For employees in Germany, the switch to private health insurance depends on the compulsory insurance earnings limit. Students are insured through the student health insurance scheme and follow a separate route, so the same limit does not apply to them in the same way.
Short answer: Employees may switch to private health insurance if their regular annual earnings exceed the compulsory insurance limit. In 2026 this limit is 77,400 euros a year, or 6,450 euros a month (as of January 2026). Students can only obtain private cover through an exemption under section 8 SGB V, and the application must be filed within three months.
The most important points
- The compulsory insurance limit applies to employees. In 2026 it is 77,400 euros of annual earnings (section 6(1) no. 1 SGB V).
- If you exceed the limit, you become exempt from compulsory insurance at the end of the calendar year (section 6(4) SGB V).
- The contribution assessment ceiling is lower, at 69,750 euros a year. Between the two limits you pay statutory contributions on the basis of the ceiling.
- Students are insured through the student scheme. Their route to private insurance runs through the exemption under section 8 SGB V.
- The decision has long-term effects on contributions, benefits, family insurance and cover in later life.
What is the compulsory insurance limit?
The compulsory insurance limit, also called the general annual earnings threshold, is an income figure. If you regularly earn more, you are no longer compulsorily insured with a statutory health fund (section 6(1) no. 1 SGB V). The limit is adjusted every year, and the federal government sets it by ordinance (section 6(6) SGB V).
| Limit | Amount in 2026 | Meaning |
|---|---|---|
| Contribution assessment ceiling for health and long-term care insurance | 69,750 euros a year (5,812.50 euros a month) | Statutory contributions do not rise above this amount |
| Compulsory insurance limit | 77,400 euros a year (6,450 euros a month) | Above it, statutory insurance is no longer compulsory |
| Family insurance income limit | 565 euros a month (one seventh of the reference earnings) | Total income of family members must not exceed this |
As of January 2026, GKV-Spitzenverband and the federal government. For 2027, a draft ordinance sets the compulsory insurance limit at 84,150 euros a year. The draft has not yet been confirmed by the Bundesrat (as of October 2026).
When can employees switch to private insurance?
- Check your regular annual earnings. Bonuses and pay rises count, and retroactive increases are attributed to the year in which they arose (section 6(4) SGB V).
- Compulsory insurance ends at the close of the calendar year in which the limit is exceeded (section 6(4) SGB V). What matters is whether earnings also exceed the limit for the following year.
- After that you can take out private insurance. The premium then depends on the tariff, your age at entry and the health check, not on your income.
If your earnings stay below the limit, you remain compulsorily insured and usually cannot switch. If you exceed the limit, you can take out private insurance or stay voluntarily insured with a statutory fund.
What applies to students?
For students, the compulsory insurance limit is generally not the relevant measure, because they are compulsorily insured through the student scheme under section 5(1) no. 9 SGB V. Those who want private cover apply for an exemption under section 8 SGB V. The deadline is three months from the start of the obligation, and proof of other health cover is required. Once granted, the exemption cannot be revoked. For details, see the German guide on enrolment without proof of health insurance.
What are the pros and cons of each system?
This comparison is general. Which route suits you depends on income, family, health and the specific tariffs offered to you.
| Aspect | Statutory health insurance | Private health insurance |
|---|---|---|
| Contribution | Based on income up to the ceiling, plus the fund’s additional contribution | Based on tariff, age at entry and health check, not on income |
| Family members | Co-insurance possible if the income limit is met | Each person needs their own contract |
| Admission | Without a health check | With a health check, which may lead to surcharges or exclusions |
| Benefits | Statutory catalogue of benefits | Depends on the chosen tariff |
This comparison does not replace a review of your documents. A personal consultation can help compare tariffs and contributions in your individual case.
What does the voluntary statutory route cost, for comparison?
If you exceed the limit and remain voluntarily insured with a statutory fund, contributions are calculated on a minimum assessment base. For 2026 this base is 1,318.33 euros a month. This results in at least 222.80 euros for health insurance (reduced rate of 14.0 percent plus an assumed additional contribution of 2.9 percent) and 47.46 euros for long-term care insurance (as of January 2026, calculated from the statutory calculation values). A childless surcharge applies to long-term care insurance on top of this.
Frequently asked questions
Does a side job count towards my annual earnings?
Whether a side job is relevant for the limit depends on the type and amount of the work. Working student positions follow their own rules, which are explained in the German guide on earning money alongside studies (in German).
Does the limit rise every year?
Yes, the limit is adjusted every year. For 2027, a draft sets it at 84,150 euros a year. Only the officially promulgated figure applies, so check the current status before deciding.
Must I switch when I exceed the limit?
No. Once you are no longer compulsorily insured, you can take out private insurance or stay voluntarily insured with a statutory fund. Both options affect contributions and benefits, so compare them beforehand.
Can I return to statutory insurance later?
That depends on the requirements in each individual case. The German guide on returning to statutory health insurance (in German) explains the rules.
What to do now
- Calculate your regular annual earnings from your employment contract and compare them with the limit for the current and the following year.
- Check whether the limit is exceeded again next year, because this determines when a switch is possible (section 6(4) SGB V).
- Have the contributions and benefits of both systems compared, ideally with concrete tariff documents. A personal consultation at Academycon is described on this page.
- Do not decide on the monthly contribution alone. Take family, age and health into account.
Related guides
- Health insurance income limit 2026: what it means
- Private health insurance for working students in Germany
- Public or private health insurance for international students
- Versicherungspflichtgrenze im Studium (in German)
Sources: section 6 SGB V, exemption from compulsory insurance (German text, retrieved October 2026), section 8 SGB V, exemption (German text), GKV-Spitzenverband, calculation values (as of 1 January 2026, German), BMAS, draft calculation values ordinance 2027 (as of October 2026, German), Federal government, contribution ceilings 2027 (as of October 2026, German).
Last updated: October 2026. This guide is general information, not individual advice.
