PKV Premium Increase 2026
German private health insurers (PKV) are raising premiums by roughly 13 % on average in 2026. If you are affected, you have a special termination right (§ 205 (4) VVG) and you can switch to a cheaper tariff with your own insurer under § 204 VVG – without losing your age reserves.
Key Takeaways
- Average 2026 increase: around 13 %, per PKV-Verband. Individual tariffs land anywhere between 3 % and 20 %+.
- Special termination right: two months from the adjustment letter to cancel (§ 205 (4) VVG).
- Best move for existing customers: § 204 VVG tariff switch within your own insurer – age reserves are preserved.
- Return to GKV: only for employees under 55 whose gross salary drops below the JAEG threshold (2026: €77,400/year).
- Regulator: BaFin oversees every adjustment under § 155 VAG; an independent trustee must approve.
Why are PKV premiums climbing in 2026?
Three forces drive the wave: medical inflation (hospital and physician fees, drug costs), longer life expectancy, and lower returns on the age reserves (Alterungsrückstellungen). Insurers must recalculate as soon as the gap between projected and actual claims exceeds a legally defined threshold (§ 155 VAG). Once the threshold breaks, the adjustment is mandatory.
The PKV-Verband points to hospital wage agreements and to catch-up effects from the unusually small 2023/2024 adjustments. If your tariff was largely spared in recent years, expect a steeper hike now.
How big will your increase be?
There is no single answer. The real number sits in your personal adjustment letter and depends on the insurer, the specific tariff, your age, and whether the tariff is still open or already closed. Several large insurers (Allianz, Debeka, DKV, Signal Iduna, Continentale, Barmenia and others) have announced adjustments – ranges in individual tariffs span 3 % to 20 %+.
Reading the adjustment letter
Look for the trustee (Treuhänder) signature, the effective date and the exact tariff name. Only then can you tell whether the main contract, the add-on or both are affected. A practical checklist is available at the German consumer protection agency (Verbraucherzentrale).
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4 ways to cut your PKV premium
1. § 204 VVG tariff switch
Stay with your own insurer and move into a cheaper tariff. Age reserves transfer in full – usually the strongest economic option.
2. Raise the deductible
Going from €300 to €1,200 deductible cuts the monthly premium by roughly €60–150 with most insurers. Works best for people who rarely visit a doctor.
3. Adjust benefits
Do you really need single rooms and chief-physician treatment? Trimming add-on modules lowers the premium – but match cuts to your life plan, some benefits cannot be added back without a fresh health check.
4. Use the premium refund
Many tariffs refund up to six monthly premiums if you do not file any claims in the calendar year. Paying small bills yourself instead of submitting them is often cheaper – check the tariff conditions.
§ 204 VVG tariff switch: step by step
- Read the adjustment letter. Note the tariff name, the new premium, the effective date and the trustee. The 2-month special termination window starts on delivery.
- Request a tariff comparison from your own insurer. You have a legal right to receive every open tariff with comparable benefits. The insurer must advise you – free of charge.
- Check the benefit difference. A health assessment is only allowed for the parts that exceed your previous benefits. Equal or lower benefits cannot be refused.
- Submit the switch in writing. Letter or online form. Age reserves move 1:1 into the new tariff.
- Verify the start date. Never cancel the old policy before the new contract is signed – a gap in PKV cover is an expensive mistake.
Legal basis: § 204 VVG. If your insurer blocks a switch, file a complaint with the BaFin consumer helpdesk.
A full insurer change is rarely worth it
Moving to a different PKV provider usually means forfeiting most of your age reserves and passing a new health check. For existing customers the § 204 VVG tariff switch within the same insurer is almost always the better option.
Going back to statutory insurance (GKV)
The return to GKV is legally limited. Employees under 55 can re-enter if their gross salary stays below the insurance threshold (JAEG) for twelve months – the 2026 figure is €77,400/year. Background and the full ceiling table: Contribution ceilings 2026 in Germany.
Over 55 the door closes for most cases. The realistic alternatives are a § 204 VVG tariff switch or, as a last resort, the statutory Standard- or Basistarif. Self-employed and civil servants effectively have no path back to GKV. Source: § 5 SGB V, § 6 SGB V.
Frequently asked questions
How much do PKV premiums rise in 2026?
On average around 13 % across the industry – individual tariffs swing between 3 % and over 20 %. Your real number is in the adjustment letter from your own insurer. Source: PKV-Verband statements, early 2026.
Why is the insurer even allowed to raise the premium?
German law (§ 155 VAG) requires a recalculation when actual claims or mortality figures diverge from the original calculation for an extended period. An independent trustee (Treuhänder) must approve every increase, and BaFin supervises the process.
Do I have a special termination right after a premium hike?
Yes. Under § 205 (4) VVG you can terminate within two months of receiving the adjustment letter, effective on the date the increase takes effect. For full health coverage you must prove follow-up insurance, otherwise the cancellation is void.
Tariff switch vs. insurer change – what is the difference?
A § 204 VVG tariff switch keeps you with your own insurer and moves all your age reserves (Alterungsrückstellungen) into the new tariff. A full insurer change forfeits most of those reserves and requires a fresh health assessment. For existing customers the § 204 switch is almost always the better economic choice.
Can I go back to public health insurance (GKV)?
Only under strict rules. Employees under 55 can return when gross salary stays below the JAEG threshold (2026: €77,400/year) for twelve months. Above 55 a return is practically impossible – the tariff switch within PKV is the realistic path. Details: /contribution-ceiling-2026/.
When does the 2026 adjustment letter arrive?
Most insurers send the adjustment letter in November or December with the new premium effective 1 January or 1 April. Some adjust mid-year. Your 2-month termination window starts the moment the letter is delivered.
Does raising the deductible really pay off?
Going from €300 to €1,200 deductible cuts the monthly premium by roughly €60–150 with most insurers, depending on age and tariff. Worth it if you rarely see a doctor. People with chronic conditions usually end up paying more, so do the math: monthly saving × 12 minus your own risk.
What about the PKV Basistarif?
The Basistarif is mandated by law and covers roughly what statutory insurance (GKV) covers. The maximum premium is capped at the GKV ceiling (2026: about €1,050/month for adults). It is a fallback for very steep increases in older tariffs – check the benefit cuts before switching.