In order to raise their children, many parents give up their careers and part of their own income, at least temporarily. This also changes their health insurance contributions.

The most important thing in brief:

• Under certain circumstances, spouses and children can be covered by statutory health insurance. They then do not have to pay their own health insurance contributions.
• In many cases, compulsory insurance is cheaper than voluntary insurance.
• Maternity allowance and parental allowance are exempt from contributions in the statutory health insurance scheme.
• A return to statutory health insurance is possible during parental leave.

Family insurance – free of charge

Statutory health insurance is attractive for families because family members can be insured under the family insurance without paying any contributions under certain conditions. The insured member only has to register the relative with his or her health insurance company. The relative receives his or her own health insurance card and can use it to make use of the services provided by the statutory health insurance company.

There is no family insurance in private health insurance. Family members must be insured themselves with an additional contract.

What are the requirements for family insurance?

• The family member to be co-insured must have his or her usual place of residence in Germany .
• There must be no other health insurance that excludes family insurance, for example compulsory insurance as an employee or pensioner.
• As a family member covered by family insurance, you are only allowed to have a low income of a maximum of 535 euros per month in 2025. Special rules apply to mini-jobbers. If a family member has a minor job , the total permissible income must not exceed the mini-job limit. This is 556 euros per month in 2025 .
• Tip: You can exceed these limits up to twice a year . Parental allowance is also not considered income for health insurance purposes, so you will still be covered by family insurance if the income limits are exceeded only because of the parental allowance.
• Being self-employed on a full-time basis excludes family insurance.
• You may not apply for exemption from compulsory health insurance (exemption from compulsory insurance).
• In addition, people in certain professional groups such as civil servants, judges, soldiers or clergy cannot be included in family insurance.

Who can take out family insurance?

If they meet the above conditions, spouses or life partners can be covered by their relative’s statutory health insurance without paying any contributions in accordance with the Life Partnership Act.

Until the divorce decree becomes final, both spouses can remain in the family insurance – even if they live separately.

As a rule, children can be covered by family insurance until they reach the age of 18. This also applies to stepchildren and grandchildren if the member is the main supporter of them, and to foster children in the same household. The period is even extended to the age of 23 if the child is not employed (e.g. because they are attending school), and to the age of 25 if they are in training or studying.

If the training is interrupted by military service, voluntary service or work as a development worker, an extension of a further twelve months is possible. Children who cannot care for themselves due to a disability remain covered by family insurance indefinitely.

termination of voluntary statutory health insurance

In addition, there must be no voluntary statutory health insurance. However, an existing voluntary insurance can be canceled in favor of family insurance if all other requirements are met. The twelve-month commitment period does not apply in this case. When exactly the family insurance begins – whether with the cancellation or when the requirements are met – is regulated by the health insurance company in its statutes. It is best to ask your health insurance company. You can also find the statutes on the Internet.

termination of private health insurance

Anyone who previously had private health insurance and meets the requirements for family insurance can also switch. However, private health insurance does not end automatically; the insured person must cancel it retroactively within three months of the start of family insurance. If those affected miss the deadline, cancellation is only possible at the end of the month in question, which means that two insurance policies exist at the same time and double contributions are due. Insured persons must also present their private health insurance company with a membership certificate from the new fund within two months, which states the reason for the statutory insurance.

When can children not be covered by family insurance?

If one parent is privately insured and the other is insured by law, family insurance is excluded if

• the privately insured parent earns more than the legally insured parent and
• the total monthly income of the privately insured parent regularly exceeds one twelfth of the annual wage limit (JAEG). In 2025, this will be 6,150 euros per month).

Example

Ms. Muller is an employee and earns 2,700 euros gross per month. She is compulsorily insured under the statutory health insurance scheme.

Her husband is employed as a manager in a company. His income is well above the annual salary limit. In 2025, this was 6,150 euros per month. He has private health insurance.

The couple’s two minor children cannot be covered by Mrs Muller’s statutory health insurance as family insurance.

Children must then either be insured in private health insurance or become voluntary members of statutory health insurance. The costs for voluntary membership in statutory health insurance are around 250 euros, which is similar to or slightly higher than private health insurance for children.

The exclusion from family insurance only applies if all three conditions are actually met. For example, if the father is privately insured and the mother is legally insured, but she earns more than her husband, the children can still be covered by family insurance.

However, both parents are only considered as a whole if both are married or in a civil partnership. If both parents are not married, the child can be insured by both the privately insured and the legally insured parent.

Continued insurance after the end of family insurance

After the end of family insurance, those affected automatically continue to have voluntary statutory health insurance, provided that no other compulsory insurance applies. However, insured persons can declare their withdrawal within two weeks of being informed by the health insurance company, provided they can prove that they have other cover in the event of illness – for example, private health insurance.

How contributions are calculated for compulsory and voluntary insured persons

Those with statutory insurance must pay 14.6 percent of their wages to the health insurance company. Half of this is paid by the employer. In addition, there is the additional contribution, which is 2.5 percent on average, but can vary depending on the health insurance company.

Parents with one child pay 3.6 percent for compulsory long-term care insurance and childless parents pay 4.2 percent.

For the second to fifth child, the contribution rate is reduced by 0.25 percent. Children up to the age of 25 are considered “children.” However, the reduction only reduces the employee’s contribution. The employer still has to pay half the general contribution rate. He does not have to contribute to the extra surcharge for those without children.

In contrast, for those who are voluntarily insured under statutory insurance, not only the earnings from employment or self-employment are taken into account for the contributions, but also the entire economic performance. This also includes pensions, retirement benefits and all other income and funds from renting and leasing as well as capital income.

The maximum income to be taken into account is the same for those with compulsory and voluntary insurance. In 2025, the insured person’s income will be taken into account for the calculation of contributions up to a maximum of EUR 5,512.50 per month.

However, there are differences in the minimum income. Compulsory insured persons pay their percentage of their wages, no matter how low they are. For voluntarily insured persons, however, a minimum income of 1,248.33 euros applies in 2025, even if their actual income is lower.

Different contributions depending on family constellation

If both parents are legally insured – whether compulsorily or voluntarily insured – they only pay the contributions from their own income.

For those who are voluntarily insured under statutory health insurance and whose spouses or life partners (according to the Life Partnership Act) have private health insurance, the income of their spouses or life partners will be added to their own income and used as the basis for calculating contributions.

First, the voluntarily insured partner’s own income (if any) is taken into account, followed by half of the spouse’s or life partner’s income, but this is limited to half the contribution assessment limit. In 2025, this limit will be EUR 2,756.25.

However, this does not apply under certain circumstances. The most important reasons are:

• The voluntary member earns more than half the contribution assessment limit or more than his or her spouse or life partner.
• For spouses who are permanently separated. For this purpose, maintenance payments are taxed, among other things.

Example

The privately insured husband has a monthly gross income of 6,000 euros. The wife has no income of her own. Half of the gross income of 3,000 euros is credited to the wife as income. However, the amount is more than half the contribution assessment limit of 2,587.50 euros. Therefore, the contribution rate of 15.9 percent including the additional contribution is credited to the maximum limit of 2,587.50 euros. The wife therefore pays a monthly contribution rate of 411.41 euros plus a contribution to nursing care insurance of 103.50 euros (4.0 percent for those without children in this example).

Child allowances when taking into account the income of a spouse or life partner

Spouses or life partners can claim allowances for children if the income of the privately insured partner is taken into account when calculating the contributions of the voluntarily insured partner. For children who are not covered by family insurance, an allowance of one third of the monthly reference amount applies, which is 1,248.33 euros in 2025.

For children insured through the family, one fifth of the monthly reference amount is deductible, which will be 749 euros in 2025. The amount is deducted from the gross income of the privately insured spouse or life partner, the remaining income is halved and then credited to the income of the voluntarily insured spouse or life partner.

Maternity allowance and parental allowance are exempt from contributions

Those with statutory insurance do not have to pay any contributions for maternity benefit and parental benefit. Anyone who only had income from an employment subject to compulsory insurance before receiving these benefits is covered by free health insurance during this period.

Even if you are a voluntary member of the statutory health insurance scheme, these wage replacement benefits are free of charge. However, this does not mean that health insurance costs nothing overall.

Voluntary insured persons pay contributions on all income. And even those who do not receive any money during maternity leave or parental leave must pay contributions. For voluntarily insured persons, the health insurance company sets a minimum income as a basis – in 2025, this will be 1,248.33 euros per month – on which the usual health insurance contributions must be paid.

If spouses or life partners are also insured under statutory insurance, family insurance may be an option. However, this is not possible if the income is too high (more than 535 euros in 2025, not more than 556 euros for a mini-job) or if the voluntarily insured person is self-employed full-time.

If one of the two parents has private insurance and the other has voluntary statutory insurance, the spouse’s income is also counted as income, up to a maximum of half the contribution assessment limit. This is 2,756.25 euros in 2025.

Privately insured mothers and fathers usually have to continue to pay insurance premiums if they receive parental allowance. Neither the receipt of parental allowance nor the start of parental leave constitutes an obligation to take out statutory health insurance. Family insurance is also excluded, even if the other person is legally insured. They will then continue to have private health insurance. The following point is an exception.

Working despite parental allowance

The time when you start a family is also an opportunity to set a new course for your health insurance. Mothers and fathers are allowed to work up to 32 hours a week in addition to receiving parental allowance. Parents of children born before September 1, 2021 are allowed to work up to 30 hours a week. It is therefore possible to pursue an activity that requires insurance during family time.

Anyone who was previously privately insured has the opportunity to switch back to the statutory health insurance system if they work part-time and earn less than the compulsory insurance limit. However, anyone who is self-employed full-time would have to give up their main job and would only be allowed to work part-time.