An independent assessment of your private health insurance benefits means checking, outside your insurer's own recommendations, whether your current tariff still fits your needs and whether cheaper or better alternatives exist. The immediate step is to write to your insurer and request tariff alternatives along with your age reserve figures, while keeping your existing policy active. German law gives you rights to this information, and if your insurer's answer falls short, you have clear ways to escalate.
TL;DR:
- German rules require insurers to disclose tariff histories, premium drivers, and ways to limit age related increases; older policyholders must receive up to ten alternatives.
- An internal tariff change generally carries your accrued age reserve, but added benefits may trigger risk surcharges, waiting periods, or exclusions that require written review.
- Ask in writing for alternative tariffs, your age reserve, and benefit waivers; insurers commonly target replies within 15 working days, though complex cases take longer.
- Before accepting a lower premium, confirm whether benefit cuts are permanent, how much reserve transfers, and whether exclusions or waiting periods could affect upcoming care.
- If the insurer refuses or gives an incomplete reply, preserve correspondence and contact the independent insurance ombudsman before escalating to BaFin.
Table of Contents
- What insurers must tell you and your legal rights in Germany
- Step-by-step: requesting an independent assessment while keeping your coverage
- Common outcomes, timing and cost considerations
- How Myhealthcarebroker supports an independent benefit review
- Why an independent check matters more than it seems
- FAQ
- Sources
What insurers must tell you and your legal rights in Germany
Your private health insurance provider does not get to decide, on its own, how much information you receive about alternatives. German insurance law sets out specific disclosure duties, and once you know them, you can hold your insurer to a higher standard than a polite brochure.
Under the VVG-InfoV, insurers owe policyholders detailed tariff information, not just a renewal notice. Section 3 of the VVG-InfoV requires insurers to provide contribution histories for comparable tariffs when available, a breakdown of what drives your premium, and information on how you can limit contribution increases as you age. If your insurer sends you a renewal letter without any of this, it is not giving you the full picture it is legally required to provide.
For older policyholders, the obligation goes further. Insurers must proactively inform older insured persons about tariffs offering equivalent coverage that could reduce their premium, including up to ten of the most relevant tariffs from the previous year, excluding the Basistarif, under §6 VVG-InfoV.
Tariff changes themselves are governed by §204 VVG, which lets you move to a different tariff within the same insurer while carrying over your accrued age reserve, though the insurer may apply risk surcharges, waiting periods or exclusions for added benefits. The treatment of these reserves, and how they are calculated during a switch, falls under the KVAV.
When you request this information, a complete reply should include:
- A written statement of your current and proposed premiums, side by side.
- Available contribution history for the tariffs being compared.
- An explicit statement on whether your age reserve transfers in full.
- Any proposed risk surcharges, waiting periods or benefit exclusions, named individually.
Step-by-step: requesting an independent assessment while keeping your coverage
You do not need to cancel anything to get a proper review of your benefits. The safest approach keeps your existing policy running until you have a written, comparable alternative in hand.
- Keep your current policy active. Never terminate coverage before you have a confirmed alternative. A gap in private health insurance in Germany can be costly and difficult to reverse.
- Submit a written request to your insurer. Ask for tariff alternatives, your current age reserve (Alterungsrückstellung) value, and available contribution history for any comparable tariff, as required under §3 VVG-InfoV.
- Ask about specific cost-reduction options. Request information on an internal tariff change, a Mehrleistungsverzicht (a waiver of certain additional benefits that can move you to a cheaper tariff without a new health check), and any available self-deductible adjustment. The Verbraucherzentrale Hamburg's survey on tariff changes found that many insurers do not volunteer the Mehrleistungsverzicht option unless you ask directly.
- Ask whether a risk surcharge or waiting period would apply. Any new tariff that adds benefits can come with conditions, and you want these stated in writing before you commit.
- Compare the replies line by line. Check whether benefit reductions are permanent, whether new waiting periods or exclusions appear, and whether your age reserve is credited in full or only partially.
- Escalate if the response is incomplete or refused. If your insurer does not answer fully or declines a legitimate request, you can contact the Ombudsmann der privaten Krankenversicherung, an independent dispute resolution body, before involving BaFin, the federal financial regulator.
Keep every letter, email and reply in one file. The Verbraucherzentrale notes that comparing private health insurance tariffs is genuinely complex and that public ratings alone are not a reliable guide, so a paper trail protects you if you need to challenge an insurer's answer later.
Pro Tip: Ask your insurer for the information in writing, by letter or secure message, rather than over the phone. A verbal promise about your age reserve carries no weight if the written tariff change turns out to be different.
Common outcomes, timing and cost considerations
Once you send your request, expect a process that moves at an uneven pace. Industry guidance points to 15 working days as a common target for handling tariff-change requests, though consumer advice from the Verbraucherzentrale notes that actual waits can run longer, especially for complex cases.
The outcome of a review usually falls into one of a few patterns:
- An internal tariff change that credits your age reserve and adjusts your premium accordingly.
- A proposal that requires a Mehrleistungsverzicht, trading away certain added benefits for a lower premium.
- In limited cases, a recommendation to move to the Basistarif or Standardtarif, a tariff comparable to public health insurance benefits.
Requesting tariff alternatives from your own insurer typically costs nothing. Where a reply is unclear or the case involves several years of tariff history, paid advisory support can be worth the cost, particularly if German is not your first language or the insurer's letter reads like a wall of clauses.
Before accepting any offer, verify three things: whether the benefit changes are permanent, what your premium looks like after the age reserve transfer is applied, and whether any new exclusions or surcharges apply. A tariff that looks cheaper on page one can include a waiting period that leaves you uncovered for a treatment you need this year. For more background on how tariff structures work, our guide to tariff levels in German private insurance walks through the terminology insurers use.
How Myhealthcarebroker supports an independent benefit review
We built our service to help make insurer letters easier to understand: an independent read of what your tariff covers and what it could cover instead. Because we work across all the major private and public health insurers in Germany rather than for one of them, our comparison is not shaped by which company pays better commission.
Our support for this kind of review includes:
- An independent check of your current benefits against comparable tariffs.
- A review of your age reserve and what happens to it under a tariff change.
- Help drafting a written request to your insurer.
- Support reading and discussing the insurer's reply.
- Guidance on escalation if your insurer's response is incomplete.
Our advice costs you nothing: insurers pay us a fixed, regulated commission when a policy is arranged, so our fee never comes out of your pocket. If you want a second set of eyes on your current plan, you can request your free assessment and we will walk through your options with you.
Why an independent check matters more than it seems
A low-cost tariff may seem suitable at first, but gaps can become apparent when a claim is denied. A tariff that looked fine on a comparison table sometimes excludes exactly the care a growing family or an aging policyholder needs most.
The age reserve question matters just as much. Once you understand that a tariff switch can carry your reserve forward, or leave part of it behind, you stop making decisions on price alone. If any of this sounds familiar, a personal review may be worthwhile.
— Marco
This article is general information, not a substitute for advice from a qualified financial advisor. Consult a qualified financial professional about your own circumstances before acting on anything here.
FAQ
What does an independent PKV benefit review actually check?
It checks whether your current private health insurance tariff still matches your needs and whether a comparable or better tariff exists at a lower premium. The review also looks at your age reserve, any waiting periods, and whether benefit changes would be permanent.
Can I switch tariffs without losing my age reserve?
Under §204 VVG, you can generally change tariffs within the same insurer and carry your accrued age reserve forward, though the insurer may apply surcharges or waiting periods for added benefits. The exact transfer depends on your contract and when it started.
What is a Mehrleistungsverzicht and does it help lower premiums?
A Mehrleistungsverzicht is a waiver of certain additional benefits that can move you into a cheaper tariff without a new health examination for those specific benefits. Many insurers do not mention this option unless you ask, according to a Verbraucherzentrale Hamburg survey.
What if my insurer refuses to give me tariff alternatives?
If your insurer's response is incomplete or it declines a legitimate request, you can contact the Ombudsmann der privaten Krankenversicherung for independent dispute resolution, and escalate to BaFin if needed. Keep all written correspondence as evidence.
Does Myhealthcarebroker charge for a benefit assessment?
No, our advice is free to you because insurers pay us a fixed, regulated commission when a policy is arranged through our service. You can request a free assessment of your current benefits at any time.
Sources
- Bafin
- § 3 VVG-InfoV - Einzelnorm
- Umfrage zum Tarifwechsel in der PKV der Verbraucherzentrale Hamburg im Rahmen des Projektes Marktwächter Finanzen – 2018