The federal government wants to abolish non-contributory co-insurance in statutory health insurance. That reports that Handelsblatt citing statements within the coalition. That would Reduce the burden on health insurance companies by a few billion euros per year. They ran into a deficit again in 2025 due to sharply rising costs. The federal government tried to compensate for this with a loan of 2.3 billion euros. This is what the new plans would mean for you.

What does non-contributory co-insurance look like so far?

If a family member is insured in a statutory health insurance company, their relatives can do so there free of charge enjoy the same services. All you have to do is apply for family insurance. However, there are limits to co-insurance, also known as family insurance. For example, a spouse or registered partner may not earn more than 603 euros per month. In addition, he or she may not have other health insurance, be self-employed full-time or be exempt from statutory health insurance. Civil servants, judges, soldiers and clergy are also excluded.

For children, stepchildren and grandchildren that the insured person supports, co-insurance applies until their 18th birthday. For children and grandchildren who are not employed, it is extended until their 23rd birthday, and if they are studying or doing training, it is extended until their 25th birthday.

What does the federal government want to change?

Co-insurance should be in place in the future only be eliminated for spouses. Instead, they should pay a minimum contribution of 225 euros per month. This consists of 200 euros for health insurance and 25 euros for nursing care insurance. Exceptions should only apply if children under the age of six or relatives in need of care live in the household. So far these are still loose plans. At the end of the month there will be a commission of experts Proposals for health and care reform make. The federal government only wants to make a decision afterwards.

How much would the additional costs be?

225 euros a month adds up to 2700 euros a year. The proposal makes no distinction between the income levels of a household. The costs would therefore be just as high for a family that lives on the minimum wage as for one whose household income is 100,000 euros per year. In the former case, disposable income would decrease by around 13 percent. In the latter case it would only be just under 5 percent.

How many people would be affected?

According to the Federal Ministry of Health, there are currently around 15.6 million people in Germany are insured free of charge. The majority of them are children. Around three million adults are also among them. However, it is unclear how many of these are adult children in college or training. It is also unclear how many others will be allowed to remain insured free of charge because they look after small children or relatives who need to be cared for.

What do experts say about this?

Jochen Pimpertz from the German Economic Institute (IW) praises the planned change. He sees the current free co-insurance as a “barrier to employment”. It would provide an incentive for spouses not to take a job. Robin Jessen from the Leibniz Institute for Economic Research sees it similarly: “Abolishing free co-insurance for spouses in statutory health insurance would noticeably increase the number of jobs available.”

But there are also opposing voices. Instead of a flat-rate minimum rate, the consulting institute IGES suggests a model in which the contributions are distributed between both partners. Similar to spousal splitting, health insurance contributions should also be divided between both partners. As a result, it expects additional income of 3.6 billion euros.

The health insurance companies themselves are strictly against the abolition. The National Association of Statutory Health Insurance Funds describes free co-insurance as an “integral part of the principle of solidarity”.