A PKV premium refund means your insurer pays back part of your annual premiums if you have submitted no bills for a year. The rate depends on the insurer and the tariff. Whether it is worth it is a calculation: you compare the possible refund with the reimbursements you forgo when you pay bills yourself.
The key points at a glance
- The condition is one year without submitted bills.
- The refund can depend on the insurer’s results and is then not certain.
- Paying yourself is worth it when the bills for the year are below the possible refund.
- The refund reduces your deductible special expenses in the year it is paid out.
How does the PKV premium refund work?
The insurer pays back part of the premiums if you do not submit any bills for reimbursement within one year. There are two forms, which differ in reliability.
| Form | What the payout depends on |
|---|---|
| Performance-dependent | The insurer must have achieved surpluses. The amount varies. |
| Guaranteed (independent of performance) | The payout is fixed in the tariff. This form is rare. |
Whether your tariff provides a refund, in which form and at which rate, is stated in the tariff conditions. Check this already when you switch to PKV (in German), because it affects the actual price of the tariff.
PKV refund calculation: submit bills or not?
Compare two options. Submitting means the insurer reimburses the bills, and the refund lapses. Paying yourself means you bear the bills alone and keep the refund. The calculation works as soon as you know your tariff’s rate. How the premium itself is made up is explained in the guide on how the PKV premium is calculated (in German).
Example with assumptions: annual premium €1,800, possible refund 25 percent, so €450. The insurer reimburses submitted bills in full, and there is no deductible. The percentage is a calculated figure and not a promise from an insurer.
| Bills in the year | Balance if you submit | Balance if you pay yourself | Better option |
|---|---|---|---|
| €300 | €0 | +€150 (-€300 + €450) | Pay yourself |
| €450 | €0 | €0 (-€450 + €450) | Even |
| €600 | €0 | -€150 (-€600 + €450) | Submit |
The rule of thumb: if the bills for the year are below the possible refund, paying yourself pays off. Above that, submitting pays off. How to submit bills properly is explained in submitting PKV bills (in German).
How does a deductible change the calculation?
With a deductible, the point at which submitting pays off shifts. Bills below the deductible bring you no reimbursement, but they can cost you the refund. Assume the deductible is €500 and the possible refund is still €450. For bills of €800, submitting costs you €500, while paying yourself costs only €800 – €450 = €350. Submitting only pays off from a total of €950 in bills for the year.
The basics of deductibles are set out in deductibles in PKV explained simply (in German). How high yours should be is answered in the guide choosing the right PKV deductible (in German).
What are the drawbacks of the refund?
The most important drawback is uncertainty. With the performance-dependent form, the payout depends on the insurer’s surpluses, so you are counting on an amount you cannot know in advance. Another point is tax: the refund reduces your deductible special expenses in the year it is paid out. More on this is in tax advantages of PKV (in German).
The refund also does not protect you from rising premiums. The insurer reviews, at least once a year and for each tariff, whether benefits and calculation are out of line. If costs deviate significantly from the calculation, the insurer can adjust the premiums; details are in PKV premium adjustments (in German). How premiums behave over the long term also depends on ageing provisions and premium stability (in German).
Important: do not skip a doctor’s visit just to keep the refund. When your health is concerned, it takes priority over any bill.
Is there a PKV premium refund for students too?
Whether a student tariff includes a premium refund depends on the tariff. Student tariffs are aimed at young first-time insureds, and the premium depends on entry age. Ask explicitly in the offer about the form, the rate and the conditions of the refund, and enter your tariff’s rate in the calculation above.
Frequently asked questions
How high is the PKV premium refund?
It is a share of the annual premium. The exact rate is set by the tariff and differs between insurers. In the performance-dependent form it fluctuates with the surpluses. Only the amount that your tariff expressly guarantees is reliable.
Should I submit PKV bills or take the refund?
Compare the total of the year’s bills with the possible refund. If the bills are below it, paying yourself pays off; if they are above, submitting pays off. With a deductible, the point shifts, as the example with €950 shows.
What are the drawbacks of the premium refund?
In the performance-dependent form it is not secure, and in the year of payout it reduces your deductible special expenses. It also does not prevent premium adjustments. If you postpone necessary doctor’s visits because of the refund, you put your health at risk.
Will I lose the refund because of one small bill?
The condition is that no bills were submitted for a whole year. A single bill can therefore cost you the entitlement for that year. How exactly your tariff handles this is stated in the conditions.
So proceed now
- Read in the tariff conditions whether and in which form your tariff provides a refund.
- Enter your tariff’s possible refund into the calculation from the table.
- Collect the bills for the year and compare their total with this amount.
- Only then decide whether to submit or pay yourself.
If you want to talk through your situation, you will find the way to advice on the Academycon homepage.
Experiences with us can be found on ProvenExpert, Trustlocal and Trustindex. Academycon was mentioned, among other places, in a press release on Nachrichten Heute. An overview of all mentions is on the press page.
Related reading
- PKV or statutory insurance as a student: which pays off more? (in German)
- Private health insurance for students: costs and benefits (in German)
- Drawbacks of PKV for students: what to know beforehand (in German)
Last updated: October 2026. This guide is general information, not individual advice. The German version is authoritative.
