Consumer Protection

Basistarif & Notlagentarif: Your Safety Nets

Private health insurance in Germany isn't a one-way street. The law guarantees multiple safety mechanisms to protect policyholders.

Why safety nets matter

One of the most common concerns about PKV is: "What if I can't afford my premiums in the future?"

German law (VAG — Versicherungsaufsichtsgesetz) addresses this directly with mandatory safety tariffs that every PKV insurer must offer. These ensure that no policyholder is ever left without coverage — regardless of their financial situation.

The Basistarif (Basic Tariff)

Since January 1, 2009 (GKV-WSG), every PKV insurer must offer a Basistarif under §152 VAG. Key features:

  • Coverage level: Equivalent to GKV statutory coverage — all medically necessary treatments are covered
  • Maximum premium: Cannot exceed the GKV maximum contribution (currently approximately €1,015/month in 2026)
  • No health screening: Your insurer must accept you into the Basistarif regardless of your health status (Kontrahierungszwang)
  • Aging reserves preserved: Your accumulated aging reserves transfer from your existing tariff, reducing the Basistarif premium
  • Hardship clause: If you receive social benefits (ALG II / Bürgergeld), the premium is halved

Who can switch to the Basistarif?

  • Anyone who was privately insured before January 1, 2009
  • Anyone who took out PKV after that date (Kontrahierungszwang applies)
  • Anyone age 55+ or receiving a retirement pension
  • Anyone receiving social benefits (§152 Abs. 4 VAG)

Important: Switching to the Basistarif is a significant decision. While it lowers premiums, it also reduces your coverage to GKV level. A switch is reversible within certain conditions — consult with your insurer or an independent advisor.

The Notlagentarif (Emergency Tariff)

Since August 1, 2013, the Notlagentarif (§153 VAG) applies automatically when a PKV policyholder fails to pay premiums:

  • Trigger: After the insurer has unsuccessfully demanded payment and issued a formal warning (Mahnung)
  • Coverage: Only acute illness treatment, pain relief, pregnancy, and preventive care for children
  • Premium: Approximately €100–€150/month (legally capped at a fraction of the regular premium)
  • Not a punishment: The Notlagentarif prevents the even worse scenario of complete insurance loss

How to exit the Notlagentarif

  • Pay all outstanding premium debts, and you automatically return to your original tariff
  • If debts are settled through a debt counselor or insolvency, you can also exit
  • Switching to the Basistarif is possible even from the Notlagentarif

The Standardtarif (Legacy tariff)

Before the Basistarif was introduced in 2009, a similar function was served by the Standardtarif. It still exists for policyholders who took out PKV before 2009:

  • Access: Available to PKV members who were insured before 2009 and are age 65+ (or 55+ with 10 years in the same company)
  • Coverage: Similar to GKV level
  • Premium: Capped at the GKV maximum contribution

For newer policyholders, the Basistarif has replaced the Standardtarif as the primary safety mechanism.

Additional protection: tariff switching rights

Beyond the Basistarif, every PKV policyholder has the right to switch between tariffs within their current insurer (§204 VVG):

  • Downgrade possible: You can switch to a lower tariff at any time — no new health check required for equivalent or lower coverage
  • Aging reserves transfer: Your accumulated reserves move with you to the new tariff
  • No waiting periods: Coverage begins immediately in the new tariff
  • Insurer must cooperate: Your insurer is legally obligated to inform you about available alternatives

This means: before you ever reach the Basistarif, there are typically several intermediate tariffs that offer strong coverage at a lower premium — using your existing aging reserves to your advantage.

The bigger picture: PKV is not a trap

Contrary to common misconceptions, PKV in Germany offers multiple layers of protection:

  • Layer 1: Tariff switching within your insurer (§204 VVG) — the easiest and most common solution
  • Layer 2: Basistarif — GKV-equivalent coverage with a capped premium
  • Layer 3: Notlagentarif — emergency coverage for acute financial hardship
  • Layer 4: Return to GKV — possible under certain conditions (employment below JAEG, age under 55, etc.)

The key is making an informed decision upfront with proper guidance — so that none of these safety nets are ever needed.

Make the right decision from the start

We help you choose a PKV tariff that fits your income, lifestyle, and long-term plans — so safety nets remain theoretical.