This paper presents the financial effects of a transition from the pay-as-you-go to a capital funded health insurance system in Germany. The focus of the following article will be on the financial need in different settings which are given by the difference of the spending for health care and the insurance contributions with an upper limit of 15% of the underlying assessment basis. Calculations made with a static microsimulation model based on the data of the German Socio Economic Panel Study (SOEP). It will be shown that substantial financial transfers are needed to realize such a kind of transition. As the alternative of doing nothing is very costly as well the authors propose a mixed system with both capital funding and pay as you go.