The basic tariff in private health insurance is a statutory tariff with benefits at the level of the statutory health insurance (gesetzliche Krankenversicherung, GKV). Insurers must offer it without risk surcharges or exclusions, and its premium is capped at the top. For all other tariffs, including those that insurers market as comfort or premium levels, the insurer itself sets the scope of benefits, the health check and the premium in the tariff conditions. This is the essential difference from the basic tariff.
Key points at a glance
- The basic tariff offers benefits like the GKV. Anyone with access rights is accepted without a risk surcharge and without an exclusion, and cover starts immediately.
- The maximum premium equals the GKV maximum contribution. If you are in need, it is halved on application.
- Access is restricted, and people who are already privately insured face additional conditions.
- For students who are exempted from compulsory insurance, the student tariff is the usual route into private health insurance. Tariffs above GKV benefits require a health check.
What is the basic tariff in private health insurance?
The basic tariff is a type of tariff that every insurer must offer. Its scope of benefits corresponds to that of the statutory health insurance. There is a duty to contract: insurers may not charge risk surcharges or exclude benefits, and cover starts immediately. Relatives cannot be covered under family insurance in the basic tariff (§ 152 VAG, Insurance Supervision Act). Aids are a special case: the GKV aids directory is generally not binding in private health insurance, but it is binding in the basic tariff.
What does the basic tariff cost?
The premium in the basic tariff is capped at the maximum contribution of the statutory health insurance. This maximum is derived from the contribution assessment ceiling, which in 2026 is €5,812.50 a month. This results in an upper limit of around €1,017 a month. If you are in need, the premium is halved on application. Your insurer will tell you the exact amount that applies in your case.
What does comfort tariff mean in private health insurance?
The term comfort tariff does not describe a tariff type defined by law. Insurers give their benefit levels different names, and what lies behind them is set out in the tariff conditions. So do not rely on the name when comparing, but read the tariff conditions.
Check points that make the difference from the basic tariff:
- Reimbursement rates: 75, 90 or 100 per cent are common, often with maximum amounts.
- Aids: An open catalogue reimburses all medically necessary aids, a closed one only the listed ones.
- Excess: An annual share of costs affects the premium.
- Health check: The application contains health questions that you must answer truthfully.
How to line up offers systematically is shown in our article on comparing PKV tariffs (in German) and in our checklist for choosing a tariff (in German).
Basic tariff and comfort tariff compared
| Feature | Basic tariff | Benefit levels above the GKV |
|---|---|---|
| Rules | Set by law | Set by the insurer in the tariff conditions |
| Scope of benefits | As the GKV | As set out in the tariff, with its own reimbursement rates and maximum amounts |
| Health check | No risk surcharges, no exclusions | Surcharge, exclusion or refusal possible |
| Premium | At most the GKV maximum contribution, halved on application if in need | Calculated individually |
| Aids | GKV aids directory applies | Open or closed catalogue depending on the tariff |
| Relatives | No family insurance | Depends on the contract |
Who can get the basic tariff, and does it apply to students?
Access is restricted by law to certain groups. These include voluntarily insured people within six months of the start of their voluntary insurance, people entitled to state aid (Beihilfe) and to medical care under the Heilfürsorge scheme, privately insured people with a contract dating from 1 January 2009, and uninsured people who are not sufficiently insured and not subject to compulsory insurance. People who are already privately insured can only switch under certain conditions, for example from the age of 55, on receiving a pension, or on receiving social assistance or basic income support.
If you do not want GKV compulsory insurance as a student, you apply for an exemption and then normally take out a student tariff. This tariff is aimed at young first-time policyholders up to the age of 30. The exemption applies for the whole of your studies and cannot be revoked. The application must reach your health insurer within three months of the start of your compulsory insurance. Our article on switching to private health insurance (in German) describes the process. For orientation, the German Consumer Advice Centre (Verbraucherzentrale) offers an overview of the options.
Can I switch between tariffs later?
With your own insurer, § 204 VVG gives you a right to switch to tariffs with equivalent cover, with your accrued rights and ageing provisions carried over. For additional benefits, the insurer may impose an exclusion of benefits or an appropriate risk surcharge. Our article on switching tariffs in private health insurance (in German) explains how the change works. If payments fall into arrears, there is a risk of moving to the emergency tariff, which only covers acute illness and pain.
Frequently asked questions
What is the difference between the basic tariff and the standard tariff?
The standard tariff has been closed since 1 January 2009. Only people who had a contract before that cut-off date and meet further conditions, such as ten years of prior insurance, have access. The basic tariff, by contrast, remains open to the groups named in the law.
Is the basic tariff a sensible option for students?
For most students it is not the usual route. Those who are exempted normally take out a student tariff, whose benefits and health check the insurer sets itself. Whether the basic tariff is accessible to you at all depends on your insurance history, and you can clarify this with the insurer or in a consultation.
Can the insurer reject me for the basic tariff?
If you belong to one of the access groups, you are accepted without risk surcharges and without exclusions. Cover starts immediately. If you do not belong to these groups, you have no entitlement to the basic tariff.
What is the maximum premium for the basic tariff?
At most the GKV maximum contribution, which works out at around €1,017 a month in 2026. The calculation is based on the contribution assessment ceiling of €5,812.50 a month. If you are in need, the premium is halved on application. Your insurer will state the exact amount.
How to proceed now
- Find out which group you belong to: exempted students, voluntarily insured people and people entitled to state aid are subject to different rules.
- Observe the three-month deadline for the exemption from compulsory insurance.
- Compare offers by reimbursement rates, aids catalogue and excess, and read the tariff conditions.
- Before an application with health questions, make an anonymous risk enquiry.
If you want to talk through your situation, you will find the route to advice on the Academycon homepage.
You can read about experiences with us on ProvenExpert, Trustlocal and Trustindex. Academycon was mentioned, among other places, in a report in VersicherungsJournal. An overview of all mentions is on our press page.
Related
- Private health insurance benefits for students: an overview (in German)
- Returning to the GKV: when a switch back from private insurance is possible (in German)
- PKV or GKV as a student: which is worth more? (in German)
Last updated: October 2026. This guide is general information, not individual advice. The German version is authoritative.
