How high your PKV deductible amount should be depends on one question: how much can you pay in a year from savings, without an overdraft or a loan? A higher deductible (often called Selbstbehalt in PKV) lowers the monthly premium, but increases what you pay yourself when medical bills are high. For students, liquidity matters most. The basics are explained in PKV deductibles explained simply (in German). This article focuses on the amount.
The key points at a glance
- Choose the level that you could pay in full from savings if it came to that.
- Set the premium saving per year against the additional risk. This shows after how many years a higher level pays off.
- If you submit bills, you may lose a premium refund.
- A later reduction of the deductible counts as additional cover and can trigger a review, a surcharge or an exclusion.
Who needs to think about the amount?
You choose a deductible in private health insurance. Statutory student insurance, by contrast, has a fixed basic contribution: in 2026 this is €87.38 per month plus the fund’s additional contribution. PKV becomes relevant for students who are exempted from compulsory insurance at the start of their studies. You submit the application to your health fund within three months of the start of compulsory insurance. More on this in the route into private health insurance (in German).
The exemption cannot be revoked and normally applies to the whole course of study. A return to the GKV is possible only in narrow cases. A switch in the middle of your studies (in German) follows these rules too. The Verbraucherzentrale gives an overview of the options for student health insurance. PKV premiums can also change over time, so do not plan with the entry premium alone.
What do €300, €500 and €1,000 deductibles mean in practice?
The figure is the amount you bear yourself for treatment costs before the insurer reimburses you. The table assumes that the deductible applies per calendar year. Check this in the tariff conditions of your offer.
| Deductible | What you pay yourself in a year with high costs | Suits you better if |
|---|---|---|
| €300 | €300 | You have little in savings and want to stay predictable. |
| €500 | €500 | You have a buffer of several hundred euros. |
| €1,000 | €1,000 | You can raise the sum at any time without a loan. |
Calculating the PKV deductible amount: when does a higher level pay off?
Divide the additional risk by the premium saving of one year. The result shows how many years it takes for the saved premiums to offset one year at the full deductible. The actual premium differences are in the offer of the insurer.
Example: Lea, 23, expects a premium difference of €25 per month between a €300 and a €1,000 deductible. This figure is a calculation assumption, not a market price. She saves 12 × €25 = €300 per year. If she pays the full deductible in the unfavourable case, she bears €1,000 minus €300 = €700 more than with the lower level.
- One expensive year in three years: €900 saved, €700 borne extra. The higher level stays €200 ahead.
- Two expensive years in three years: €900 saved, €1,400 borne extra. The calculation tips by €500 into the red.
Here, a year counts as “expensive” if costs reach at least €1,000. Below that, you pay only the actual costs anyway.
What role does the premium refund play?
With a premium refund, the insurer pays back part of the annual premiums if you have not submitted any bills for a year. It usually depends on the insurer’s surplus and is therefore not guaranteed. This changes the calculation: if you pay smaller bills yourself and do not submit them, you can keep the entitlement to the refund. Whether that works for you depends on the conditions of your tariff.
Can you lower or adjust the deductible later?
Lowering it comes with hurdles. Under section 204 VVG, you are entitled to switch to other tariffs with similar cover at your own insurer, with acquired rights being credited. A lower deductible counts as additional cover. For this, the insurer may demand an exclusion, an appropriate risk surcharge and, where necessary, a waiting period.
Under the voluntary guidelines of the PKV association, enquiries about a tariff change should be answered within 15 working days. You also ask the insurer about raising the deductible, and the tariff sets the conditions. You should therefore check the amount carefully before you sign the contract.
What comes before the decision on the amount?
The application contains health questions that you must answer truthfully. Ongoing treatment and recommended operations often lead to a refusal. It is therefore worth making an anonymous risk enquiry before you apply. Whether there is PKV without a health check (in German) is covered in a separate article.
Frequently asked questions
Which PKV deductible amount makes sense as a student?
The one you can pay from savings within a year, without a loan or overdraft. If you have little in savings, €300 or €500 is often more predictable. A level of €1,000 suits you if that sum is available at any time. The premium saving alone should not decide.
Is a high deductible worth it if I rarely go to the doctor?
If you rarely go to the doctor, a high deductible saves premium every year. The advantage only holds while expensive years stay rare. In the example, with €700 of additional risk and €300 of savings, it takes more than two years for a single expensive year to be offset. In such a year, you must also be able to pay the amount.
Can I adjust the deductible later?
Yes, through a tariff change at your own insurer under section 204 VVG. A lower deductible counts as additional cover, and the insurer may then demand an exclusion, a risk surcharge or a waiting period. For a higher deductible, the conditions of your tariff apply, so ask in advance.
Does submitting small bills cost me the premium refund?
The premium refund requires that you submit no bills for a whole year. If you submit one, the entitlement for that year can lapse. The conditions and amounts differ by tariff, so compare them in every offer.
So what should you do now
- Work out how much you could pay within a year from savings.
- Ask for offers with several deductible levels and calculate savings against additional risk, as in the example.
- Ask about the conditions of the premium refund and the route to lowering the deductible.
- If you have pre-existing conditions, make an anonymous risk enquiry before you apply.
If you want to talk through your situation, you will find the way to advice on the Academycon homepage.
You can read about our work on ProvenExpert, Trustlocal and Trustindex. Academycon was mentioned, among other places, in a press release for the Münchner Merkur. 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)
- Drawbacks of PKV for students: what to know beforehand (in German)
- Private health insurance during your studies: costs and benefits (in German)
- University of applied sciences or university (in German)
Last updated: October 2026. This article provides general information and does not replace individual advice.
