Health care reform: What will change for insured persons

The healthcare reform will bring higher co-payments, lower subsidies, and new contribution limits for those with statutory and private health insurance in 2027. We provide an overview.

The German government aims to improve the financial situation of statutory health insurance with the Statutory Health Insurance Contribution Rate Stabilization Act . Insured individuals should expect higher costs in the coming years , as co-payments will increase and subsidies will decrease. The reform affects both those with statutory and private health insurance. Below you will find information about the changes you can expect.

Important dates

Since July 30, 2026, statutory health insurance companies no longer reimburse their members for homeopathic and anthroposophic medicines. Health insurance companies may still provide such coverage voluntarily until the end of 2026.

From January 1, 2027, statutory co-payments will increase . Subsidies for dental prosthetics will be reduced. Furthermore, the legislature is raising the contribution assessment ceiling and the annual earnings threshold in an unscheduled measure.

From 2028, free family insurance coverage for many spouses and registered civil partners will be restricted . Many insured individuals will then have to pay an additional premium. Children will remain covered free of charge under family insurance. Exceptions apply in special circumstances.

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Higher co-payments from 2027

From January 2027, co-payments for medications and medical aids will increase. Insured individuals will continue to generally cover ten percent of the costs, but will pay a minimum of €7,50 and a maximum of €15 . For example, for a medication costing €80, the co-payment will be €8, while for medication costing €200, the maximum co-payment of €15 will apply.

For therapeutic treatments such as physiotherapy , occupational therapy, speech therapy, and home nursing care, you will now pay ten percent of the costs plus a fixed co-payment of 15 euros per prescription. Previously, it was ten euros per prescription.

The co-payment for inpatient hospital stays is increasing from ten to 15 euros per day. The maximum number of days remains at 28 per year. A two-week stay will therefore cost 210 euros, up from 140 euros previously.

Subsidies for dental prosthetics are decreasing.

Out-of- pocket expenses for dental prosthetics are also increasing for those with statutory health insurance. The fixed subsidy for standard care will decrease from 60 to 50 percent starting in 2027. Those who regularly attend preventative dental checkups will receive a subsidy of 60 percent instead of 70 percent after five years, and 65 percent instead of 75 percent after ten years.

Private supplemental health insurance often covers the increased out-of-pocket costs. This means that policyholders often do not face additional financial burdens as a result of the reform. The hardship clause remains in place for people with low incomes. They can continue to receive full reimbursement for medically necessary standard care.

Difference between contribution assessment ceiling and annual earnings ceiling

Two terms are frequently confused: The contribution assessment ceiling (BBG) determines the income level up to which contributions to statutory health and long-term care insurance are calculated. Those earning more than this amount do not pay additional contributions on the extra income. In 2027, the ceiling will be € 76.500 annually or € 6.375 monthly. This means that employees with higher incomes will have to pay contributions on a larger portion of their earnings in the future. The actual additional burden depends, among other things, on income and the specific supplementary contribution.

The annual earnings threshold (JAEG) determines whether employees can switch from statutory to private health insurance . For 2027, it is €84.150 annually or €7.012,50 monthly . The crucial factor is that the regular annual earnings remain above this threshold on a permanent basis.

Sources: Federal Ministry of Health; ARAG

Details on the Social Security Calculation Parameters Ordinance 2027: You can download the text of the preliminary ordinance > here! The German Crafts Journal is now also available digitally! Simply click here and register for the digital edition!