Basistarif

What is the Basistarif?

The Basistarif is a legally mandated tariff under § 152 VAG that every private health insurer in Germany has had to offer since 2009. Its purpose is social: to ensure that everyone who is legally required to hold health insurance can find coverage somewhere, regardless of health history or income trajectory.

Three design features make it unusual compared to a normal PKV tariff:

• Benefits mirror the GKV. Coverage follows the 3rd chapter of SGB V, the same scope of services a statutory-insurance member receives. No hospital upgrades, no chief-physician cover, no premium dental treatments.

• The premium is capped at the GKV maximum contribution. In 2026 that cap is around €1,226 per month with children and €1,261 per month for childless full-payers (KV + long-term care combined, see the BBG entry).

• No one can be rejected. Insurers are under a Kontrahierungszwang (obligation to accept) and may not apply risk surcharges or benefit exclusions. Health history does not matter.

Who has access to the Basistarif?

The access rules are narrower than the "safety net" label suggests:

• Anyone with a privately insured contract signed from 1 January 2009 onwards can switch into their insurer's Basistarif at any time

• Freiwillig GKV members (those who stayed in the statutory system voluntarily) can move to the Basistarif within 6 months of their mandatory cover ending

• Residents without GKV obligation who need to comply with the general mandatory-insurance rule

• Civil servants may use it as their Beihilfe top-up cover

Employees and self-employed currently in PKV who bought before 2009 are mostly covered by the Standardtarif instead, a similar but older safety-net that has been closed to new entrants since 2009.

What it is not

The Basistarif is often misread as a "cheap entry route into the PKV". It is not:

• You pay the GKV maximum, not a low introductory premium. For a healthy young employee the regular PKV market is almost always cheaper.

• Benefit levels are significantly below what a typical comfort tariff offers. A switch into the Basistarif from a comfort tariff feels like a major downgrade.

• You do not gain a cost advantage over the GKV itself: you pay the same maximum.

Where it genuinely helps: acute premium distress, rejection elsewhere due to pre-existing conditions, or temporary cover during a benefit gap.

Half-price premium if you are in need

Under § 152 Abs. 4 VAG, the Basistarif premium halves automatically if you qualify as hilfebedürftig (in need) within the meaning of SGB II or SGB XII. This is an important line of defence for insured members who are temporarily out of work or facing hardship, it is preferable to the alternative Notlagentarif (§ 153 VAG), which is triggered by unpaid premiums and strips cover back to emergency care only.