PKV benefits for students depend on the tariff you choose. In statutory health insurance (GKV), the same statutory catalogue of benefits applies to everyone. In private health insurance (PKV), the contract states what is reimbursed and to what extent. Students face one particular feature: the decision for PKV is made at the start of studies, the application for exemption from compulsory insurance must be submitted within three months of the start of compulsory insurance, and the exemption then applies for the entire course of study.
The most important points in brief
- If you want to be privately insured during your studies, you need the exemption from compulsory insurance. It is irrevocable and normally applies for the entire course of study.
- PKV benefits are set in the tariff: reimbursement rates, deductible, inpatient extras, and dental and aids components differ from provider to provider.
- GKV works with benefits in kind and co-payments: currently generally 10 per cent, at least 5 euros, at most 10 euros. Higher co-payments have been decided for 2027.
- The PKV premium depends on entry age, health status and tariff, not on income, and it can rise later.
- A return to statutory insurance is normally not possible during your studies.
Who can be privately insured during their studies?
Anyone enrolled at a state or state-recognised university is in principle subject to statutory insurance, unless a priority insurance applies. On application, the health insurer exempts you from this obligation (section 8 of the Social Code Book V). The deadline is three months from the start of compulsory insurance. The exemption takes effect retroactively if you have not used any benefits from the health insurer by then. Otherwise, it takes effect from the month following the application.
The exemption only takes effect once you prove other protection in case of illness, in practice a private contract. The university nevertheless requires confirmation from a statutory insurer for enrolment, including from privately insured persons. The exemption cannot be revoked. A switch to statutory insurance is normally only possible after your studies, for example through employment subject to compulsory insurance. The Verbraucherzentrale (in German) explains the options for students in an overview.
Even without an exemption, PKV becomes a topic later. Student compulsory insurance ends at the end of the semester in which you turn 30. Beyond that, it only applies if the type of training or personal reasons justify going beyond this. Anyone who completes a doctorate after a university degree is no longer subject to student compulsory insurance, according to the case law of the Federal Social Court. In both cases, your further cover depends on your situation: with employment subject to compulsory insurance you normally move into statutory compulsory insurance, otherwise voluntary statutory or private insurance remains.
What are the PKV benefits for students at a glance?
PKV replaces statutory health insurance entirely. The table shows which areas it covers and how it differs from the GKV. The PKV column describes what matters in the tariff, because there are no fixed values in that column.
| Area | PKV (depends on the tariff) | GKV |
|---|---|---|
| Outpatient treatment | Doctor’s bill reimbursed according to the tariff, often with a deductible | Benefit in kind via the insurance card, co-payments on medicines and aids |
| Hospital | Extra services such as treatment by the chief physician and single or double rooms, depending on the tariff | Standard services, 10 euros co-payment per day for up to 28 days |
| Dental prosthetics | Reimbursement rate according to the tariff, sometimes with maximum amounts | Fixed subsidy, in 2026: 60 per cent of the standard supply |
| Glasses and aids | Open or closed aids catalogue, reimbursement rates usually 75, 90 or 100 per cent | Aids where necessary, glasses for adults only in cases of severe visual impairment |
| Vaccinations | According to the tariff | Vaccinations recommended by the STIKO are a compulsory benefit |
| Travel costs | According to the tariff | Only where medically necessary and usually with approval |
| Psychotherapy | According to the tariff | Consultation as an entry point, short- and long-term therapy on application |
Many insurers grade their tariffs into benefit levels, from a lean basic cover to tariffs with extensive extra services. Where the limits lie is decided by each provider. For this reason, always compare the conditions, not the tariff names.
How does billing work in PKV?
PKV follows the principle of cost reimbursement: you first pay the doctor’s bill yourself and submit it to the insurer. There is no direct contractual relationship between doctor and insurer. For inpatient treatment, the hospital usually bills the insurer directly.
Doctors bill according to the German scale of medical fees (GOÄ). For personal medical services, the threshold is 2.3 times the standard rate and the maximum rate is 3.5 times. Up to the threshold, the doctor needs no justification; above it, they must justify each service on the bill. You can submit bills within three years from the end of the year in which they were issued. A bill from March 2026, for example, can be submitted until 31.12.2029.
What does PKV cover at the doctor and for medicines?
For outpatient treatment, the tariff reimburses the costs of doctor visits, diagnostics, therapies and medicines at the agreed level. Reimbursement rates and an annual deductible that you bear yourself are common. How quickly privately insured patients get appointments is explained in appointments as a privately insured patient (in German). The rules on prescriptions and co-payments can be found under medicines in PKV (in German).
In the GKV, the central appointment service under the number 116117 arranges a specialist appointment within one week, and the waiting time must not exceed four weeks. There is no entitlement to a specific doctor.
What does PKV pay in hospital?
The inpatient component often includes extra services: treatment by the chief physician and accommodation in a single or double room. Tariffs also differ in which hospitals they reimburse. What a tariff pays in an ordinary hospital is described in PKV and hospital stays (in German). For hospitals without statutory approval, see What is a private clinic? (in German).
What does PKV cover for dental care?
PKV tariffs regulate dental treatment and dental prosthetics separately, often with maximum amounts and a scale in the first years of insurance. The GKV pays a fixed subsidy for dental prosthetics: in 2026 it is 60 per cent of the standard supply. A reduction to 50 per cent has been decided for 2027. The details are in PKV and dental benefits (in German).
What applies to glasses, aids, check-ups and vaccinations?
For aids, PKV tariffs distinguish between an open catalogue, which reimburses all medically necessary aids, and a closed one, which lists only aids explicitly named. The GKV aids directory is not binding for PKV, except in the basic tariff. In the GKV, adults are entitled to glasses only in cases of severe visual impairment, as a rule from more than 6.0 dioptres of short- or long-sightedness or more than 4.0 dioptres of astigmatism. What tariffs pay for glasses is described in PKV and glasses (in German).
Vaccinations recommended by the STIKO are a compulsory benefit of the GKV. The binding basis is the vaccination directive of the Federal Joint Committee. What lies outside this directive is not a compulsory benefit. Ask your insurer whether it covers such vaccinations voluntarily. In PKV, the tariff determines which vaccinations and preventive check-ups are reimbursed. More on this is in PKV and vaccinations (in German) and PKV preventive benefits (in German).
Who pays for patient transport and treatment abroad?
The GKV covers patient transport only where it is medically necessary and prescribed; for outpatient treatment, usually only with prior approval. In addition, a co-payment of 10 per cent applies, at least 5 euros and at most 10 euros per journey. In PKV, the tariff decides what counts as a reimbursable journey. Details are under patient transport in PKV (in German).
Abroad, protection also varies by tariff. As a guide, the European Health Insurance Card of the GKV applies in the EU, the EEA and Switzerland, and covers medically necessary benefits under the rules of the country you are in. The GKV does not pay for repatriation to Germany. Insurers and the Verbraucherzentrale therefore recommend private travel health insurance that matches the length and scope of your trip.
What does PKV cost during your studies, and what comes later?
The premium depends on entry age, health status at the conclusion of the contract and the tariff. Income plays no role. From the calendar year after your 21st birthday at the latest, a statutory surcharge of 10 per cent is added to the premium, which flows into the ageing reserve and is intended to dampen premiums in old age. Premium adjustments are possible: if actual benefits deviate from calculated benefits by more than 10 per cent (tariff conditions may provide for 5 per cent), premiums are reviewed and adjusted with the approval of an independent trustee. In the event of an increase, there is a special right of termination, but a termination only takes effect with uninterrupted follow-on cover. How high premiums are during your studies is described in What does PKV cost for students? (in German).
With Beihilfe, the premium during studies can be low at first. For eligible children, the Beihilfe rate is usually 80 per cent, but the exact rates are set by the Beihilfe office. Beihilfe generally ends on reaching the age of 25, after which the burden rises noticeably.
What happens during the health check?
The application contains health questions that you must answer truthfully. Ongoing treatments and recommended operations often lead to rejection. If you are unsure, you can make an anonymous risk enquiry before applying. If you conceal known circumstances about which the insurer has asked, the insurer can withdraw from the contract. If you acted without intent and without gross negligence, withdrawal is excluded, but the insurer can then terminate with one month’s notice.
Frequently asked questions
How long do I have to be exempted from compulsory insurance?
The application must reach your health insurer within three months of the start of compulsory insurance. It takes effect retroactively if you have not used any benefits from the insurer by then. It only becomes effective once you prove other cover, usually a private contract.
Can I return to statutory insurance later?
Normally not during your studies, because the exemption applies for the entire course of study. Afterwards a switch is possible, for example through employment subject to compulsory insurance below the annual earnings threshold (2026: 77,400 euros a year). A mini-job is not enough. Anyone who would only become subject to compulsory insurance after their 55th birthday generally remains exempt.
Do I have to pay doctors’ bills upfront?
For outpatient treatment, yes. You pay the bill and submit it to the insurer, which reimburses according to the tariff. For inpatient stays, billing usually runs directly between hospital and insurer. You have three years from the end of the billing year to submit bills.
Which benefits are the same in every PKV tariff?
There is no fixed list. Tariffs may differ in scope, rates and maximum amounts. The basic tariff is an exception, as its scope of benefits corresponds to that of the GKV. Compare therefore the tariff conditions, especially for aids, dental benefits, choice of hospital and deductible.
What to do now
- Note the date on which your compulsory insurance begins and the three-month deadline for the exemption application.
- Read the tariff conditions on hospital, dental care, aids and deductible, and note the differences from the GKV.
- If you have pre-existing conditions, make an anonymous risk enquiry before applying.
- Plan how you will fit premiums and deductible into your budget, even if they rise later.
- If you want to talk through your situation, you will find the way to advice on the Academycon homepage (in German).
You can find reviews of us on ProvenExpert, Trustlocal and Trustindex. Academycon was mentioned, among other things, in a report in VersicherungsJournal (in German). An overview of all mentions is on the press page (in German).
Related articles
- Financing your studies without BAföG: how the money for university works (in German)
- What does PKV cost for students? (in German)
- Insurance for students: an overview (in German)
Last updated: October 2026. This guide is general information, not individual advice. The German version is authoritative.
