Private Health Insurance: Vaccinations Explained

Whether private health insurance pays for a vaccination depends on your tariff. Here is what the STIKO recommends and how the GKV compares.

In private health insurance, your tariff decides whether and how much is paid for a vaccination. Statutory health insurance has a clear framework: vaccinations recommended by the STIKO (Standing Vaccination Committee) are a standard benefit. There is no uniform catalogue in PKV, so standard vaccinations, travel vaccinations and vaccinations at your own request differ from tariff to tariff.

Before any vaccination, clarify two questions: is it included in the benefits of your tariff, and is there a deductible that uses up the reimbursement?

The key points at a glance

Statutory health insurance pays for vaccinations recommended by the STIKO as a standard benefit.
In PKV, the tariff determines what is reimbursed. It may follow the STIKO recommendations and include travel vaccinations, limit them or exclude them.
The STIKO recommends the FSME vaccination for people exposed to ticks in risk areas, and the shingles vaccination from age 60, or from age 18 where the risk is increased.
You pay the bill first and submit it to the insurer, within three years after the end of the billing year.
Deductibles and premium refunds affect whether it is worth submitting a small vaccination bill.

Which vaccinations does the health insurer pay for, and which not?

Statutory health insurance pays for vaccinations recommended by the Standing Vaccination Committee (STIKO). The STIKO issues the recommendations, while the vaccination guideline of the Federal Joint Committee (G-BA) is the binding basis for the entitlement. Recommended vaccinations are a standard benefit of the GKV (sections 20d and 20i SGB V). An overview is provided by betanet on vaccinations.

For everything else, such as travel vaccinations or vaccinations without a STIKO recommendation for your situation, the position is less clear. Whether the health insurer pays then differs from fund to fund. Your health insurer will tell you its rules.

In PKV, reimbursement depends on the tariff. The emergency tariff, to which insured people switch automatically in case of arrears, includes STIKO vaccinations according to our review. Everything else is set by the individual tariff.

Which vaccination does the STIKO recommend, and who pays what?

The table shows, for the most important vaccinations, what the STIKO recommends, what the GKV covers as a standard benefit and how PKV handles them.

Vaccination	STIKO recommendation (status 22.01.2026)	GKV	PKV
FSME	People exposed to ticks in risk areas, also when travelling there	Standard benefit if recommended	According to tariff terms
Shingles	Two doses from age 60, from age 18 where the risk is increased	Standard benefit if recommended	According to tariff terms
HPV	Ages 9 to 14, catch-up until one day before the 18th birthday	Standard benefit if recommended	According to tariff terms
Hepatitis A and B	Increased risk, occupational exposure, hepatitis A for endemic areas	Standard benefit if recommended	According to tariff terms
Meningococcal	Standard for ages 12 to 14, catch-up up to age 25	Standard benefit if recommended	According to tariff terms
Flu	Yearly from age 60, and below that for underlying conditions and occupational risk	Standard benefit if recommended	According to tariff terms
Travel vaccinations (for example rabies, yellow fever, typhoid)	Travel recommendations from the STIKO and DTG (status 02.07.2026)	Rules differ by fund, ask	Fully, partly or excluded depending on the tariff
Vaccination without STIKO recommendation at your own request	No recommendation for your situation	Ask the fund on a case-by-case basis	Depends on the tariff

The recommendations correspond to the Epidemiological Bulletin 4/2026 of the Robert Koch Institute dated 22 January 2026, and the travel recommendations to the Epidemiological Bulletin 27/2026 dated 2 July 2026. Whether a vaccination is right for you is for you to decide with your doctor.

What is different in statutory health insurance?

In statutory health insurance, the Federal Joint Committee decides which vaccinations are standard benefits. The basis is the STIKO recommendations, and the vaccination guideline is binding (section 20i SGB V).

For vaccinations due to a stay abroad, the fund as a rule covers them as a standard benefit only for stays related to work, training or studies, and where there is a particular public interest in preventing the introduction of a disease. The condition is that the vaccination is listed in the vaccination guideline.

In addition, each health insurer may provide further vaccinations in its statutes. Such statutory services are voluntary. Your fund’s statutes determine which vaccinations these are.

How do PKV tariffs differ for vaccinations?

Because tariffs are designed freely, it pays to look at the terms. These points determine your own share:

Scope: Does the tariff cover only STIKO vaccinations, or also travel vaccinations and vaccinations without a recommendation?
Reimbursement rate: Do you get the full invoice amount back, or only a percentage?
Maximum amount: Is there an annual budget for vaccinations?
Deductible: How much do you pay yourself each year before the tariff reimburses anything?
Requirements: Is reimbursement tied to age, destination or a medical indication?
Consultation: Is the medical vaccination consultation reimbursed as well?

To see how vaccinations fit into the overall picture, read the overview of what PKV pays for.

Example: travel vaccinations before a semester abroad

Assumptions: Anna, 22, has private insurance and plans a semester abroad. The practice bills a total of 300 euros for the travel vaccinations. The amounts are freely chosen calculation figures and not a price quote.

Tariff	Rule	Reimbursement	Own share
A	Travel vaccinations at 100 percent	300 euros	0 euros
B	Travel vaccinations at 80 percent	240 euros	60 euros
C	Travel vaccinations excluded	0 euros	300 euros
D	Travel vaccinations at 100 percent, deductible of 500 euros per year, otherwise no invoices	0 euros	300 euros

Tariff D shows why the deductible matters: as long as the reimbursable invoices of a year stay below 500 euros, you bear everything yourself. If further invoices arrive in the same year, for example from the dentist, the limit can be reached. How the deductible is applied is governed by the conditions of your tariff.

How does reimbursement work?

If you have private insurance, you pay the doctor’s bill first and submit it to the insurer. There is no direct contractual relationship between the practice and the insurer. How much you get back depends on the tariff.

You can submit within three years after the end of the year in which the invoice was issued. Example: an invoice from March 2026 can be submitted until 31 December 2029. Still, submit it promptly. That way the reimbursement arrives sooner and the receipt does not get lost.

For travel vaccinations, it is worth asking before the appointment. Ask your insurer whether and how much the tariff reimburses for the vaccination, and ask the practice for a cost estimate. Both protect you from surprises.

Submit the invoice or keep the premium refund?

Some tariffs pay back part of the premiums if you submit no invoices for a year. This premium refund is usually performance-related and depends on the insurer’s surplus. With a small vaccination invoice, a calculation question therefore arises: what does the reimbursement bring, and what premium refund do you lose if you submit the invoice?

The answer depends on your tariff, the amount of the possible refund and the deductible. The tariff information from your insurer provides the figures you need.

Travel vaccinations case by case: rabies, hepatitis A, FSME and shingles

If you plan a semester abroad or a longer trip, clarify vaccinations early, because vaccination schedules need lead time. Vaccinations are only one part of protection abroad. What else you need for cover abroad is described under health insurance abroad.

What does the rabies vaccination cost, and who pays?

There is no fixed price. The costs depend on the vaccine, the practice and the vaccination schedule, and the practice will tell you the amount in advance. For a vaccination before the trip, reimbursement follows the terms of your tariff: a tariff that includes travel vaccinations in its benefits reimburses them, a tariff without this component does not. If you have had contact with a possibly rabid animal, see a doctor immediately.

Who pays for the hepatitis A vaccination, and what does it cost?

Whether the STIKO recommends the vaccination for your situation depends, among other things, on destination and risk. Ask your statutory health insurer in advance whether it pays. In PKV, the tariff counts. The vaccine and the practice set the price, and a cost estimate provides clarity.

FSME vaccination: does private health insurance pay?

Whether private health insurance pays for the FSME vaccination is decided by your tariff. If it follows the STIKO recommendations, the area where you live or stay plays a role. If it includes travel vaccinations only to a limited extent or not at all, you bear the costs in full or in part yourself. Ask the insurer before the appointment and get a cost estimate from the practice.

The STIKO recommends the FSME vaccination for people who are exposed to ticks in FSME risk areas. The recommendation therefore depends on the risk, which relates to the area where you live or stay and your activities. Check whether your tariff ties the vaccination to the recommendation or to an area.

Shingles vaccination in private health insurance: when is it paid?

Whether private health insurance pays for the shingles vaccination is decided by your tariff. The STIKO recommends two doses at an interval of 2 to 6 months from age 60. From age 18, the recommendation applies where the risk is increased, for example due to immunodeficiency or severe chronic underlying conditions.

Whether your tariff also reimburses the vaccination without a recommendation is set out in the terms. Whether you belong to the recommended groups is something to discuss with your doctor. When comparing tariffs, it is still worth checking this, because a tariff often accompanies you for many years.

Are vaccination benefits a reason for PKV during studies?

Vaccination benefits are one tariff detail among many. Other points weigh more heavily in the decision between GKV and PKV during studies. The Verbraucherzentrale points out that exemption from compulsory insurance normally applies for the whole course of study, and that a switch to the GKV is usually possible only after studies end, for example through employment subject to compulsory insurance. The exemption also cannot be revoked (section 8 SGB V).

In addition, the application contains health questions, and PKV premiums can rise over time. An overview of premiums is available under what PKV costs during studies. What PKV offers for doctors, clinics and therapy is described in the article on the advantages as a privately insured patient.

Frequently asked questions

Which vaccinations does the health insurer not pay for?

Vaccinations with a STIKO recommendation are a standard benefit. For travel vaccinations and vaccinations without a recommendation for your situation, there is no uniform rule. Here the individual health insurer decides, and in PKV the tariff does. Ask before the appointment so you know the costs.

Does PKV pay for travel vaccinations?

That depends on the tariff. Some tariffs include travel vaccinations, others limit reimbursement or exclude them. A look at the benefits overview shows what your tariff provides. Before an expensive course of vaccinations, it is worth checking with the insurer.

Does private health insurance pay for the FSME vaccination?

Your tariff decides. There is no uniform PKV catalogue, and the recommendation for the FSME vaccination depends on the area where you live or stay and on your activities. Check the vaccination clause in your terms, clarify reimbursement with the insurer in advance, and submit the paid invoice within the deadline.

How long can I submit a vaccination invoice?

You can submit the invoice within three years after the end of the year in which it was issued. An invoice from March 2026 is therefore valid until 31 December 2029. Still, submit it as early as possible while you have the receipt to hand.

Which vaccinations does PKV pay for in the emergency tariff?

According to our review, the emergency tariff includes STIKO vaccinations. It applies to insured people who fall into arrears with their premiums and covers only a narrow range of benefits, including acute illnesses and pain. Once all arrears are paid, you return to your previous tariff.

What to do now

Open your tariff terms or benefits overview and search for “protective vaccinations” or “vaccinations”.
Note the scope, reimbursement rate, maximum amount and deductible.
Before a travel vaccination, ask your insurer about reimbursement and ask the practice for a cost estimate.
Submit the paid invoice promptly and check whether your tariff pays a premium refund.

Vaccinations in studies: what health insurance pays for, abroad and for travel, is described in Vaccinations during studies: what health insurance pays.

Information, not individual advice.
Editorial team: Academycon · Status: October 2026

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Status: October 2026. This article provides general information and does not replace individual advice.