The PKV health check consists of the health questions in the application. You must answer them completely and truthfully. The insurer then decides whether to accept you unchanged, charge a risk surcharge, exclude certain benefits or refuse the application. If you want to join PKV as a student, the check must be completed within the three-month exemption period, because the exemption from compulsory insurance only takes effect once you prove other cover.
An anonymous risk enquiry before the application shows you how an insurer assesses your details, without committing you to anything.
The key points at a glance
- Answer the health questions in the application truthfully. False information can lead to withdrawal from the contract.
- Possible outcomes are acceptance on normal terms, a risk surcharge, an exclusion or refusal.
- Ongoing treatment and recommended operations have a particularly strong effect on acceptance.
- An anonymous risk enquiry before the application is worthwhile.
- Even with a later tariff change, the insurer may demand a surcharge, an exclusion or a waiting period for additional benefits.
How does the PKV health check work?
You answer the health questions that the insurer asks in text form in the application. It then assesses the risk and decides on acceptance.
- If you are unsure, first make an anonymous risk enquiry.
- Complete the application, including all health questions.
- The insurer checks your answers and can ask follow-up questions if something is unclear.
- You receive the decision: acceptance, acceptance with a surcharge or exclusion, or refusal.
If you want to know the full route to the contract, you will find it in the article on switching to PKV as a student (in German).
Which health questions does PKV ask?
Typical questions concern diagnoses, treatments, medication and current complaints. The insurer decides which questions it asks. Answer what is asked, and answer completely. If you have documents from earlier treatment, they help you give precise details.
Why must you answer honestly?
Before the contract is concluded, you must disclose known circumstances that are significant to the insurer and about which it has asked in text form (section 19 VVG). If you breach this duty, the insurer can withdraw from the contract. Without intent or gross negligence, withdrawal is excluded, but the insurer can then terminate with one month’s notice.
The insurer has these rights only if it has informed you of the consequences in a separate notice in text form. It must assert them within one month of becoming aware (section 21 VVG). They lapse five years after the contract is concluded, or after ten years in cases of intent or fraud.
So do not leave anything out, even if a detail is uncomfortable. A contract that is later called into question does not help you when you are ill.
What results can the health check have?
| Outcome | What it means | What you can do |
|---|---|---|
| Acceptance on normal terms | The insurer accepts you without a surcharge and without exclusions. | Accept the offer and keep the deadline in view. |
| Risk surcharge | You pay an addition to the tariff premium. | Compare offers and check whether the surcharge fits your budget. |
| Exclusion | Certain conditions or benefits are not covered. | Check whether the exclusion is acceptable for you. |
| Refusal | The insurer does not accept the application. | Ask for the reasons and review the decision calmly. |
Example: A tariff costs €150 per month and the insurer demands a surcharge of 20 per cent. The surcharge is €30, so you pay €180 per month. The figures are for illustration only. The insurer decides how high a surcharge is in your individual case.
What is an anonymous risk enquiry?
With an anonymous risk enquiry you describe your health details without giving your name. The insurer then states whether, and under what conditions, it would accept you. This shows you in advance whether a surcharge or exclusion is likely before you submit the actual application. The assessment is not a promise for the later application. It is particularly useful if you are undergoing treatment or an operation has been recommended.
What does the health check mean for students?
As a student you are initially in statutory compulsory insurance. You apply for the exemption within three months of the start of compulsory insurance, and it only takes effect if you prove other cover, in practice a private contract. If the insurer refuses, you remain in the statutory fund. So plan the application early. The exemption generally applies to the whole course of study and cannot be revoked.
Before enrolment, the university also requires digital confirmation of statutory cover, even from privately insured students.
If you want to join PKV with a pre-existing condition (in German), you will find the details there. Whether the route is worthwhile at all is shown by the calculation behind PKV (in German).
Is there PKV without a health check?
Acceptance without health questions is the exception. In the basic tariff there is an obligation to accept, without risk surcharges or exclusions, but access is tied to conditions. It is open, for example, to people entitled to Beihilfe, and to voluntarily insured members of statutory funds within six months of starting voluntary insurance.
Civil servants also have an opening action. The application must be made within the first six months after the first appointment as a civil servant. The risk surcharge is at most 30 per cent of the tariff premium, and there are no exclusions. The details are in the information sheet of the PKV association. More on this is in acceptance without health questions (in German).
Does the health check apply to a tariff change too?
Only in a limited way when you change within your own insurer. Under section 204 VVG, you are entitled to switch to other tariffs with similar cover. Acquired rights and ageing provisions are credited. Only for additional benefits may the insurer demand an exclusion or an appropriate risk surcharge and, where necessary, a waiting period. An exclusion for the additional benefit can avert the surcharge and the waiting period. A lower deductible counts as an additional benefit. The guidelines of the PKV association describe the process.
How to prepare for the health check
- Collect doctors’ letters, findings and medication details from earlier treatment.
- Note diagnoses, periods of treatment and medication before you fill in the application.
- Make an anonymous risk enquiry if you have had or currently have treatment.
- Answer every question completely and truthfully.
- Start early so that you meet the three-month deadline for the exemption.
Frequently asked questions
What is the PKV health check?
The health check means answering the health questions in the PKV application. The insurer uses your answers to assess the risk and decides on acceptance, surcharge, exclusion or refusal.
Can PKV refuse my application?
Yes. Ongoing treatment and recommended operations often lead to a refusal. In the basic tariff, by contrast, there is an obligation to accept, but access is tied to conditions. An anonymous risk enquiry shows you in advance what to expect.
What happens if I give false information?
The insurer can withdraw from the contract. Without intent and gross negligence, withdrawal is excluded, but the insurer can then terminate with one month’s notice. This requires that it informed you of the consequences in a separate notice in text form.
How can I find out whether a risk surcharge is likely?
Most reliably with an anonymous risk enquiry before the application. It tells you whether a surcharge or exclusion is possible, without committing you.
So what should you do now
- Check whether any of the health questions apply to you in a way that worries you.
- Make an anonymous risk enquiry and compare the responses.
- Decide whether the surcharge or exclusion is acceptable for you.
- Submit the application only once you have the three-month deadline in view.
If you want to talk through your situation, you will find the way to advice on the Academycon homepage.
You can read about our work on ProvenExpert, Trustlocal and Trustindex. Academycon was mentioned, among other places, in a press release on the portal of the Süddeutsche Zeitung. An overview of all mentions is on the press page.
Related reading
- PKV without a health check: does it really exist? (in German)
- PKV with pre-existing conditions: what applies to students (in German)
- Is PKV worth it during your studies? The calculation over many years (in German)
- Living healthily during your studies (in German)
Last updated: October 2026. This article provides general information and does not replace individual advice.
