During the clerkship, the question of health insurance often comes up sooner than expected. Whether statutory or private cover makes more sense depends on whether you hold a civil servant position on a provisional basis, which Beihilfe (the German civil servant health allowance) your state pays, and how your salary is structured. This guide compares the options and uses a worked example to show which contributions to expect.
Short answer: During the clerkship you usually choose between voluntary statutory health insurance (GKV) and private health insurance (PKV). If you are entitled to Beihilfe, a PKV policy that tops it up is the usual route. Voluntary GKV cost at least 222.80 euros per month for health insurance in 2026, plus long-term care insurance. Last updated: October 2026.
The most important points at a glance
- Whether PKV or GKV fits depends mainly on your status: a civil servant position on a provisional basis, with or without a Beihilfe entitlement.
- If you receive Beihilfe, you usually need a top-up policy that covers the remaining costs. Beihilfe alone rarely covers everything.
- Voluntary GKV has a minimum contribution base. For 2026, the calculated minimum is 222.80 euros per month for health insurance.
- A PKV premium depends on age, health and tariff, so we do not give a fixed figure for insurance premiums.
- According to the PKV association’s leaflet, the opening offer for civil servants has a six-month window. Check it early.
Which insurance is suitable during the clerkship?
Statutory health insurance (GKV) and private health insurance (PKV) are generally both options, unless you are already insured by law. The classification depends mainly on your status. As a civil servant on a provisional basis you usually have a Beihilfe entitlement. In that case, PKV with a Beihilfe top-up is the usual route, because Beihilfe covers part of the costs and the policy covers the rest.
In a public law training relationship (öffentlich-rechtliches Ausbildungsverhältnis), for example in some legal clerkships, the situation is different. Whether you are entitled to Beihilfe there is decided by your employer under the rules of your state. That answer determines whether you need a PKV with a Beihilfe top-up or a full policy without Beihilfe.
Comparison: GKV, PKV with Beihilfe and PKV with lump-sum Beihilfe
| Feature | Voluntary GKV | PKV with Beihilfe top-up | PKV with lump-sum Beihilfe |
|---|---|---|---|
| Basic principle | Contribution based on income, set by law | Beihilfe plus a private tariff for the remaining costs | Allowance towards contributions under state rules |
| Contribution | At least 222.80 euros per month for health insurance (calculated for 2026), plus long-term care insurance | Individual, depending on age, health and tariff | Individual; the allowance depends on your proven contributions |
| Benefits | Scope set by law | Scope depends on tariff, Beihilfe is topped up | Scope depends on tariff, allowance instead of invoice reimbursement |
| Health check | None | Yes, when you apply | Yes, when you apply |
The table shows the basic principles. Which option suits you depends on contributions, the scope of benefits and the rules of your state.
What does voluntary GKV cost during the clerkship?
Contributions to statutory health insurance are calculated from your contribution-liable income. Voluntary members are subject to a minimum contribution base, which for 2026 is 1,318.33 euros per month according to the Techniker Krankenkasse. Applying the reduced contribution rate of 14.0 percent and the average additional contribution of 2.9 percent gives 222.80 euros per month. This figure is our calculation from the minimum base and the rates. The additional contribution of your own fund may differ.
Long-term care insurance comes on top. At the contribution rate of 3.6 percent, this is 47.46 euros per month. For people without children from the age of 23, a surcharge applies, which makes it 55.37 euros per month. Together with health insurance, the total is 270.26 euros per month without the surcharge and 278.17 euros with it.
Assumed: You are 25, have no children, and your fund charges the average additional contribution. You would then pay 222.80 euros for health insurance and 55.37 euros for long-term care insurance, so 278.17 euros per month in total. Your actual contribution calculation depends on your contribution-liable income, which your fund checks.
What does private insurance cost during the clerkship?
We deliberately do not give a fixed figure for PKV premiums, because they depend on your age at entry, your health, the tariff and the scope of benefits. Trainee tariffs for civil servants often come with a reduced contribution. They deserve a separate look, which is why they are discussed separately.
A comparison makes sense once you can roughly estimate your remaining costs. Beihilfe covers one part, the tariff the rest. Contributions can therefore only be compared meaningfully against the costs you realistically expect.
What to look for when comparing PKV tariffs
Two tariffs with similar monthly contributions can differ considerably in what they pay. A comparison should therefore look beyond the premium and at the conditions that apply in a claim. The following points are a useful benchmark.
- Reimbursement rates for medical and dental treatment, especially for treatments above the standard fee.
- Scope for aids and therapies, such as physiotherapy, glasses or hearing aids, and whether the catalogue is open or closed.
- Rules on changing tariffs and on option rights, so you know whether you can move to a better tariff later without a new health check.
- What happens when you become a civil servant on probation, because trainee tariffs are often designed only for the training period.
- Coverage abroad, if you plan an elective placement or a stay abroad.
It helps to run the same example for two or three tariffs. Enter your expected costs and compare what remains for you at the end. This shows whether the extra cost of a tariff is offset by better reimbursement.
When does the opening offer apply?
The PKV opening offer is meant to make access easier for civil servants, including people with pre-existing conditions. According to the leaflet of the PKV association (status September 2022), the offer only applies within the first six months after the first appointment as a civil servant. The leaflet says the scope also includes civil servants on a provisional basis. If you clarify early whether the conditions apply to you, you can make use of the window.
Frequently asked questions
Do I have to be privately insured during the clerkship?
No, it is not mandatory. What matters is your status and whether you receive Beihilfe. With a Beihilfe entitlement, a PKV policy that is compatible with Beihilfe is the usual route. Without a Beihilfe entitlement, voluntary GKV or a full PKV policy may be options.
Can I switch from GKV to PKV later?
That depends on your status and on the terms of the tariff. Have the conditions confirmed in writing before you cancel an existing policy. The deadlines and consequences of a switch differ from case to case.
Is voluntary GKV expensive during the clerkship?
It has a fixed minimum contribution, which for 2026 is 222.80 euros per month for health insurance, plus long-term care insurance. Whether it costs less or more than a PKV policy depends on the costs you can expect and on the benefits that matter to you.
Who can help with the decision?
Your employer clarifies your status and Beihilfe. Your health insurance fund or insurer answers questions about contributions and benefits. For a personal assessment, you can speak to Academycon (in German).
What to do next
- Ask your employer whether you hold a civil servant position on a provisional basis and whether you are entitled to Beihilfe.
- Estimate your expected remaining costs for one year, for example for dental work, glasses and medication.
- Have contributions calculated for your age and health, for voluntary GKV and for at least one PKV tariff.
- Check the deadline of the opening offer before you submit a formal application.
Related articles
- Beihilfe in Thuringia: rates, out-of-pocket costs and PKV
- Health insurance during clerkship: GKV, PKV and Beihilfe
- Health insurance for Referendare in Germany
- Beihilfe during the clerkship (in German)
- Trainee pay by federal state (in German)
Sources: Contribution figures, GKV-Spitzenverband (status 1 January 2026); Section 243 SGB V, reduced contribution rate (gesetze-im-internet.de, in German); Minimum contribution rules for voluntary members, Techniker Krankenkasse (status 2026, in German); Leaflet for civil service entrants with pre-existing conditions or disabilities, PKV association (status September 2022, in German).
Last updated: October 2026. This guide is general information, not individual advice.
