Family insurance

In statutory health insurance, the spouse and children can, under certain conditions, be co-insured free of charge. They then do not have to pay their own contributions to the health insurance fund. The insured member only has to notify the health insurance company of the dependents. Read here who comes in for free.

Family insurance in the statutory health insurance is in many cases more favorable than voluntary private health insurance. Especially when one parent takes a career break to care for the children and temporarily forgoes part of his or her own income. Even while receiving maternity/parental benefits, membership in the GKV continues (non-contributory for employees subject to compulsory insurance and non-contributory for those insured voluntarily). The option of family insurance does not exist in private health insurance. There, all family members must be insured themselves subject to contributions.

A non-contributory family insurance is possible if

• the family member to be co-insured has his/her place of residence or habitual abode in Germany,
.
• the/the family member to be co-insured has only low income, the income must not exceed the amount of 470 euros per month (parental allowance does not count),
.
• no other health insurance exists that excludes family insurance, for example, mandatory insurance as an employee or pensioner,
.
• no full-time self-employment is given.

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If the above conditions are met, spouses or civil partners can be co-insured in the statutory health insurance free of charge under the Civil Partnership Act. In the family insurance come in:

• Children up to the age of 18.
• The time is extended until the age of 23, if the child is not gainfully employed, for example, because of school attendance, and until the age of 25, if it is in training or a study. An extension of another 12 months is possible if the training is interrupted by military service, voluntary service or work as a development worker.
• Stepchildren and grandchildren, if the member predominantly maintains them.
• Foster children in domestic partnership.
• Children who are unable to care for themselves due to a disability. They can remain indefinitely family insurance.
.
• A separated spouse or a separated spouse until the divorce decree is final.

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• Persons of certain professional groups are excluded. These include civil servants, judges, soldiers and clergy.
• If one parent has private insurance and the other statutory insurance, family insurance is excluded if:
  • the privately insured parent earns more than the legally insured and
  .
  • the total monthly income of the privately insured parent regularly exceeds one-twelfth of the annual earnings limit (JAEG) (2021: 5,362.50 euros per month).
  • Children must then either also be insured in the private health insurance or become a voluntary member of the statutory health insurance.

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Whoever was privately insured and meets the requirements for family insurance can change. The private health insurance must be terminated retroactively by the insured person within 3 months of the start of family insurance. Insured persons must provide their private health insurance company with a membership certificate from the new fund within two months, stating the reason for the statutory insurance.

If the conditions for family insurance no longer apply, those affected automatically continue to have voluntary health insurance, but must then pay contributions. However, the insured person can declare his or her resignation if he or she wishes to change the health insurance company or enter a private health insurance company.