Statutory health insurance fund — official procedures

The general contribution rate is 14.6% of gross salary, plus a fund-specific supplementary contribution (average 2.9%). Employers and employees each pay half. The contribution assessment ceiling is €69,750/year.

Yes. Since 1996, all GKV members have had free choice of fund. Every statutory fund must accept you — there is no health check. Around 95% of benefits are identical at every fund; the difference lies in the supplementary contribution and the optional supplementary benefits.

Spouses and children can be co-insured free of charge (without their own contribution) if their income is below €565/month (one seventh of the monthly reference value under § 10 Abs. 1 Satz 1 Nr. 5 SGB V (Social Code Book V, Sozialgesetzbuch Fünftes Buch); for a minijob the minijob earnings limit of €603 applies instead). Children are covered by family insurance up to 18 (up to 25 if studying or in training).

From the 7th week of illness (after 6 weeks of continued pay from the employer). Amount: 70% of gross wages, maximum 90% of net wages. Maximum entitlement period: 78 weeks for the same illness.

GKV: income-based contributions, family insurance, solidarity principle. PKV: risk-based contributions, individual tariffs, no free family insurance. Employees can only switch to the PKV once their income exceeds the annual earnings threshold (2026: €77,400/year); self-employed people as their main occupation and civil servants can take out PKV regardless of this.