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Private Health Insurance for Children (PKV): Costs & Comparison to GKV

In the German healthcare system, families face the choice between statutory health insurance (GKV) and private health insurance (PKV). While the GKV allows for contribution-free family insurance for children under certain conditions, a separate premium must be paid for children in the PKV. This raises a central question: What does a child cost in the PKV and how are the premiums calculated? This article examines the calculation bases and the crucial factors that determine the costs for a child's private health insurance.

How are the costs for children in the PKV calculated?

Premium calculation in the GKV primarily depends on the parents' income (up to the contribution assessment ceiling). In clear contrast, the PKV premium is based on three pillars: the chosen tariff, the age of entry, and the health status at the time of contract conclusion.

A significant difference and cost advantage for children in the PKV is that no age reserves are formed for them. These savings components, which are intended to cushion the increasing healthcare costs for adults in old age, are not factored into the premium for children. This practice only begins at the age of 21. For this reason, premiums for children are usually significantly cheaper than for adults and are mainly based on the selected scope of benefits.

Which factors determine the PKV premium for your child?

Several key factors have a direct impact on the amount of the monthly premium for a child in private health insurance:

Choice of Tariff and Scope of Benefits: The extent of the desired benefits in the outpatient, inpatient, and dental areas is the biggest lever for the premium amount.
Age of Entry and Health Status: Even for children, these are fundamental factors. However, there are advantageous special regulations for newborns (child re-insurance), which allow admission without a new health check and waiting periods, provided a parent is already privately insured for a sufficiently long period.
Employer Contribution: Employed parents who are privately insured receive a contribution from their employer towards the child's PKV premiums. This amounts to up to 50% of the premium and is limited to the maximum employer share in the GKV.
Tax Deductibility: Premiums for the basic coverage of the child in health and long-term care insurance can be claimed as precautionary expenses for tax purposes.

When is it necessary to insure a child in the PKV?

Whether a child can be covered by family insurance free of charge in the GKV depends on the insurance and the parents' income. Contribution-free family insurance in the GKV generally applies if both parents are statutorily insured.

However, it does not apply if the parents are married and the following three conditions are met:

One parent is privately insured.
This parent earns more than the GKV-insured partner.
Their income is above the annual income threshold (JAEG) of 73,800 Euros (as of 2025).

In this case, the child must be insured either voluntarily and at a cost in the GKV or in the PKV.

Cost Consideration: Is the PKV for children more expensive?

Although each child in the PKV requires a separate premium, the total costs for a family in certain constellations (e.g., for two high-earning, privately insured parents) can indeed be competitive with the premiums in the GKV. The income-independent child tariffs of the PKV can be cheaper overall than the high, income-dependent GKV premium of a parent who would also have to bear the premium for the voluntarily insured child.

However, a blanket statement is not possible; the costs must always be calculated individually. Some PKV providers also advertise family-friendly tariff features, such as contribution-free months after birth or special tariffs for pupils and students.

Conclusion: Individual Decision for the Family

The costs for children in private health insurance are always individual and depend crucially on the chosen tariff. Since no age reserves are formed for children, their premiums are comparatively low. Employer contributions and tax deductibility can further reduce the financial burden.

The decision between GKV family insurance and PKV for children is complex. It depends heavily on the individual family and financial situation. While contribution-free GKV membership is the most cost-effective solution for many families, the PKV can be a viable alternative in certain high-earning constellations. Detailed, professional advice is essential for a well-informed decision.

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