The German government is planning to end the free dependent health insurance for spouses (beitragsfreie Familienversicherung für Ehepartner).
According to reporting by Handelsblatt, the coalition is discussing replacing free coverage with a flat minimum contribution of €200 per month for health insurance and €25 per month for long-term care insurance. This is €225 per month, or €2,700 per year.
The first proposal will be out on Monday (30 March 2026).
Why is the government considering abolishing free dependent health insurance for spouses?
There are several reasons for the government to abolish free dependent health insurance.
- Germany’s statutory health insurance system (GKV) is running out of money. The GKV is expected to face a deficit of €12 to €15 billion in 2026. And the gap is widening every year.
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- Increasing public health insurance premiums is not helping cover the rising healthcare costs. Supplementary contributions (Zusatzbeitrag) have already risen from 2.5% in 2025 to an average of 2.9% in 2026. Some health insurance companies are charging an additional contribution of over 4%.
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- According to the IGES Institute, around 2.5 to 3 million spouses are insured free of charge in the public health system. This costs the German public health insurance €11.4 billion per year.
- Collecting a flat €200 monthly contribution from the spouses currently covered at no cost could generate close to €6 billion in new revenue per year. This is equivalent to 0.3 percentage points less contribution rates for everyone else.
- Another benefit is that the current proposal will make employment more attractive to people. Free family coverage currently reduces the financial incentive to take a job subject to social security contributions. If you already have to pay €200 per month, taking a job with a gross salary of around €2,300 means you pay roughly the same amount in contributions.
- As more people might return to work after the reform, this means more revenue for the public health and pension systems.
Who is currently covered for free in the public health insurance?
Currently, your spouse and registered civil partner can be co-insured at no extra cost under your public insurance, if they meet the following conditions:
- Your spouse is not self-employed
- Your spouse is not privately insured
- Your spouse’s monthly income does not exceed €565 (2026 limit for regular employment income)
- Mini-jobbers can be co-insured if they earn no more than €603 per month
NOTE: Children remain covered at no cost under the family insurance rules and are not part of this reform discussion.
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Who can still be co-insured for free in the public health insurance?
The flat fee for public health insurance won’t apply to everyone. The following people are not included.
- Spouses with children under six years old
- Spouses caring for dependents requiring long-term care
These exceptions significantly reduce the number of people who would actually pay. Thus, the GKV’s savings will be lower.
What do the critics say about abolishing free public health insurance?
- Ver.di, one of Germany’s largest trade unions, argues that the proposal will spread the financial burden across all employees. It doesn’t fix the underlying structural problems.
- The GKV-Spitzenverband, which represents statutory health insurance funds, pointed out that the problem lies on the spending side, not the revenue side.
- The IGES Institute proposed a contribution-splitting model (Beitragssplitting). Under this model, both partners’ incomes would be combined, the total halved, and contributions calculated on each resulting amount. This approach would generate similar revenue while spreading the burden more proportionally by income. This would mean that high earners will pay even more in public health insurance. The side effect could be high earners moving to private health insurance. Hence, reducing the revenue for the public system.
NOTE: Nothing has been approved yet. The government will present a full reform package after the Health Finance Commission publishes its report. Changes, if they come, are unlikely to take effect before late 2026 at the earliest.
What can you do about the rising public health insurance costs?
Whether the reform passes in its current form, a modified version, or not at all is still open. But there are steps worth taking now:
- Check whether you or your partner is affected. If your partner is co-insured under your GKV policy, verify whether you would fall under the proposed exceptions.
- Compare your current health insurance. Regardless of this reform, the gap between the cheapest and most expensive statutory funds in Germany runs to several hundred euros per year. If your fund charges a Zusatzbeitrag above the average 2.9%, switching to a cheaper fund is worth considering. We find TK the best public health insurance provider for expats. Its website, mobile app, and customer service are in English. You can register with TK online.
- Start looking for a job.
- Start investing. The German social security system is falling. It’s vital that you plan for your future without relying on the government policies.
