Full versus supplementary insurance differs in its purpose: Full health insurance replaces your cover as a whole, while a supplementary policy only fills gaps in specific areas. The first meets your obligation to be insured in case of illness, the second covers what remains open. As a student you are usually in statutory compulsory insurance, and you can extend that full cover with a supplementary module if you need one.
The key points at a glance
- Full health insurance means you are covered as a whole, either in the statutory health insurance (GKV) or the private health insurance (PKV).
- A supplementary policy pays only for the area you have taken out, for example dental prosthetics. It does not replace full cover.
- If you are enrolled at a state or state-recognised university, you are in the GKV under compulsory insurance, unless a prior insurance applies.
- The exemption from this obligation is irrevocable and normally applies to the whole course of study.
- Whether GKV with a supplement or PKV suits you better depends on your health, your plans after your studies and your budget.
What is full health insurance?
Full health insurance covers you comprehensively against medical costs and so fulfils the obligation to be insured. In Germany there are two forms: Statutory health insurance with a health fund, and private health insurance with an insurance company. Both are full insurance, even though benefits, contribution calculation and billing differ considerably.
Billing works differently. Statutory insured people generally receive benefits in kind. Under section 13 para. 2 SGB V, you can choose cost reimbursement, but you must inform the fund beforehand and are bound to it for at least one calendar quarter. In PKV, the principle is cost reimbursement: You pay the doctor’s bill yourself first and submit it to the insurer. How much you get back depends on your tariff.
More on what PKV concretely covers during your studies can be found in our overview of PKV benefits for students (in German).
What is a supplementary insurance?
A supplementary insurance is additional cover for individual areas of benefits. It requires an existing full health insurance and reimburses only what is set out in your contract. There is no obligation to take one out.
Typical areas are dental prosthetics, glasses, optional hospital services and alternative treatments. Which modules are relevant for students and what to look for when comparing them is explained in our article on supplementary modules for GKV (in German).
Full versus supplementary insurance compared
| Feature | Full insurance (GKV or PKV) | Supplementary insurance |
|---|---|---|
| Purpose | Covers you comprehensively in case of illness | Supplements the full insurance in individual areas |
| Obligation | You need cover in case of illness | Voluntary |
| Provider | Health fund (GKV) or insurer (PKV) | Private insurers |
| Benefits | GKV: Benefits within the statutory framework. PKV: Benefits according to the chosen tariff | Only the area you have taken out |
| Sufficient on its own? | Yes | No, requires full insurance |
Important: A supplementary insurance can never replace full insurance. Someone who takes out only dental supplementary cover and has no health insurance is not covered in case of illness.
Which full insurance applies to students?
If you are enrolled at a state or state-recognised university, you are compulsorily insured in the GKV under section 5 para. 1 no. 9 SGB V. This does not apply if a prior insurance exists, for example as an employee, or if you are family insured through your parents under section 10 SGB V. The statutory basis can be found in section 5 SGB V and section 10 SGB V.
At the start of your studies, you can apply to be exempted from this obligation and move to PKV. You submit the application to your health fund within three months of the start of compulsory insurance. The exemption only takes effect if you prove that you are otherwise covered in case of illness, in practice through a private contract.
What to know before the exemption
The exemption cannot be revoked and normally applies to the whole course of study. A return to the GKV is usually possible only after your studies, for example through employment subject to compulsory insurance. A mini-job is not enough for this. During the exemption, family insurance is also ruled out. The Verbraucherzentrale explains the options during your studies in detail.
Which gaps does the GKV have that a supplementary insurance can close?
The GKV covers illness costs, but not every bill in full. Three examples show where out-of-pocket costs arise.
- Dental prosthetics: The fund pays a fixed subsidy of 60 per cent of the standard supply (2026). Under the GKV Contribution Rate Stabilisation Act (GKV-Beitragssatzstabilisierungsgesetz), it is to fall to 50 per cent, or to 60 and 65 per cent with regular dental check-ups. The Federal Ministry of Health does not state a date for the entry into force. Current amounts are published by the National Association of Statutory Dental Insurance Physicians.
- Glasses: As an adult, you are entitled to visual aids only with a severe visual impairment or with short or long-sightedness of more than 6.0 dioptres, and with corneal astigmatism of more than 4.0 dioptres. The fund never pays for frames.
- Co-payments: Co-payments apply to medicines, aids and hospital stays. According to the Federal Ministry of Health, co-payments are planned to rise by 50 per cent, and it does not state a date for the entry into force.
These are exactly the areas that a supplementary policy can partly cushion. Whether it pays off for you depends on how likely such costs are for you.
GKV with a supplement or PKV: How do you decide?
Which model suits you depends on your situation. These criteria help with the decision:
- State of health: The PKV application contains health questions that you must answer truthfully. An anonymous risk enquiry before the application shows in advance whether an insurer would accept you.
- Time horizon: Consider what your path after your studies looks like. If you want to return to the GKV, you can generally do so before age 55 through employment subject to compulsory insurance below the annual earnings threshold. From age 55, a return is generally ruled out.
- Contribution development: Private contributions depend on entry age and can be adjusted later. Adjustments are regulated by law, and in case of increases you have a special right of termination.
- Family planning: If you want children, it is worth looking early at how your family will be covered. Background is given under family planning and health insurance (in German).
Frequently asked questions
Can a supplementary insurance replace health insurance?
No. A supplementary insurance reimburses costs only in the area you have taken out, such as dental prosthetics. Cover in case of illness as a whole comes from full health insurance, either GKV or PKV. Without such full insurance, a supplementary policy on its own is ineffective, because it does not cover basic protection.
What is meant by full health insurance?
Full health insurance is cover that bears treatment costs in case of illness comprehensively, and so fulfils the obligation to have health insurance. Statutory and private health insurance both belong to it. GKV benefits follow a statutory framework, while in PKV they depend on the chosen tariff. A supplementary insurance is not part of it.
Does the statutory fund pay for dental prosthetics in full?
No. The fund grants a fixed subsidy of 60 per cent of the standard supply (2026). Under the GKV Contribution Rate Stabilisation Act, it is to fall to 50 per cent, or to 60 and 65 per cent with regular dental check-ups. If the treatment is more elaborate than the standard supply, you bear the extra cost yourself. A dental supplementary insurance can partly cover this share, depending on the contract.
Do I need a supplementary insurance as a student?
It is not compulsory. Your health insurance exists through compulsory student insurance or family insurance. Whether an additional module makes sense depends on which costs you want to cover and what your budget allows. It is always worth comparing the conditions before you sign.
So what should you do now
- Clarify how you are currently insured: Compulsory student insurance, family insurance, or already exempted and privately insured.
- Note which costs matter to you, for example dental prosthetics or glasses.
- Before any decision on PKV, check the three-month exemption deadline and remember that the exemption is irrevocable.
- Compare supplementary modules by their terms and conditions, not only by their contribution.
- If you want to talk through your situation, you will find the way to advice on the Academycon homepage.
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Related reading
- PKV benefits for students: The overview (in German)
- Supplementary insurance for students: Which modules pay off (in German)
- Emergency room and emergency doctor for privately insured people: Who pays what (in German)
- Taxes for students: When you pay and when you do not (in German)
- Dental supplementary insurance during your studies (in German)
Last updated: October 2026. This article provides general information and does not replace individual advice.
