Once PKV, always PKV. Is there a way back

Once PKV, always PKV. Is there a way back?

These options are available if you want to return to the SHI system.

Private health insurance – that sounds very good at first, and it is, as long as you are young. Low premiums, preferential treatment and great service offers are the lure. When they get older, things don’t look quite so rosy, especially on the contributions side.

Private health insurance (PKV)

Anyone who has more than 54.899 (as of 2015) per year or who is self-employed can take out health insurance through a private provider. Initially, people can look forward to lower health insurance contributions and better medical services.

But this is only the case in the years when you are still young. With the age also the contributions rise, completely automatically and unchangeably. And not just by a few percent, which one could easily cope with on the side, but quite significantly.
For many people insured in private health insurance, this means that they simply can not pay their insurance, because the contributions must be paid even during retirement. But a change back into the GKV is often impossible.

Statutory health insurance (GKV)

In the GKV is normally everyone who has the o.g Points that would allow a switch to private health insurance, not met. Everyone is then automatically insured in the GKV.
But even if there is a duty to health insurance in Germany, individual people fall through the cracks for various reasons again and again and are without health insurance there, sometimes for several years. But this is not the normal case.

Is there a way from the PKV back to the GKV?

The best option for high-income earners would of course be to take advantage of the benefits of private health insurance when they are young, such as treatment by a chief physician, fast appointments or single rooms in the hospital, and then to switch back to statutory health insurance when they are older and the premiums become much more expensive.
This way, which would go fully at the expense of the solidarity community, the legislator has understandably prevented. But there are a few ways to switch back to the GKV, at least you are not yet over 55 years old.

These are the possibilities to return to the GKV.

Who less than 54.earns 900 euros a year, may switch back to the GKV. With a few tricks, such as reducing working hours, unpaid leave or paying into a company pension plan, so that one falls under the 54.900 euro limit slips, one can achieve the necessary reduction in remuneration. Unemployment also makes it possible to return to GKV.

The self-employed, on the other hand, have somewhat higher hurdles to overcome. You would first have to give up your self-employment. Then they could register as unemployed or get family insurance with the wife, if one is married then. Taking up a salaried job also allows you to return to GKV.

If you are creative, you can find ways to escape from a private health insurance that has become too expensive back into the arms of the solidarity community.

For whom the train has finally sailed?

But this does not apply to all. For insured persons who are over 55 years old, it is almost impossible to switch back to GKV. This would only be allowed if the insured was a member of a GKV for at least one day in the past 5 years. However, if you have been self-employed for a longer period of time and have therefore been a member of the PKV for a longer period of time, you have definitely missed the boat.

Insured persons who are already pensioners also have no chance of returning to the system. Until the end of their lives, they have to pay the sometimes horrendous premium sums, which can exceed 1.000 euros per month can be paid for.

For those who can no longer afford such premiums in old age, but are prevented from switching to the GKV, the only way out is to switch to a basic tariff within the PKV. All private health insurers must offer this basic tariff, which includes fewer benefits. However, co-payments may still be due.


So you should think twice about switching to private health insurance. And the initially lower contributions “saved” money on an extra account for old age to accumulate, so that you can later still pay the significantly more expensive contributions.