If you can no longer pay your private health insurance (PKV) premium, contact your insurer as early as possible, before reminders arrive. Once arrears amount to two monthly premiums, a statutory dunning procedure begins, which can end with a move to the emergency tariff. This tariff only covers acute illnesses and pain, pregnancy and childbirth, and children and young people.
That sounds threatening, but it is easier to avert if you act early. Payment problems in PKV arise, for example, from premium adjustments, a tight student budget or lost income, and can happen to anyone.
The key points in brief
- The first reminder follows when arrears reach two monthly premiums, and the second one two months later.
- If an outstanding premium plus late-payment surcharges remains after that, the contract is suspended and you move to the emergency tariff.
- The emergency tariff only covers acute illnesses and pain, pregnancy and childbirth, and children and young people.
- Once all arrears are paid, you return to your old tariff from the month after next.
- A conversation with your insurer and a tariff switch are usually better than cancelling without continuous cover.
What happens if you do not pay your PKV premium?
The procedure is set out in the Insurance Contract Act (Versicherungsvertragsgesetz, section 193(6) VVG). It runs in stages.
- When arrears reach two monthly premiums, you receive the first reminder.
- Two months later, the second reminder follows.
- If one monthly premium plus late-payment surcharges is still outstanding after that, the contract is suspended from the first day of the following month.
- You are placed in the emergency tariff.
Example: Assumption: your premium is €180 per month. The first reminder follows as soon as two monthly premiums are outstanding, that is, at arrears of €360. Each further month without payment increases the arrears by €180 plus any late-payment surcharges.
What is the emergency tariff?
The emergency tariff is protection on a low setting. It covers acute illnesses and pain, pregnancy and childbirth, and children and young people, including preventive care for children and the vaccinations recommended by the STIKO (Standing Vaccination Committee). No new ageing provisions are built up during this time.
The good news: once you have paid all arrears, you return to your old tariff from the month after next.
What can you do about PKV payment problems?
Do not face the problem alone. The earlier you act, the more room you have.
- Talk to your insurer: Describe your situation and ask for a solution. Whether instalments or deferral are possible is something you clarify directly with your insurer.
- Calculate your arrears: Note how many monthly premiums are outstanding. That shows you which reminder stage you are in.
- Keep the letters: File reminders and notices so that you keep track of deadlines.
- Check funding: As a student, you can ask the BAföG office whether you are entitled to supplements for health and long-term care insurance, and how much (currently €102 and €35 for students under 30).
- Seek advice: An independent debt advice service or the consumer advice centre (Verbraucherzentrale) can help you get an overview of your finances.
Can you lower the premium without cancelling?
Yes, often through a tariff switch. Under section 204 VVG, you are entitled to switch to other tariffs with similar cover at your own insurer, with accrued rights and ageing provisions credited. The insurer may only charge a surcharge, exclude benefits or impose a waiting period for additional benefits. A reduction in the deductible counts as an additional benefit. How health questions in PKV (in German) play a role is covered in a separate article. The guidelines of the PKV Association (German) describe the process.
The basic tariff offers benefits similar to statutory health insurance, and its maximum premium equals the statutory maximum contribution. It is therefore not automatically cheaper. If you are in need, the premium is halved on application. Whether you can switch as someone already privately insured depends on your situation and is subject to conditions, for example receiving social assistance or basic income support. Ask your insurer.
Does cancelling help with payment problems?
Rarely. A contract that meets compulsory insurance requirements can only be cancelled if an equivalent contract is in place with another insurer. The cancellation only takes effect if continuous follow-on cover is proven within two months. For students who were exempted from compulsory insurance, the following also applies: the exemption cannot be revoked. A return to statutory health insurance (GKV) is normally only possible after the end of your studies, for example through employment subject to compulsory insurance. The article on cancelling PKV during your studies (in German) explains how.
How do you avoid payment problems with PKV?
Plan the premium with room to spare before you sign. In 2026, statutory student health insurance costs around €143 to €148 per month. A PKV premium should be affordable in the long term, even if it rises later.
Premiums can change. At least once a year, the insurer compares the required benefits with the calculated benefits. If the figure deviates by more than 10%, the premiums are reviewed and adjusted where necessary, and the tariff conditions may lower this threshold to 5%. An independent trustee must agree. If the insurer raises the premium, you have a special right of termination of two months from receipt of the notice.
For students entitled to Beihilfe (state aid for civil servants), there is another point: Beihilfe generally ends at the age of 25 when the family supplement ends, and the cost burden then rises significantly. If you want to check the numbers before you sign, look at the cost-effectiveness of PKV (in German) over many years. The path to a contract is explained in how to switch to PKV as a student (in German).
Frequently asked questions
What happens if I cannot pay my PKV premium?
When arrears reach two monthly premiums, the first reminder follows, and two months later the second. If a premium plus late-payment surcharges remains outstanding after that, the contract is suspended and you are placed in the emergency tariff.
Do I lose my insurance cover?
You do not lose it completely, but it is heavily restricted. The emergency tariff covers acute illnesses and pain, pregnancy and childbirth, and children and young people. Other treatment is not covered.
Can I defer my PKV premium?
Whether your insurer offers deferral or instalments is something you clarify directly with them. Get in touch before the first reminder, because that is when your chances of finding a solution are best.
How do I return from the emergency tariff?
Once you have paid all arrears, you return to your old tariff from the month after next. All outstanding premiums, including late-payment surcharges, must be settled first.
What to do now
- Read the reminder carefully and note the arrears and deadlines.
- Call your insurer or write to them and describe your situation.
- Ask about a tariff switch, a higher deductible or other relief.
- If needed, get help from a debt advice service or the consumer advice centre.
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 press release by Kurier. A full list of mentions is on the press page (in German).
Related articles
- Cancelling PKV during your studies: deadlines, process and proof (in German)
- PKV health check: what you need to know (in German)
- Is PKV worth it during your studies? The calculation over many years (in German)
- Switching to PKV as a student: process, application and documents (in German)
Last updated: October 2026. This guide is general information, not individual advice. The German version is authoritative.
