Is it too late to get private health insurance at 40?

What do you get for the premium at 40?

A very good tariff pays for a single or double room and the senior consultant in hospital, refunds doctors' fees above the standard rate of the official fee scale and covers most dental work. The premium of about €650 to €750 a month, with a deductible of up to €600 a year, also includes long-term care insurance and the statutory 10% surcharge. Your employer pays half of it, up to €613.22 a month in 2026.[1]

What if you only arrive in Germany at 40?

An employee can choose private cover from the first day of a job that pays above the income threshold, €77,400 a year in 2026, without waiting for the turn of the year.[2][3]

A new contract can have waiting periods of up to three months, and up to eight months for a birth, psychotherapy and dental treatment.[4] If the tariff provides for it, the insurer can waive them if you provide a medical certificate about your health.[5] Whether cover from your home country counts towards them is up to the insurer, and it can depend on whether you are employed or self-employed. We clarify this with the insurer before you apply.

The insurer's health questions include treatment abroad, so medical records from your home country help you answer them completely.[6]

How do you know before applying what insurers will offer?

An anonymous pre-inquiry shows what insurers would offer before anything is filed in your name. It needs your year of birth, the cover you want and your answers to the health questions, and the insurers reply with acceptance, a risk surcharge, an exclusion or a decline. We check the whole market for you: book a free 30-minute call to start.

The health questions usually go back about 3 years for outpatient treatment and 5 years for hospital stays and psychotherapy, and some have no time limit.[6]

Can you still change your cover after joining at 40?

Yes, within your insurer. You can switch to another of its tariffs at any age and keep the ageing reserves (Altersrückstellungen) you have built up.[7] A tariff with the same or less cover needs no new health check. For benefits the new tariff adds, the insurer can ask for a risk surcharge or an exclusion and a waiting period, and you can avoid the surcharge by leaving out the extra benefit.[7]

Moving to another insurer needs a new health check, and only part of the ageing reserves moves with you.[7] Cover you want in later years, such as a single room in hospital, is best included when you join, because extra benefits need a health check later. Whether and up to which age you can add a premium-relief tariff later depends on the insurer. A higher deductible lowers your premium and counts as less cover, so it needs no health check.

What if you have children after 40?

A newborn joins your private insurer from birth without a health check, risk surcharges or waiting periods, if you register the baby within two months, as newborn enrolment explains.[8] One condition concerns you, not the baby: the insurer can require that you have been insured with it for up to three months by the day of the birth. The baby's cover can be no better than yours.[8] A child's premium is about €150 to €250 a month, and your employer's half covers the child too, up to €613.22 a month for the whole family.[1]

In public cover, children and a spouse without income are insured at no extra cost. For a single earner aged 35 with such a spouse and two children, public cover costs the same or up to about €590 a month less, as our comparison of households on a six-figure salary shows, and the gap grows with the age at which the parents join. If your partner is in public cover, your children may be able to join public family insurance instead, depending on whether you are married and on your incomes; family health insurance in Germany compares the costs.

Will the premium still fit your budget in retirement?

Your premium falls when the statutory 10% surcharge ends after the year you turn 60.[9] The money paid through the surcharge until then is used from 65 to cushion premium increases.[10] If your contract includes a daily sickness allowance, that part of the premium ends when you stop working.

A premium-relief tariff (Beitragsentlastungstarif) lowers the premium by a fixed amount, typically €250 to €500 a month from 65 or 67, as our retirement examples show. If you draw a statutory pension, the pension insurance pays 8.75% of your pension towards the health premium in 2026, up to half of that premium.[11]

How we calculated

Private figures are typical premiums for healthy employees in a very good tariff with a deductible of up to €600 a year, including long-term care insurance and the statutory 10% surcharge. Public figures use the 2026 values, the average additional contribution of 2.9% and the rates outside Saxony, for an employee without children.