Private or public health insurance on a six-figure salary: which costs you less?

Which costs less on a six-figure salary, public or private health insurance?

Public cover charges an employee on a six-figure salary its maximum contribution, now and in the coming years, and insures a spouse without income and children at no extra cost. Private cover charges a premium for each person, and the employer pays half of the total, up to €613.22 a month in 2026.[1] How much health insurance costs in Germany shows both systems side by side.

• Single, 30. Private cover costs about €350 to €400 a month less, or €4,200 to €4,800 a year.
• Single, 40. Private cover costs about €275 to €325 a month less, or €3,300 to €3,900 a year.
• Couple, one income. Private cover costs between about €150 less and €40 more a month, on a full premium of €1,000 to €1,300 for both.
• Family of four, one income. Public cover costs the same or up to about €590 a month less, against four private premiums of €1,200 to €1,800 in total.

Why does a six-figure salary cost the same in public cover as €70,000?

Public health insurance charges contributions only on income up to €69,750 a year in 2026, so every salary above it pays the same maximum.[2] An employee without children pays €648.09 a month, with one child €613.22 and with two children €598.69, because parents pay a lower long-term care rate.[3][4]

The figures include long-term care insurance and the average additional contribution of 2.9%.[5] The employer adds €613.22, so the total without children is €1,261.31 a month. In private cover your salary plays no part: on €100,000 you pay the same premium as on €80,000, and private premiums are adjusted only when costs change across your whole tariff.[6]

Because the public contribution stays at its maximum and private insurers do not ask about your salary, the figures on this page apply to any six-figure salary, and in 2026 to any salary above the income threshold of €77,400.

How fast is the public maximum rising?

The employee share at the public maximum has risen from about €470 a month in 2021 to €648 in 2026 without children, more than a third in five years.[7][2] In that time the income ceiling rose from €4,837.50 to €5,812.50 a month and the average additional contribution from 1.3% to 2.9%. In 2027 the ceiling rises to €6,375 a month, 9.7% more, so the employee share rises to about €711 at today's rates.[8]

A six-figure salary stays above the ceiling of €76,500 a year in 2027, and the ceiling would have to rise by about 30% to reach €100,000. The finance commission appointed by the health ministry puts the funding gap of public health insurance at about €15 billion in 2027, growing to about €40 billion in 2030 without further measures.[9] Without reforms, the average additional contribution would reach 3.7% in 2027 and 4.7% in 2030, according to the commission.[9] Private premiums are not tied to the income ceiling or to these contribution rates.

What does a single employee pay at 30 and at 40?

A healthy single employee in a very good tariff pays about €500 to €600 a month when joining at 30 and about €650 to €750 at 40. Both figures include long-term care insurance and the statutory 10% surcharge. After the employer's share that is €250 to €300 and €325 to €375. The employer subsidy is tax-free for you.[10]

The premium is calculated on the age at which you join and does not rise because you get older. Is it too late to get private health insurance at 40? covers joining later, for example after a move to Germany. Insurers ask about your health before they offer cover, and how the health assessment works explains the questions.

What does a couple on one income pay, now and from 2028?

A married couple, both 35, on one income of €100,000 pays about €500 to €687 a month in private cover after the employer's share, against €648 in public cover in 2026. In public cover the spouse without income is insured through family insurance (Familienversicherung) at no extra cost.[11] Family insurance covers a spouse or registered partner, not an unmarried partner. In private cover the employer pays half of both premiums, up to €613.22 a month in total.[1]

From 2028, public insurance adds 2.5 percentage points to the member's contribution rate for a spouse insured through family insurance, and the member pays it alone.[12] No surcharge applies while a child under 12 lives in the spouse's household. A couple without children pays it unless another exception applies, such as the spouse caring for a relative with at least care grade 2 for ten hours a week or reaching the standard retirement age.[12] The surcharge does not touch private premiums.

What does a family with two children pay?

A single earner on €100,000, 35, with a spouse without income and two children aged 4 and 7 pays €600 to €1,187 a month in private cover after the employer's share, against €599 in public cover in 2026. Public cover wins here: it insures the spouse and both children at no extra cost, while private cover charges four premiums and the employer pays at most €613.22 of them.[1] Each child costs about €150 to €250 a month in private cover, while children stay insured at no extra cost in public cover, also from 2028.[11][12]

When both parents earn above the income threshold, each employer pays half of its own employee's premium, and private cover usually stays cheaper.[1] Family health insurance in Germany compares typical families, and we run the numbers for your household in a free call.

Does a six-figure salary keep you eligible in 2027?

Yes. Every six-figure salary is above the income threshold of €77,400 in 2026 and of €84,150 in 2027, so an employee on such a salary can choose private cover in both years.[2][8] If your regular pay falls below the threshold for good before you turn 55, public insurance becomes compulsory again.[13] Who can get private health insurance sets out the rules, and switching back to public insurance explains the way back.

Can paying yearly or in advance lower your costs?

Many private insurers give a discount if you pay half-yearly or yearly instead of monthly; the amount and the conditions depend on the insurer. Contributions for basic cover are tax-deductible as special expenses without a cap.[14] Contributions paid in advance for later years count in the year you pay them, up to three times that year's contributions.[14] In the years paid in advance, the health premium no longer fills the yearly cap of €1,900 for employees, so other insurance such as personal liability or occupational disability cover can count towards it. The effect is larger in a year with a high tax rate.

Whether it pays off depends on your tax rate, your other insurance and your cash. A tax adviser can work that out, and we tell you which payment options your insurer offers.

What do these figures leave out?

The figures assume a healthy applicant, a deductible of up to €600 a year and today's household.

• Your health. An anonymous pre-inquiry shows how insurers rate your health before you apply, and we check the whole market for you.
• Your deductible. A higher deductible lowers the premium, because you pay more of your costs yourself.
• Your premium in retirement. Savings built into every premium and a premium-relief tariff keep it affordable, as what PKV costs in retirement shows.
• Children later. Each child adds a private premium of about €150 to €250 a month. A newborn joins your insurer without a health check if you register the baby within two months, and the insurer may require you to have been insured with it for up to three months, as newborn enrolment explains.

Book a free 30-minute call, and we run the pre-inquiry for you. Our advice costs you nothing.

How we calculated

Public figures use the 2026 values, the average additional contribution of 2.9% and the rates outside Saxony. Private figures are typical premiums for healthy applicants in a very good tariff with a deductible of up to €600 a year, including long-term care insurance and the statutory 10% surcharge. The couples are married and 35, the children 4 and 7.