From 2026, significant changes will come into force for privately insured persons, including higher subsidies, adapted care services and expanded functions of the electronic patient record (ePA). Our overview shows the key innovations.

New limits for switching to private health insurance

From 2026, employees must have an annual income of at least 77,400 euros in order to leave statutory health insurance (GKV) without insurance and switch to private health insurance (PKV). In comparison, the limit in 2025 was 73,800 euros. Anyone who is already privately insured and is affected by the new limit can be exempted from compulsory statutory health insurance and remain in private health insurance. Persons with a low income that does not exceed 603 euros per month from 1 January 2026 (2025: 556 euros) are exempt from compulsory statutory health insurance and can take out private insurance. Family members of civil servants can take out private insurance under certain conditions if their income from self-employment does not exceed the aid limit. In the case of federal aid in 2026, this is 22,648 euros per year (2025: 21,832 euros), although the values for state civil servants may vary depending on the federal state. In the case of dependent employment, however, the statutory health insurance obligation applies regardless of whether the aid is taken into account.

Subsidies for private health insurance contributions

In 2026, employers will pay a maximum subsidy of 508.59 euros for health insurance (2025: 471.32 euros) and 104.63 euros for long-term care insurance (2025: 99.23 euros) for privately insured employees. Those who do not use the maximum subsidy can partially redirect it to family members if they have no income or only a low income that does not exceed 565 euros per month in 2026 (2025: 535 euros). In the case of marginal employment, the marginal income threshold of 603 euros applies. Pensioners with a statutory pension are entitled to a subsidy from the German Pension Insurance, which must be applied for. The amount depends on the pension amount and the statutory health insurance contribution rate, with the additional contribution rate rising to 2.9 percent from 2026, which increases the subsidy slightly.

Changes in social tariffs

The basic rate of private health insurance provides for a maximum contribution of 1,017.18 euros in 2026, which can be halved in the event of social assistance and additionally subsidized by the social assistance agency. In the standard rate, the maximum contribution is 848.62 euros, for married couples 1,272.93 euros. Access to the standard rate requires a total income of a maximum of 69,750 euros per year (2025: 66,150 euros) for those under 65, in accordance with the statutory health insurance contribution assessment ceiling.

Digital transmission

From 2026, paper certificates for the employer subsidy and income tax will no longer be required. Private health insurance companies transmit the contribution values digitally to the Federal Central Office, which makes them available to employers, which means that insured persons have less administrative work.

Care

From 2026, care allowance recipients with care level 4 or 5 will only have to attend a counselling visit every six months instead of quarterly. In communal forms of housing, people in need of care receive a lump-sum subsidy of 450 euros per month for self-determined care. These changes are based on the “Act on the Expansion of Powers and Reduction of Bureaucracy in Care”, which has yet to be adopted.

Advanced EHR functions

From mid-2026, many private health insurance companies will offer new ePA functions, including an expanded medication list with over-the-counter medicines and an electronic medication plan that clearly displays drug therapy.

The innovations are aimed at modernising insurance conditions and improving financial relief as long as the legal framework is implemented.

Editor: X-Press Journalistenbüro GbR

Gender Notice. The personal designations used in this text always refer equally to female, male and diverse persons. Double/triple naming and gendered designations are used for better readability. ected.