A premium adjustment for private health insurance requires you to check the insurer’s notice first and then decide whether to stay in your tariff, switch internally or terminate. The insurer may only adjust premiums if the deviation between required and calculated benefits exceeds a threshold and an independent trustee approves. You have three levers: first, switching tariffs with your own insurer under § 204 VVG; second, a higher excess; and third, the special termination right after receiving the notice.
The key points in brief
- The insurer compares required and calculated benefits, and mortality probabilities, at least once a year.
- The statutory threshold is 10 percent. Tariff conditions may lower it to 5 percent.
- You have a right to switch to other tariffs with similar cover at your own insurer, with credit for your acquired rights and the provision for ageing.
- After receiving the notice, you can terminate within two months at the time of the change. A contract that fulfils the duty to insure requires seamless follow-on cover.
When may the insurer make a premium adjustment?
The insurer checks at least once a year for each tariff whether the required benefits deviate from the calculated ones, and compares mortality probabilities (§ 155 VAG). If the deviation exceeds the limit, the premiums are reviewed and adjusted if necessary. The statutory limit is 10 percent (§ 203 para. 2 VVG). Tariff conditions may lower it to 5 percent, as the Federal Court of Justice has decided (judgment of 22.06.2022, IV ZR 253/20).
In addition, an independent trustee must approve. Why premiums can rise over the years is explained in premium increases in private health insurance (in German).
What to do when premiums rise?
Proceed in this order:
- Read the notice. Note the tariff, the new premium, the date of the change and the date on which the letter reached you. The deadline for the special termination right runs from that date of receipt.
- Classify the increase. Convert it into a yearly figure and set it against your budget.
- Check a tariff switch with your own insurer (see below).
- Check the excess and the scope of benefits if the premium no longer fits.
- Only then decide on termination and changing insurer.
Example: With a premium of €300 a month and an adjustment of 6 percent (assumed value), you pay €18 more, that is €318 a month and €216 more a year. Set this sum against the alternatives: a higher excess only saves money if you do not use it up during the year.
How does a tariff switch work after an increase?
Under § 204 VVG, you have a right to switch to other tariffs with similar cover at your own insurer. Acquired rights and the provision for ageing are credited. For additional benefits, the insurer may require an exclusion of services or an appropriate risk surcharge and, where applicable, a waiting period. A surcharge and a waiting period can be avoided by excluding the additional benefit.
Note: a reduction of the excess counts as an additional benefit. The voluntary guidelines of the PKV association provide that enquiries about a tariff switch should be answered within 15 working days. A switch from gender-neutral to gender-based tariffs is excluded. The tariff switch guidelines of the PKV association explain the procedure.
How can you reduce your private health insurance premium?
| Measure | Effect | What to watch |
|---|---|---|
| Increase the excess | Usually lowers the monthly premium | You bear more costs yourself. A later reduction counts as an additional benefit |
| Switch tariff | Different scope of benefits, different premium | Acquired rights are credited. Check gaps in the benefit catalogue |
| Use the premium refund | Part of the annual premiums is refunded | Requires that you submit no bills for a year and that the insurer makes surpluses. Usually not guaranteed |
Further approaches for existing contracts are in the article on saving on your premium during an existing contract (in German). What the PKV premium depends on (in German) is explained in a separate article.
Can you object to a premium increase?
You can have the notice checked. If in doubt, first write to the insurer and ask for the calculation to be explained. Check whether the tariff, the date and the amounts named are correct. Whether an increase is effective in the individual case can only be assessed by a legal review. For this, a consumer advice centre or a lawyer specialising in insurance law is the right contact. The deadline for the special termination right continues to run in the meantime, so do not let it pass.
When does special termination make sense?
After receiving the notice, you can terminate within two months at the time of the planned change (§ 205 para. 4 VVG). Because the deadline depends on receipt, note the date of receipt and, if in doubt, have the deadline confirmed by the insurer or a consumer advice centre. Two hurdles are important:
- A contract that fulfils the duty to insure can only be terminated if an equivalent contract exists with another insurer (§ 205 para. 6 VVG).
- The termination only takes effect if you prove seamless follow-on cover within two months of the termination. The Federal Court of Justice rules out retroactive effect (judgment of 14.01.2015, IV ZR 43/14).
Therefore, never terminate before the new insurance has confirmed cover. With another insurer you need a new application with health questions. If you were exempted as a student, termination does not lead back into compulsory student insurance, because the exemption is irrevocable. The procedure for switching is described in switching to PKV as a student (in German).
What happens if you cannot pay the increased premium?
Do not ignore arrears. If two monthly premiums are outstanding, the first reminder follows, and two months later the second. If a monthly premium with late-payment surcharges remains open, the contract is suspended and you move to the emergency tariff (Notlagentarif). It essentially only covers acute illnesses and pain, pregnancy and maternity, and children and young people. After paying all arrears, you return to the old tariff from the month after next. What you can do with payment problems is explained in what to do if the PKV premium cannot be paid (in German).
Frequently asked questions
How often may private health insurance raise premiums?
An increase is possible as soon as the review triggers it. The insurer checks at least once a year whether the conditions for an adjustment are met. An adjustment only takes place once the deviation exceeds the 10 percent threshold (or 5 percent if the tariff provides for it) and the trustee approves.
Do I have a special termination right after an increase?
Yes. You can terminate within two months after receiving the notice, at the time of the change. For a valid termination of compulsory insurance, you must prove seamless follow-on cover.
Can I switch to a cheaper tariff after an increase?
Yes, with your own insurer, to tariffs with similar cover, crediting acquired rights and the provision for ageing. For additional benefits, the insurer may require exclusions, surcharges or waiting periods. A reduction of the excess counts as an additional benefit.
Will the emergency tariff apply to me because of the increase?
The emergency tariff only applies in case of arrears, so after reminders. If you pay the new premium on time, you stay in your tariff. If you have difficulties, talk to the insurer early and check a tariff switch before arrears arise. After paying all arrears, you return to the old tariff.
So what should you do now?
- Note the date of receipt of the notice and calculate the two-month deadline.
- Ask your insurer in writing about tariffs with similar cover.
- Check whether a higher excess is manageable for you.
- Only terminate once the new contract has been confirmed.
If you want to talk through your situation, you will find the way to a consultation on the Academycon homepage.
You can find experiences with us on ProvenExpert, Trustlocal and Trustindex. Academycon was also mentioned, among other places, in a press release by Leinetal24. An overview of all mentions is on the press page (in German).
Related articles
- PKV premium development: what students should know (in German)
- Saving on your PKV premium (in German)
- How the PKV premium is calculated for students (in German)
- What to do if the PKV premium cannot be paid (in German)
Last updated: October 2026. This guide is general information, not individual advice. The German version is authoritative.
