Why is my PKV premium going up, and what can I do?

What should you do when the letter arrives?

You have two months to decide, counted from the day the letter arrives, not from the date the new premium starts.[1] Within that time, find out what your insurer offers and whether another insurer would take you.

1. Read the letter. It sets out the premium adjustment (Beitragsanpassung): your new premium and the date it starts. Every increase gives you a special right to cancel (Sonderkündigungsrecht) the contract concerned.[1] If only a separate daily sickness allowance or dental policy goes up, only that policy can be cancelled.
2. Ask your insurer for its other tariffs. You have a legal right to move to another tariff with the same insurer, called a Tarifwechsel.[2] For the same or less cover there are no new health questions, and your savings for old age stay in the contract. For better cover, only the extra part is assessed. On request, your insurer has to list the tariffs open to you, including older ones it no longer advertises.
3. Find out whether another insurer would take you. A new insurer asks about your health again and decides afresh. At most part of your savings for old age moves with you: for contracts since 2009, the share that matches basic cover.[2] An anonymous check with several insurers shows their answers before anything is on record.
4. Compare the routes. A tariff switch suits you if your insurer's premiums have been steady over the years. A move can pay off if they have risen sharply again and again and your health allows it. A higher deductible can also lower the premium. Comparison portals show starting premiums, not how an insurer has raised them in the past.
5. If you move, cancel only once the new cover is confirmed. The cancellation takes effect on the day the increase would have started.[1] You then have two months to prove new cover without a gap.[3] Keep paying until then: unpaid premiums move your contract into an emergency tariff that covers little more than acute care.[4]

Staying in your tariff can also be the right result, once you have checked the alternatives. A return to public insurance is open only to some people. The basic tariff caps the premium at the public maximum, but it is meant for hard cases.[5]

Why do PKV premiums go up?

PKV premiums go up because treatment has become more expensive than the tariffs were calculated for, above all in hospitals and for medicines.[6] In 2025 private insurers paid about 7% more for care than the year before, public health insurance about 8% more.[7][8]

How much will my premium go up?

There is no general answer: it depends on your insurer and your tariff, and an adjustment does not come every year. In public health insurance, the law sets the general contribution rate and a regulation sets the income ceiling. In private insurance, your insurer recalculates each tariff on its own.[9] The basis is the cost of treatment, the general rise in costs and the interest it earns on its invested reserves. Your insurer can also use money set aside for premium refunds to limit an increase.[6] What this means for your tariff is something we check with you in a consultation.

When can a private insurer raise your premium?

A private insurer may only raise your premium when the costs in your tariff differ from the plan by more than 10%, or when life expectancy has clearly shifted.[10] An independent actuary, the trustee (Treuhänder), has to approve the new figures.[9] The letter has to state the reasons for the increase.[11] While costs stay within the threshold, the premium stays the same, sometimes for years. Once the threshold is crossed, the new premium catches up on the whole rise at once, which is why increases come in jumps. The same rule can also lower a premium.[10]

Your own claims play no part, because the calculation covers the whole tariff.

Is public health insurance getting more expensive too?

Yes. Spending in public health insurance rose at least as fast as in private insurance in 2025, and the rise continued in early 2026.[8][12] According to the Federal Ministry of Health, public health insurance spending grew by about 3.5% a year from 2013 to 2022, and by about 8.2% a year on average since then.[12] How the two systems differ overall is set out in our comparison of PKV and GKV.

Does getting older make my premium go up?

No. Your premium is based on your age when you joined, and part of every premium is saved for old age.[13] Until the end of the year in which you turn 60, a statutory surcharge adds to these savings.[14] From 65, these savings are used to hold your premium down.[15]

If you plan to retire in Germany, you can keep your monthly premium affordable in old age. A premium-relief tariff (Beitragsentlastungstarif) builds up extra reserves during your working years. From retirement, they lower your premium straight away. Which amount suits you is something we work out with you in a consultation. What happens to your premium in retirement explains the details.

How can a broker help?

An independent insurance broker works for you, not for the insurer, and owes you advice for as long as the mandate runs.[16][17] We compare all tariffs of your insurer, run the anonymous check with other insurers and make sure your decision falls within the deadline. Book a consultation and bring your letter.