For students applying for private health insurance (PKV), the questions about pre-existing conditions are often the biggest hurdle. An incomplete answer can, in the worst case, cost you the cover. This guide explains what you must disclose, how to complete the application step by step and what false information can lead to.
Short answer: In a PKV application you must disclose all material circumstances that the insurer asks about in text form (section 19 subsection 1 VVG). If the breach is intentional or grossly negligent, the insurer may withdraw from the contract. It may also impose surcharges or exclusions if it would have insured you on those terms. Complete, precisely dated and documented answers are the safest approach (last updated October 2026).
The most important points
- The duty to disclose covers all circumstances about which the insurer asks in text form (section 19 subsection 1 VVG).
- The insurer must inform you separately, in text form, about the consequences of a breach (section 19 subsection 5 VVG).
- Even with only gross negligence, the insurer may impose surcharges or exclusions (section 19 subsection 4 VVG).
- Anyone choosing private insurance must apply to be exempt from student statutory insurance within three months of the start of compulsory cover (section 8 subsection 1 no. 5 SGB V).
- In the basic tariff, an application may be refused only for fraudulent deception or intentional breach of the duty to disclose (section 193 subsection 5 VVG).
Why pre-existing conditions matter so much in a PKV application
Private health insurance is a contract-based insurance. Before concluding the contract, the insurer checks whether and on what terms it accepts the risk. Your answers are the basis for that check. That is why the statutory duty to disclose under section 19 VVG applies, and it covers all questions the insurer puts to you in text form.
Statutory health insurance works differently. Compulsory student insurance is linked to your status as a student (section 5 subsection 1 no. 9 SGB V), not to your state of health. For that reason, health questions play no role there, but they do in a PKV application. Our guide on the requirements explains more (requirements for private health insurance during study (in German)).
Which information should you prepare?
Before you open the application, collect the information the insurer usually asks for. An overview helps you not to miss anything:
| Area | What you should clarify | How to document it |
|---|---|---|
| Treatments | Type, date and result of each treatment or examination in recent years | Medical reports, discharge letters, findings |
| Diagnoses | All diagnoses made, including those that are resolved | Medical confirmations |
| Medication | Long-term medication and dosage, even if taken less often | Current medication plan |
| Hospital stays | Period, reason and clinic | Discharge reports |
| Symptom-free periods | Periods in which you were symptom-free or under treatment | Medical letters from the treatment phases |
The table does not replace a conversation with your doctor. If you are unsure whether a finding must be disclosed, ask the insurer in text form. A written answer protects you better than a verbal assessment.
How to complete the application step by step
- Read all questions before you fill in anything, and mark those that apply to you.
- Enter diagnoses, treatment periods and medication completely in the designated fields. Do not refer to attachments if the form asks for the details directly.
- State periods as precisely as possible, ideally with month and year.
- Compare your answers with your documents before you sign.
- Keep a copy of the completed application and all letters from the insurer.
The insurer may only ask about circumstances that it asks about in text form. You do not have to answer questions that were never asked. In case of doubt, however, disclose more rather than less, because the law scales the consequences according to the degree of fault.
What happens if the answers are incomplete?
If you breach the duty to disclose, the insurer can react differently depending on the degree of fault. For an intentional or grossly negligent breach, withdrawal is possible, unless the insurer already knew the circumstance or the notice of consequences was missing (section 19 subsections 2 to 5 VVG). For simple negligence, the insurer may terminate the contract with one month’s notice (section 19 subsection 3 sentence 2 VVG).
If the insurer would have accepted you on other terms had it known, these terms become part of the contract (section 19 subsection 4 VVG). If the premium then rises by more than 10 percent or the insurer excludes cover, you have a right to terminate within one month (section 19 subsection 6 VVG). The insurer must point out this right.
When does PKV fit, and when does it not?
The choice between statutory and private insurance is a personal assessment. The table lists factors that feed into it. It does not replace a check of your individual case.
| Points more towards PKV | Points more against PKV |
|---|---|
| You are healthy and do not need to disclose any pre-existing conditions | You have pre-existing conditions that can lead to surcharges or exclusions |
| You have access to Beihilfe or another entitlement that supplements PKV | You do not want to complete a health questionnaire, which statutory insurance does not require |
| You have found a tariff whose premiums and benefits fit your situation | You cannot judge how premiums in the PKV tariff will develop |
Exemption from student statutory insurance is subject to deadlines. The application to the health insurer must be made within three months of the start of compulsory cover and cannot be revoked. It is effective only if you prove an entitlement to cover in case of illness (section 8 subsection 1 no. 5 and subsection 2 SGB V). More on the process is in our guide PKV-Wechsel als Student: Ablauf, Antrag und Unterlagen (in German).
Frequently asked questions
Do I have to disclose old pre-existing conditions that have healed?
Whether a circumstance must be disclosed depends on what the insurer asks. If the questionnaire asks about completed treatments or a particular period, you must answer. Resolved conditions are therefore not automatically irrelevant. The actual question decides.
What if I forgot a pre-existing condition?
Report it to the insurer as soon as possible in text form. For circumstances before the contract is concluded, the consequences depend on the degree of fault. A supplementary notice can help clarify the situation. If in doubt, get advice before you sign anything.
Can the basic tariff be an alternative?
The basic tariff must be offered to certain groups of people (section 193 subsection 5 VVG). It has its own scope of benefits and premium. The differences from the comfort tariff are explained in our basic tariff guide (in German). Check with the insurer whether you belong to these groups.
Do I need personal advice for an application?
With pre-existing conditions, a personal assessment is useful, because several answers interact. How we work with clients is described on our page So arbeiten wir (in German). Before you conclude the contract, check the answers yourself in any case.
Your next steps
- Create a list of all treatments, diagnoses and medication from recent years.
- Collect the medical reports and findings that document your answers.
- Ask the insurer in writing what exactly unclear questions mean.
- Compare the offers and check surcharges, exclusions and benefits in the terms.
- Complete the application in full and keep all documents.
Related guides
- Public or Private Health Insurance for International Students
- Requirements for private health insurance during study (in German)
- PKV switch as a student: process, application and documents (in German)
- Student health insurance: PKV or statutory, what suits you (in German)
Sources: Section 19 VVG, gesetze-im-internet.de (retrieved October 2026, German); Section 193 VVG, gesetze-im-internet.de (retrieved October 2026, German); Section 5 SGB V, gesetze-im-internet.de (retrieved October 2026, German); Section 8 SGB V, gesetze-im-internet.de (retrieved October 2026, German).
Last updated: October 2026. This guide is general information, not individual advice.
