible to switch to cheaper plans within the insurer.
  3. Premium Increases: Costs increase in both GKV and PKV due to medical advancements.
  4. Cost Reduction: Early preventive measures can reduce costs in old age.
  5. Health: PKV offers the best possible medical care, which is particularly important in old age.