Every expat in Germany faces the same fork in the road: public (GKV) or private (PKV/PHI). The decision has a bigger impact than most people realise, because switching back is legally restricted. This side-by-side comparison shows what each system actually costs, what it covers, and which one fits your situation.
Benefits: where PHI genuinely wins
- Faster specialist appointments — private patients are often seen within days.
- Single or double hospital rooms and chief-physician treatment.
- Dental cover of 80–100% including implants and orthodontics (subject to tariff).
- Comprehensive alternative medicine and psychotherapy cover.
- Worldwide travel cover typically included.
- Premium refunds if you don't claim.
Where GKV wins
- Free family co-insurance for a non-working spouse and children.
- Premium falls when your income falls (unemployment, parental leave).
- Simpler for very frequent chronic-condition claims.
Eligibility rules you cannot ignore
Employees can only choose PHI if their gross salary is above the JAEG income threshold (€77,400 in 2026) for a full calendar year. Freelancers and self-employed professionals can choose freely from day one. Civil servants are the classic PHI clientele because the state pays a subsidy (Beihilfe) covering 50–80% of their medical costs.
Switching from PHI back to GKV after age 55 is essentially impossible. That is not a scare tactic — it is a legal rule you should plan around before signing.
A concrete example
A 32-year-old software engineer on €85,000 gross typically pays around €900/month in GKV (employee + employer share). A comparable PHI tariff often runs €650–€800/month total, with single hospital room, 90% dental and worldwide cover. Over ten years the difference easily crosses €25,000 — plus better benefits.
For a self-employed designer on €55,000 gross the picture flips: PHI at €400–€500/month vs. voluntary GKV at €800+ because self-employed pay both halves of the GKV contribution.
Frequently asked questions
Based on 11 Google reviews
As an international student, navigating the health insurance requirements can be confusing, but their team made the entire process smooth and stress-free. They were always responsive, professional, and willing to answer my questions.
I have been working with Ms. Fröhlich for several years and I am extremely satisfied. As an outstanding insurance broker, she finds excellent tariffs, and communicating with her makes dealing with insurance genuinely pleasant. Her expertise across all insurance topics makes her an incredibly reliable specialist. I consider myself lucky to have such a competent insurance broker by my side and can recommend her to anyone without reservation.
Nobody enjoys dealing with the topic of insurance. With Ms. Fröhlich by my side that has changed: perfect advice tailored individually to me, always reliable — without ever building any pressure. On top of that, Ms. Fröhlich works in an extremely service-oriented way. Compared to online services, she offers real added value. In short: I'm thrilled. Thank you so much!
Some client reviews have been translated from German into English for better readability. The original reviews are available on our Google Business Profile.
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Editorial Review
Reviewed by our advisory team
This article was prepared with editorial support and professionally reviewed for accuracy, relevance and clarity before publication.
Tina Fröhlich
Founder & Managing Director
Independent German Health Insurance Broker (§ 34d GewO)
Tina is the founder of Happy Expats and a licensed independent broker under § 34d GewO. She specialises in independent PKV strategy for internationals and is legally bound to act in the client's interest.
Joachim Wiedmann
International Health Insurance Advisor
Joachim advises expats, freelancers and employees on German private health insurance. He focuses on making the German system understandable in plain English and matching each client with a tariff that fits their life in Germany.
Happy Expats provides independent guidance on private health insurance in Germany for internationals. Every article is reviewed before publication and updated regularly to help ensure that the information remains accurate and relevant.