Gesetzlicher Zuschlag

Q: What is the Gesetzlicher Zuschlag?

The Gesetzlicher Zuschlag (statutory surcharge) is an additional 10 % on top of your PKV premium that German law requires insurers to charge between age 21 and the end of age 60. The legal basis is § 149 VAG (Versicherungsaufsichtsgesetz). Every cent of the surcharge flows into the member's ageing provision (Altersrückstellung), it is not a profit margin for the insurer. The mechanic is pre-funding. Healthcare costs rise with age. Rather than letting premiums drift upwards year by year, the law forces a surcharge during the earning years when members use healthcare little. That surcharge builds a reserve that later cushions the cost curve.

Q: Who pays it?

• Every PKV full-insurance member aged 21-60 in private full cover (Krankheitskostenvollversicherung) • Not paid on supplementary policies (Krankenzusatzversicherung): those have their own reserve rules • Not paid in the Basistarif: that tariff uses a different reserve structure The surcharge is calculated on the base premium only, not on optional add-ons like premium-relief tariffs (BET).

Q: When does it end?

On 1 January of the year after you turn 60, the surcharge falls away automatically. The cut-off is calendar-year-based (someone who turns 60 in March pays the surcharge until 31 December of that year). You do not need to apply; the insurer stops charging it on the next invoice. An important detail: the end point is a calendar birthday, not the retirement date. If you retire at 63, the surcharge has been gone for two years already. If you keep working past 61, it is still gone. For a base premium of €550 per month, the surcharge contribution during working life is €55. When it ends, the next invoice drops by €55. If a PKV advisor or a price comparison tool presents a "premium without the Gesetzlicher Zuschlag" to make the product look cheaper, **treat that as a red flag**. **The surcharge is non-negotiable**, and every legitimate offer includes it. Comparing without it is either lazy or dishonest.

Q: How does it interact with other costs?

• Employer subsidy: applies to the full premium including the surcharge. The employer pays half of €605 (base + surcharge), not half of €550. • Tax deductibility: the surcharge is part of the Basisvorsorge share under § 10 Abs. 1 Nr. 3 EStG, tax-deductible within the general cap. • Tariff change (§ 204 VVG): when you switch tariffs inside your insurer, your accumulated surcharge capital moves with you. The reserve stays yours. • Insurer change: only the Basistarif-equivalent portion of the reserve transfers. The rest stays with the original insurer.

Statutory Surcharge (10%)

Updated: 22 May 2026

The Gesetzlicher Zuschlag, the statutory 10 % surcharge, is a legally mandated 10 % charge on the PKV premium paid by every member between age 21 and the end of age 60. The surcharge goes straight into the ageing provision, so the premium in old age is lower than it would otherwise be. It ends automatically on the 61st birthday.

Key facts

Legal basis: § 149 VAG
10 % surcharge on the PKV premium from age 21 to the end of age 60
Every cent flows into the Altersrückstellung (ageing provision)
Ends automatically at the start of age 61, not at retirement
Employer subsidy applies to the gross premium including the surcharge
The surcharge is tax-deductible as Basisvorsorge (basic-provision tax category) under § 10 Abs. 1 Nr. 3 EStG

What is the Gesetzlicher Zuschlag?

The Gesetzlicher Zuschlag (statutory surcharge) is an additional 10 % on top of your PKV premium that German law requires insurers to charge between age 21 and the end of age 60. The legal basis is § 149 VAG (Versicherungsaufsichtsgesetz). Every cent of the surcharge flows into the member's ageing provision (Altersrückstellung), it is not a profit margin for the insurer.

The mechanic is pre-funding. Healthcare costs rise with age. Rather than letting premiums drift upwards year by year, the law forces a surcharge during the earning years when members use healthcare little. That surcharge builds a reserve that later cushions the cost curve.

Who pays it?

• Every PKV full-insurance member aged 21-60 in private full cover (Krankheitskostenvollversicherung)

• Not paid on supplementary policies (Krankenzusatzversicherung): those have their own reserve rules

• Not paid in the Basistarif: that tariff uses a different reserve structure

The surcharge is calculated on the base premium only, not on optional add-ons like premium-relief tariffs (BET).

When does it end?

On 1 January of the year after you turn 60, the surcharge falls away automatically. The cut-off is calendar-year-based (someone who turns 60 in March pays the surcharge until 31 December of that year). You do not need to apply; the insurer stops charging it on the next invoice.

An important detail: the end point is a calendar birthday, not the retirement date. If you retire at 63, the surcharge has been gone for two years already. If you keep working past 61, it is still gone.

For a base premium of €550 per month, the surcharge contribution during working life is €55. When it ends, the next invoice drops by €55.

How does it interact with other costs?

• Employer subsidy: applies to the full premium including the surcharge. The employer pays half of €605 (base + surcharge), not half of €550.

• Tax deductibility: the surcharge is part of the Basisvorsorge share under § 10 Abs. 1 Nr. 3 EStG, tax-deductible within the general cap.

• Tariff change (§ 204 VVG): when you switch tariffs inside your insurer, your accumulated surcharge capital moves with you. The reserve stays yours.

• Insurer change: only the Basistarif-equivalent portion of the reserve transfers. The rest stays with the original insurer.

The common misreading

"I pay 10 % more and get nothing back for it" is wrong. The 10 % is not lost, it funds the reserve that stabilises your premium later. § 12a VAG (from age 65) deploys it to dampen future increases rather than actively cut the monthly figure, and the broader Altersrückstellung pool keeps the baseline premium lower in old age than it would otherwise be. Compared to a system without the surcharge, the working-life premium is higher but the retirement-phase premium is materially lower.

It is also one of the reasons PKV premium comparisons done at a single point in time are misleading. A 35-year-old quoted at €550 is paying €495 base + €55 surcharge. Another insurer at €520 may have a different base-and-reserve structure. You need to compare lifetime cost, not just the headline at 35.

Practical example

Mark, 35, pays €550/month for the base PKV premium plus a 10% statutory surcharge under § 149 VAG of €55/month, every cent of which flows into his individual ageing reserves. The surcharge ends in the calendar year he completes his 60th year of life: from 1 January after that birthday, the €55 falls away and his headline premium drops by exactly that amount. The accumulated reserve continues working in his favour for the rest of his life.

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