The biggest PKV disadvantages for students are the binding effect and the development of premiums. The exemption from compulsory student insurance applies for the entire course of study and cannot be revoked, and premiums can rise later. In addition, there is the loss of free family insurance, the health check and the administrative effort with advance payment. Countermeasures exist for most of these points, but the binding effect itself cannot be reversed once you have applied. The arguments on the other side are set out in our article on the advantages of PKV during your studies (in German).
The most important points in brief
- You apply for the exemption within three months of the start of compulsory insurance. It applies irrevocably for the entire course of study.
- During the exemption, family insurance is excluded. This matters particularly if you are currently insured free of charge through your parents.
- The entry premium is not a guarantee. Premiums are adjusted if the required and calculated benefits diverge.
- You pay bills yourself first. They can be submitted within three years from the end of the billing year.
- Returning to statutory insurance is possible, but subject to conditions. From age 55, it is generally excluded.
What are the PKV disadvantages for students at a glance?
| Disadvantage | Why it matters | What you can do |
|---|---|---|
| Binding effect | The exemption applies for the entire course of study and is irrevocable. | Clarify your career path and life plans before you apply |
| No family insurance | It is excluded for the duration of the exemption. | Check beforehand whether you could use it |
| Premium development | Premiums can be adjusted after review by the insurer. | Use the tariff change option with your own insurer |
| Health check | Ongoing treatments often lead to rejection. | Submit an anonymous risk enquiry in advance |
| Advance payment and effort | You pay bills yourself and submit them. | Build a reserve and note the deadlines |
| Tariff conditions | The tariff determines what is reimbursed. | Check the deductible and the catalogue of aids |
How binding is the exemption from compulsory insurance?
Very binding. The exemption generally applies for the entire course of study, and the law expressly states that it cannot be revoked. A switch to statutory health insurance is normally only possible after your studies, for example through employment subject to compulsory insurance.
What you can do about it: use the three-month deadline to think things over. The application takes effect retroactively from the start of the obligation if you have not yet claimed any benefits from the fund by then. So you do not have to decide on the first day, but you should note the deadline in your calendar. The exemption only becomes effective once you prove other cover, usually with a private contract. A comparison is set out in PKV or statutory insurance as a student (in German).
What is lost with family insurance?
Anyone who obtains an exemption does not meet the requirement of “not exempt from compulsory insurance”. Free family insurance is excluded for the duration of the exemption. It is possible through a parent with statutory insurance until the age of 25 during your studies, as long as your total income does not exceed €565 per month (2026). For a minijob, the limit is €603. BAföG, child benefit and maintenance do not count as income.
Check before you apply whether you have this entitlement, because with the exemption you give it up for the duration of your studies. The legal basis is set out in § 10 SGB V.
Why can PKV premiums rise?
At least once a year, the insurer compares the required benefits with the calculated benefits and mortality probabilities for each tariff. If the deviation exceeds the threshold of 10 per cent, the premiums are reviewed and adjusted if necessary. Tariff conditions may lower the threshold to 5 per cent, and an independent trustee must approve the adjustment.
The ageing reserve, into which a statutory surcharge of 10 per cent flows, absorbs part of this effect. Countermeasures: with your own insurer, you have a right to switch to other tariffs with similar cover, and the accrued rights and the ageing reserve are credited. A reduction of the deductible counts as additional cover, and for additional cover the insurer may demand an exclusion of benefits or a risk surcharge. How the system is structured at its core is shown in PKV explained simply (in German).
There is a special rule for children of civil servants: with Beihilfe, the premium during your studies can initially be low. Beihilfe usually ends with the 25th birthday, when the family supplement falls away, and the burden then rises significantly.
How does the health check affect you?
The application contains health questions that you must answer truthfully. You must disclose known circumstances that are material to the insurer under § 19 of the German Insurance Contract Act (VVG) if you are asked about them in text form. If you breach this duty, the insurer can withdraw from the contract, but withdrawal is excluded without intent and gross negligence.
Ongoing treatments and recommended operations often lead to rejection. The countermeasure is the anonymous risk enquiry before the application: you find out how an insurer assesses your information before an application is made.
What do advance payment and administrative effort mean?
You pay the doctor’s bill yourself and submit it to the insurer. The reimbursement follows your tariff. You can submit bills within three years from the end of the year in which the bill was issued. A bill from March 2026, for example, must be submitted by 31 December 2029. For inpatient treatment, the hospital and the insurer usually settle the bill directly.
You can limit the effort. Build a reserve for larger bills, collect receipts in one place and check bills for the GOÄ factors: above the threshold of 2.3, the doctor must justify a service on the bill.
What happens if you cannot pay your premiums?
If you remain in arrears, the contract switches to the emergency tariff (Notlagentarif). The first reminder is sent when arrears amount to two monthly premiums, and the second two months later. The emergency tariff only covers acute illness and pain, pregnancy and maternity, and children and young people. Statutory student insurance, by contrast, has a fixed base premium of €87.38 per month, to which long-term care insurance and the additional contribution are added.
How do you return from PKV to statutory insurance?
Before your 55th birthday, a return is generally possible, for example through employment subject to compulsory insurance below the annual earnings threshold of €77,400 (2026). A minijob is not enough. A working student job with up to 20 hours per week during the lecture period also remains exempt from health insurance and so is not a route back. More on this is in our article on PKV for working students (in German).
If you become subject to statutory insurance, you can terminate the private insurance retroactively to the start of the obligation within three months. The termination is invalid if you do not prove the start of the obligation within two months of the insurer’s written request. Anyone who would become subject to compulsory insurance after the age of 55 generally remains exempt if they were not statutorily insured in the five years before and were exempt or privately insured for at least half of that time. Your health insurer will clarify whether the return is possible in your case. More on the conditions is available from the Verbraucherzentrale (in German).
Frequently asked questions
What are the disadvantages of PKV for students?
The exemption is irrevocable and applies for the entire course of study, family insurance is excluded during this time, premiums can be adjusted, and the health check can lead to rejection. Advance payment and administrative effort for bills come on top.
Can I return to statutory insurance later?
That is generally only possible after your studies, when you are in employment subject to compulsory insurance and below the annual earnings threshold of €77,400 (2026). A minijob is not enough. From age 55, the return is generally excluded. Your health insurer will clarify whether it works in your case.
Does the PKV premium rise during my studies?
Premiums are adjusted if the deviation between calculated and required benefits exceeds the threshold, which is 10 per cent by law and may be 5 per cent under the tariff conditions. A trustee must approve the change. In addition, Beihilfe for children of civil servants generally ends with the 25th birthday.
Do I lose family insurance if I obtain an exemption?
Yes, for the duration of the exemption. Anyone exempt from compulsory insurance does not meet one of the requirements for family insurance. Check before you apply whether you meet the income limit of €565 per month (2026).
How to proceed now
- Check whether you would be entitled to family insurance, and compare it with an offer.
- Note the three-month deadline from the start of your compulsory insurance.
- If you have pre-existing conditions, submit an anonymous risk enquiry.
- Decide how you will advance bills and manage the deadlines.
If you want to talk through your situation, you will find the way to advice on the Academycon homepage (in German). The overall picture of costs and benefits is in private health insurance during your studies at a glance (in German).
You can find reviews of us on ProvenExpert, Trustlocal and Trustindex. Academycon was mentioned, among other things, in a press release from Frankfurter Rundschau. An overview of all mentions is on the press page (in German).
Related articles
- Private health insurance for students: costs and benefits (in German)
- Advantages of PKV for students: what speaks for switching (in German)
- What is PKV for students? Structure, principle and process (in German)
- PKV or statutory insurance as a student: what pays off more? (in German)
Last updated: October 2026. This guide is general information, not individual advice. The German version is authoritative.
