Choice of family health insurance

Family insurance

Insure the family free of charge

Julia Rieder
Expert for insurance as of November 24, 2020

Julia Rieder

Julia Rieder is an editor for insurance companies and, as the deputy head of text, takes care of the linguistic quality of all texts. During her traineeship at Finanztip, she sat in on RBB Inforadio. Before that, she gained journalistic experience in the editorial offices of Frontal 21, the Berliner Zeitung and the online magazine politik-digital. Julia graduated with a master's degree in political science in Berlin.

  • People with statutory health insurance can also insure their children and their spouses or registered partners and sometimes even grandchildren free of charge.
  • This is a big advantage over private health insurance - because each family member costs extra there.
  • Parents with whom one is privately insured have to be careful. Then free family insurance can be excluded by law.
  • Check that all the requirements for family insurance are met.
  • Under certain circumstances, you can co-insure your children and grandchildren up to the age of 25. However, the conditions for this are strict.
  • You can also insure your partner if he or she hardly earns anything. In addition, he may not be a civil servant, self-employed and not privately insured.
  • Submit an application for inclusion in family insurance. In order not to make mistakes, you should use the form that your health insurance company provides on the website.

Statutory health insurance (GKV) is particularly cheap for many families because children, including stepchildren and foster children, are also insured free of charge. You can also insure your spouse or registered partner free of charge under certain conditions. The same applies to a grandchild who lives with you. With one contribution, the entire family can possibly be covered by statutory health insurance.

What are the requirements for family insurance?

Compared to private health insurance (PKV), statutory family insurance can be significantly cheaper even for one child. Because in private health insurance, each family member needs their own contract, so each child costs extra.

Family members who are legally co-insured, on the other hand, receive the full benefits of the health insurance fund, with the exception of sick pay. According to the Association of Substitute Funds, more than 16 million family members were insured free of charge in July 2020.

So that you can co-insure your family members free of charge, you have to following criteria hold true:

  1. The family member must in Germany dwell.
  2. The family member is allowed to not self-insured be. Depending on the type of employment, certain income limits are relevant.
  3. The family member is allowed to not insurance-free be, for example, as a well-paid employee or civil servant.
  4. The family member is allowed to not self-employed full-time be active. This is at least the case if they devote more than 18 hours a week to self-employed work.

If your child, spouse or partner does not meet one of these points, co-insurance is excluded: Your family member must take out health insurance themselves. Family insurance always takes a back seat to its own compulsory insurance.

For example, if someone becomes unemployed and receives unemployment benefit (ALG I), they are compulsorily insured themselves and cannot be insured through family insurance. Spouses and life partners who were not insured in the statutory health insurance at the beginning of the maternity protection period cannot also be insured. The same applies to the protection period after childbirth and the start of parental leave.

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How much can family members earn?

Children and partners who are to be insured with a family free of charge may only have a low income themselves. How high they Income limit for family insurance varies depending on the type of employment. If the earnings of your relatives exceed the limit applicable to them, they must insure themselves.

The income limit for family insurance is 470 euros per month (as of 2021). However, the total income includes the income in terms of tax law (Section 16 SGB IV). Therefore, regular employees can also deduct advertising costs or the corresponding lump sum from their income.

Thus, in the end, the total income of regular employees is allowed 553.33 euros per month do not exceed so that you can remain insured with your family. This value is made up of the income limit for family insurance of 470 euros and the flat-rate allowance for income-related expenses of 83.33 euros per month (1,000 euros per year). The maximum income is therefore just under 6,640 euros per year.

If co-insured the Exceed income limit, you must take out self-insurance from the day you receive your income tax assessment. As a rule, the health insurance company asks once a year about the income of the insured family.

What counts as income

For family insurance, not only income from wage and salary payments is relevant. Other income also counts: For example Rental and leasing income, Pension payments as well Interest income from investments.

For income from investments, however, there is a savings allowance of 801 euros per year. Income up to this amount therefore has no impact on total income.

How the regular monthly income that is relevant for family insurance is calculated depends on the individual case and the type of income. Earned income is usually for the Looking at months in which it was achieved. Regular payments once a year, such as Christmas bonuses, are divided by twelve, which means that they are credited proportionally for each month. In the event of fluctuating income from self-employment, the health insurance company estimates the income for the future based on the twelfth annual income of the last income tax assessment. The umbrella association of health insurance companies has regulated the details.

New rules for stepchildren and grandchildren

With the Appointment Service and Supply Act (TSVG) coming into force in May 2019, stepchildren and grandchildren are also generally allowed to take out family insurance, provided they live in the member's household through which they are to be insured. Before the Change of law That was only possible if the person who wanted to co-insure the child also mainly covered the child's livelihood. If the child was earning something himself, that could be problematic.

Become Mainly financed livelihood, now only check the health insurers if stepchildren or grandchildren live in a different household than the person through whom they are covered by family insurance. We explain exactly how this works in our guide to income limits in family insurance.

How do I apply for family insurance?

If you want to insure family members free of charge, you have to with your health insurance company apply for. You can find the applications on the website of your cash register. There you have to provide information about your previous insurance, income and children, among other things. The National Association of Statutory Health Insurance Funds has developed a standardized questionnaire for this purpose (family insurance reporting procedure, Appendix 1).

The spouse or life partner must also be specified. The term life partner refers exclusively to registered same-sex partnerships, not to partnerships similar to marriage. Partners who are not married or who live in a registered civil partnership cannot insure one another with family insurance.

The Health insurance companies check regularly, if she requirements are still met for family insurance. To do this, they use an extensive questionnaire that you have to fill out (family insurance registration procedure, Appendix 2).

If both parents are gainfully employed and have to be insured, you can decide yourself with whom the children should be insured. The amount of income is not decisive. Note that it is not permitted to have family insurance with different health insurance companies at the same time.

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What age limits are there for children in family insurance?

Children can remain insured in family insurance up to the age of 23, provided they are not yet working themselves. The kids should be one Studies or vocational training If you take up without pay, the free co-insurance is extended up to the age of 25. You must insure yourself for the duration of your engagement in the federal voluntary service or during a voluntary social or ecological year (FSJ / FÖJ). Family insurance is excluded for the duration of the engagement.

Family insurance can be extended by twelve months beyond the age of 25 if school or vocational training is interrupted or delayed by the following services:

Children who are unable to earn a living on their own due to a disability can be insured with the family without any age limit.

When can children not be included in the insurance?

Not every family can insure their children through the family insurance in the statutory health insurance. If with married parents, the higher earners is privately insured and exceeds a certain income limit, the parents must insure their children against their own contribution - either in the private health insurance or in the statutory health insurance. Because in this constellation the children should not be protected at the expense of the solidarity community.

Is one parent has statutory insurance and one parent has private insurance, a free family insurance according to the law (§ 10 Abs. 3 SGB V) is excluded if the following three characteristics are present:

  • The parents are spouses or life partners and
  • the income of the privately insured person is higher than that of the legally insured person and
  • the monthly total income of the privately insured person exceeds one twelfth of the annual income limit (5,362.50 euros gross in 2021).

An example: The husband and father are members of the GKV, while the wife and mother are members of the PKV. You have a 15 year old son. The father earns 3,700 euros, the mother 5,500 euros per month. Since the mother is privately insured, her income exceeds the annual wage limit and is also regularly higher than the father's income, the son cannot be insured through the father's family insurance. For the son, the parents must take out their own health insurance - either private or voluntary membership in a statutory health insurance company.

Incidentally, family supplements under salary law are not taken into account when it comes to whether a child can be insured with a family. According to a judgment of the Federal Social Court, the health insurance companies are not allowed to include such family supplements when they check whether the earnings of a privately insured person are above or below the annual wage limit (BSG, judgment of July 29, 2003, Az. B 12 KR 16/02 R).

If you have opted for voluntary statutory health insurance, although you could have switched to private health insurance, you can also legally insure your children free of charge.

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What applies to students in family insurance?

Students can until the 25th birthday remain in the parents' family insurance. However, this only applies as long as your total income remains below 553.33 euros per month.

With a two-month part-time job during the lecture-free period, students can earn more and continue to be covered by family insurance. In the case of such short-term employment, the amount of earnings is basically irrelevant.

If you earn too much as a family-insured student, you will be required to take out insurance yourself and will not be covered by family insurance. It can then even happen that you have to pay additional contributions. Before you get one Part-time job you should therefore speak to your health insurance company beforehand.

When family insurance is no longer possible

Students who are no longer included in the family insurance free of charge can take out statutory insurance at a reduced rate. Since October 1, 2020, the monthly fee for the student health insurance around 77 euros plus additional contribution from the respective health insurance company. For long-term care insurance there is around 23 euros a month on top, for childless students over 23 years of age it is around 25 euros a month.

The contribution for student health insurance is linked to the student loan rate. If the state subsidy is increased, the health insurance contributions will also rise.

Student health insurance does not have unlimited validity. According to Section 5 Paragraph 1 No. 9 SGB V, it ends at the end of the semester in which the student did 30 years of age accomplished. After that, students have to take out voluntary insurance, because in November 2019 the legislature abolished the transitional tariff that previously applied to students in the final phase. You can read more about this in the student health insurance guide.

In this way, students also save on disability insurance

  • Schoolchildren, trainees and students can take out BU insurance before starting their career. The lower the entry age, the easier the health check and the lower the monthly contributions.
  • Be sure to get advice before you graduate and get several offers. Brokers recommended by us: Hoesch & Partner, Buforum24, Zeroprov, Dr. Schlemann independent financial advice, P&F.

To the advisor

Julia Rieder

Julia Rieder

Julia Rieder is an editor for insurance companies and, as the deputy head of text, takes care of the linguistic quality of all texts. During her traineeship at Finanztip, she sat in on RBB Inforadio. Before that, she gained journalistic experience in the editorial offices of Frontal 21, the Berliner Zeitung and the online magazine politik-digital. Julia graduated with a master's degree in political science in Berlin.

Nicolas Heronymus

Nicolas Heronymus

Nicolas Heronymus is currently doing all of the editorial work as a trainee. Even before Finanztip he gained his first experience in the world of finance and insurance: during a gap year at Allianz and as a student trainee at Generali. He studied political science in Lüneburg, Berlin and Rome.

Max Mergenbaum

Max Mergenbaum

Max Mergenbaum writes about travel and insurance in the editorial office. He acquired the necessary skills during a traineeship at Finanztip, including an internship in the business editorial department of RBB Inforadio. Max studied politics, economics & society as well as German at the Ruhr University in Bochum. After a semester abroad in Canterbury, he completed his political studies at the Free University of Berlin with a master’s degree.

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