What is the co-insurance of health insurance

Family insurance in the health insurance: Who comes in free of charge

Children must then either also be insured in private health insurance or become voluntary members of statutory health insurance. The costs for voluntary membership in statutory health insurance are usually higher than private health insurance for children.

Exclusion from family insurance only applies if all three conditions are actually met. For example, if the father has private insurance and the mother has statutory insurance, but earns more than her husband, the children can still have family insurance.

Both parents are only considered as a whole, however, if both are married or linked in accordance with the Civil Partnership Act. If both parents are not married, the child can be insured through both the privately and legally insured parent.

Continued insurance after the end of family insurance

After the end of family insurance, those affected will 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 that they can provide evidence of other coverage in the event of illness - usually private health insurance.

This is how the contribution is calculated

People with statutory health insurance have to pay a percentage of 14.6 percent of their wages to the health insurance company. The employer pays half of this. In addition, there is the additional contribution, which varies from fund to fund, which is one percent on average, but can vary depending on the health insurance company. Parents pay 2.55 percent and childless 2.8 percent for the long-term care insurance. Here, too, the employer pays half, but does not contribute to the extra premium for the childless.

In the case of voluntarily statutory insured persons, on the other hand, not only earnings from employment or self-employment are used 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 insurance and those with voluntary insurance. The income of the insured is used to calculate the contributions up to a maximum of 4425 euros per month.

However, there are differences in the minimum income. People with compulsory insurance pay their percentage of their wages, no matter how low it is. For voluntarily insured persons, however, a minimum income of 1015 euros applies, even if lower income is actually achieved.

Different contributions depending on the family constellation

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

In the case of voluntarily legally insured persons whose spouses or partners have private health insurance (in accordance with the Civil Partnership Act), the income of the spouse or partner is added to their own income and used as the basis for calculating the contributions.

First of all (if available) the voluntarily insured partner's own income is taken into account and then half of the income of the spouse or life partner, however up to a maximum of half the contribution assessment ceiling. In 2018, this limit is 2212.50 euros.

However, this does not apply under certain conditions. The main reasons are:

  • The voluntary member earns more than half the income threshold or more than the spouse or partner.
  • For spouses who are permanently separated. Among other things, the maintenance payments are contributed to this.