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Emergency

From private back to statutory health insurance

The switch from private (PKV) back to statutory health insurance (GKV) is only possible under certain conditions. What matters above all are age, income, and the type of employment. From age 55, the return is severely hampered.

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Your chances of getting your money back

A return to the GKV generally requires that a compulsory insurance arises again, for instance through employment subject to social insurance contributions with income below the compulsory insurance threshold (SGB V).
From completing the 55th year of age, the return to the GKV is largely excluded under certain conditions if one was previously privately insured for a long time. A careful examination is important here.

What you should do now

  1. 1

    1. Check the requirements

    Clarify whether, through income, employment, or family insurance, a compulsory insurance can arise again.

  2. 2

    2. Consider age

    Take into account the special hurdles from the age of 55.

  3. 3

    3. Choose the route

    Check options such as employment subject to social insurance contributions or family insurance.

  4. 4

    4. Meet deadlines

    Take the necessary steps and applications in good time.

How to spot the scam

  • The hurdles from age 55 are underestimated.
  • An arrangement solely for the purpose of switching can be questioned by the fund.
  • Deadlines for membership are missed.

Frequently asked questions

Can I go from PKV back to GKV?

Only under certain conditions, above all when a compulsory insurance arises again, for instance through employment subject to compulsory insurance with income below the annual earnings threshold. Family insurance can also be a route.

Why is the return so hard from age 55?

The law largely excludes the return to the GKV for people aged 55 and over who were previously insured privately or not at all under the statutory scheme for a longer time. This is meant to prevent switching to the GKV only in old age with higher costs.

Does family insurance help?

Under certain circumstances, yes. Anyone who meets the requirements, for instance as the spouse of a statutorily insured person with low own income, can be co-insured premium-free under family insurance. The requirements must be checked carefully.

Take action now

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General information for self-help, not legal advice (RDG). In case of a high loss or uncertainty: contact a consumer advice center or a lawyer.