For high-earning employees and for the self-employed in Germany, the choice between statutory health insurance (GKV β gesetzliche Krankenversicherung) and private cover (PKV β private Krankenversicherung) is one of the largest financial decisions of a working life. The stakes compound to six figures, and the door mostly swings one way: returning to GKV gets harder with age and is all but shut after 55.
The decision is usually argued with this month's premium, which is the one number that barely matters. What matters is the whole path: GKV charges a percentage of income up to a ceiling that rises every year; PKV charges a premium that is independent of income but rises with medical inflation and age. Employers subsidise both. Families are free in one and priced per head in the other. Taxes treat the two differently, retirement rewires both, and every euro saved early can compound for decades. This page simulates the two paths year by year over a lifetime β and because the future rates of premium growth, contribution drift, income, and investment returns are genuinely unknowable, it makes them scenarios you can duplicate, bend, and compare side by side.
Legal parameters are the 2026 values and everything is editable. It is a model of the money only β service quality, benefit levels, and risk appetite are the other half of the decision, and no calculator will weigh those for you. This is not financial advice.
Facts about you, shared by every scenario. The uncertain assumptions β growth rates, returns β live further down, in the scenarios themselves.
The quiet giant of this comparison. In GKV, a spouse without substantial own income and children are covered free through Familienversicherung. In PKV, every head pays its own premium. (A spouse with their own job carries their own insurance either way and drops out of the comparison; children can ride free in GKV only if the GKV parent out-earns the PKV parent β otherwise they are priced too.)
Enter a real quote if you have one β premiums vary enormously with entry age, health, and tariff. The default is a mid-range comprehensive tariff for a healthy thirty-something with a modest deductible. For the self-employed, remember that a Krankentagegeld (sick-pay) add-on belongs in the quote if you want parity with GKV's Krankengeld.
Both systems change shape at retirement. In GKV, pensioners in the KVdR (Krankenversicherung der Rentner) pay half the contribution rate on their statutory pension only β capital and rental income stay free. Voluntarily insured pensioners (typically the long-term self-employed, who miss the KVdR's 9/10 rule) pay the full rate on all income. In PKV, the premium keeps rising regardless of income, but the pension fund pays a subsidy of about 8.75 % of the statutory pension toward it.
Health insurance is deductible as Vorsorgeaufwendungen, but not symmetrically: GKV contributions count in full minus a 4 % haircut for the Krankengeld entitlement, while a PKV premium counts only for its Basisabsicherung share β the part matching GKV-level cover, typically 80β90 % (your insurer certifies the exact figure). Employer and pension-fund subsidies are not yours to deduct. The model applies your marginal rate to the difference; set the rates to zero to switch taxes off.
Everything above is fact or quote. What follows is guesswork, and pretending otherwise is how this decision goes wrong. Historically, PKV premiums rose about 3 % a year on long averages (with brutal variance between tariffs), GKV's effective burden β rate times a rising ceiling β grew slightly faster, the average Zusatzbeitrag alone went from 0.9 % in 2015 to 2.9 % in 2026, and every serious projection sees it climbing further. Each preset below is one coherent world; duplicate one and bend it to taste. Edits to a preset fork it into a custom scenario automatically.
Each year's cost difference is invested at the scenario's return rate; the curve is the wealth gap between the two lives. Above zero, the PKV chooser is richer; below, the GKV chooser. Dots mark break-even ages of the active scenario.
| scenario | cheaper today β¬/mo | break-even | advantage at 67 | at 90 | at 90, today's β¬ |
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| age | year | GKV net β¬/yr | PKV net β¬/yr | GKV β PKV β¬/yr | PKV advantage β¬ |
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One simulated year at a time, from your age today to the horizon, in nominal euros (the today's β¬ toggle deflates the display by the scenario's inflation):
2026 ceilings and thresholds from the federal government's RechengrΓΆΓen 2026; the 2.9 % average Zusatzbeitrag from the GKV-SchΓ€tzerkreis; minimum bases and the BezugsgrΓΆΓe from krankenkassen.de; long-run premium-growth history from the PKV-Verband and industry analyses of 2005β2026 tariff data.