Civil Servant Health Insurance Germany 2026

Beihilfe is the German state's healthcare subsidy for civil servants. Your employer reimburses a fixed share of each medical bill, 50 percent for a serving Beamter under Section 46 BBhV, and you insure the rest through a private health insurance (PKV) tariff built for exactly that gap. Because you only insure part of the risk, PKV for civil servants costs far less than a full private policy.

There is no honest flat number. The premium depends on your age at entry, your Beihilfe rate, the deductible you accept, the hospital and dental modules you choose and your health questionnaire. Trainees (Beamtenanwärter) pay noticeably less than established Beamte because the Anwärter tariff carries no ageing provisions. The comparison tool on this page prices your own case in about two minutes. We do not print example figures, because a price without those inputs is a marketing claim, not information.

Yes. As a Beamter with a Beihilfe entitlement you are exempt from compulsory statutory insurance under Section 6(1) no. 2 SGB V, whatever you earn. In most Länder Beihilfe only tops up a private tariff, so if you stay in GKV you pay the full contribution yourself. A few Länder, Hamburg first in 2018, offer a pauschale Beihilfe, a 50 percent contribution towards GKV instead. Check your own Land's rule before you decide.

Your PKV continues. Under Section 46(2) BBhV the federal Beihilfe rate for pension recipients is 70 percent, so the share you insure privately shrinks from 50 to 30 percent and the insurer adjusts the tariff. Whether your premium actually falls depends on the tariff and on how your ageing provisions were built up over the years.

Single civil servants get 50% Beihilfe. With two or more children eligible, the rate rises to 70% (Section 46(3) BBhV). A spouse receives 70% for their own medical bills, but only if their total income stayed under the threshold in the second calendar year before the application (Section 6(2) BBhV). The Bundesverwaltungsamt sets that federal threshold at 22,648 euros for applications from 1 January 2026 and 23,608 euros from 1 January 2027; each Bundesland runs its own figure. Children get 80%. Each family member needs their own PKV policy for the remaining share.

Within six months of your first appointment. That is the window of the PKV-Verband's Öffnungsaktion: a participating insurer may not refuse you on health grounds, may not exclude a pre-existing condition from cover, and may add at most 30 percent to the tariff premium. You still answer the health questionnaire; the Öffnungsaktion caps the consequences. After six months normal underwriting applies, and a surcharge, an exclusion or a refusal are all possible.

A spouse qualifies only if their total income stayed under the applicable threshold in the second calendar year before the application (Section 6(2) BBhV; 22,648 euros federally for 2026, state figures differ). Children are eligible at an 80% Beihilfe rate. Each person needs their own separate PKV policy to cover what Beihilfe does not.

You lose Beihilfe together with the status. Your PKV contract continues, but you have to raise it to full cover because the state no longer pays its share. Whether you can return to GKV then depends on your new job: an employee below the income threshold becomes compulsorily insured again, but from age 55 Section 6(3a) SGB V normally keeps you in PKV. Talk to your insurer before you hand in notice.