What happens to my private health insurance in Germany when my salary falls below the threshold?
In short
What happens to my private health insurance in Germany when my salary falls below the threshold? As an employee you become compulsorily insured in public health insurance; in 2026 the threshold is EUR 77,400 a year. You may cancel private insurance within three months, backdated. Exemption is only possible in special cases. From age 55 you usually stay exempt.
Thresholds for compulsory health insurance of employees.
Example
Typical range
Threshold 2026
EUR 77,400 a year, EUR 6,450 a month
Threshold for long standing private members 2026
EUR 69,750 a year
Threshold 2027 for newcomers, draft
EUR 84,150 a year
Protected threshold 2027 for today's private members, draft
EUR 80,550 a year
As of October 2026.
Figures for 2027 from the draft regulation;
the Federal Council (Bundesrat) still has to agree in November.
Legal position under SGB V, VVG and the PKV association.
Worked example
Employee, 42, changes employer
Her salary falls from EUR 85,000 to EUR 70,000 a year with the new contract. She has been privately insured for eight years.
New salary below EUR 77,400
compulsorily insured from the start of the new job
Exemption
not possible, the reason is the pay cut
Cancel private insurance
within three months, backdated
Option
supplementary tariff or dormant policy with her insurer
She joins public insurance and cancels private insurance backdated. A dormant policy keeps the way back open.
When compulsory public insurance starts
Employees are only exempt while their regular annual pay exceeds the threshold. It includes monthly salary, holiday and Christmas pay, capital forming payments and regular variable pay. If this total falls below the threshold, you become compulsorily insured in public health insurance.
If a new contract, for example, lowers your salary permanently, the duty usually starts with the change. The public health fund decides, even if you were privately insured before.
Exemption: only in these cases
Anyone who becomes compulsorily insured can only opt out and stay private in certain cases. The application must reach a public fund within three months and cannot be withdrawn.
Reason for compulsory cover
Exemption possible?
Threshold rises, salary unchanged
yes
Part time at half or less after five years exempt
yes
Part time during parental leave
yes, for the parental leave
Pay cut or new job with lower pay
no
The special rule from 55
Anyone who would become compulsorily insured after turning 55 stays exempt if they were not publicly insured in the last five years. In addition they must have been exempt, opted out or mainly self employed for at least half of that time.
For long standing private members this means: if your salary drops below the threshold after 55, you stay in private insurance. Public insurance is then closed to you.
Ending private insurance correctly
Once compulsorily insured, you may cancel private insurance within three months, backdated to the start of compulsory cover. You must prove the compulsory cover within two months after the insurer asks in writing.
If you cancel later, the contract only ends at the end of the month in which you provide proof. Until then you pay twice.
What you can keep from private insurance
Many insurers let you switch from the full tariff to a supplementary tariff. Without better benefits there is no new risk assessment, and your ageing reserves are credited.
If you expect to return to private insurance later, a dormant policy makes sense. You then return to your old tariff without a health check.
What changes in 2027
According to the draft, the threshold rises extraordinarily to EUR 84,150 in 2027. Employees who are already privately insured and earn above today's threshold at the end of 2026 keep a protected threshold of probably EUR 80,550.
According to the PKV association there is no protection for privately insured part timers, self employed people and civil servants. If they become employees in 2027 earning below EUR 84,150, they become compulsorily insured without the option of exemption.
Step by step
Compare your regular annual pay with the threshold.
Check for a reason for exemption and note the three month deadline.
From 55, check the five year rule.
Discuss a supplementary tariff or dormant policy with your insurer.
Cancel within three months with proof from the public fund.
Checklist
All pay elements counted
Reason for exemption checked
Three month deadline noted
Dormant policy or supplementary tariff requested
Proof of public cover sent to the private insurer
Common mistakes
Missing the three month deadline and paying twice
Expecting an exemption after a pay cut
Cancelling without considering a dormant policy
Forgetting Christmas pay in annual pay
Questions and answers
Frequently asked
Do Christmas pay and bonuses count?
Holiday and Christmas pay usually count.
Variable pay counts if it is regularly expected; for one off payments this is disputed.
Do I cancel private insurance if I get an exemption?
No.
With the exemption you stay private as long as you are employed.
Can I return to private insurance later?
Yes, once your salary is above the threshold again.
Compulsory cover ends at the end of the calendar year if you also exceed next year's threshold.
Does this apply to the self employed?
The threshold concerns employees.
Moving from self employment into a job below the threshold makes you compulsorily insured.
