Children’s health insurance information

Children in health insurance (c) S. Hofschlaeger / In most cases, children are covered by the GKV through a parent in the GKV. Nevertheless, there are a number of other constellations in which the private insurance of a child may make sense. This depends, among other things, on the insurance status of both parents as well as their income and distribution, but in the case of a private health insurance application also on the child’s current state of health.

Family insurance (GKV)

Family insurance – GKV Die non-contributory co-insurance can be claimed in the statutory health insurance if a family member or parent has compulsory statutory health insurance or is voluntarily insured in the statutory health insurance. Free of charge means that people who receive their health insurance cover through family insurance do not pay their own contribution to the health insurance company have to. There are also no extra surcharges for the compulsory family member.

Which children can be covered by family insurance??

The non-contributory family insurance in the GKV applies to the following children:

  • own biological children or biological children of spouses and recognized partners
  • adopted children and children in the adoption process who live in the receiving family
  • care childr in home with foster parents
  • Step and grandchildren, if they are mainly cared for by the compulsorily insured member

Insurance in the private health insurance

Children in the PKV © DOC RABE Media – For the question, Whether a child can be privately insured through a parent, for example, is critical to whether one for the parent Exemption from compulsory insurance and the income is above or below the Annual earnings limit (JAEG) lies. If a child is to be insured with a parent insured with a private health insurance, this requires, in contrast to the statutory health insurance, a separate insurance contract with an additionally calculated independent contribution rate. Irrespective of this, some companies generally offer their own private health insurance tariffs for children.

Basically there is the possibility to have a child covered by private health insurance through a parent ( Kindernachversicherung ) or to conclude an individual PKV contract for the child ( individual contract).

When is private health insurance for a child excluded??

The easiest decision is made if there is a reason for exclusion from the outset for private health insurance for the children. This is the case in the following constellations:

  • Both mother and father are compulsorily insured in the SHI
  • Father is compulsorily insured under statutory health insurance, mother is family insured as a housewife
  • Father privately insured with income below JAEG, mother compulsory health insurance
  • Father voluntarily insured SHI with higher income as a mother, mother privately insured

When is there freedom of choice between the two systems??

Children GKV – PKV Freedom of choice GKV or PKV In the following example cases, the parents can decide whether they prefer to insure their child legally or privately.

  • Father privately insured with income above JAEG, mother compulsory health insurance
  • Mother PKV with higher income than father, father voluntarily insured through statutory health insurance

When does a child have to be covered by private health insurance??

If both parents or partners are privately insured, the child must also be insured in the private health insurance.

What does PKV insurance cost for a child??

For the insurance or co-insurance of a child in the PKV between 60 and 120 euros are to be raised. This amount does not include any aging provisions, as they have to be calculated for adults in the private health insurance.

Who as a member Allowance claims for private health insurance can also claim this for the calculated child premiums.

Also the Employer contribution to private health insurance extends in many cases over the child bonuses and is paid up to the maximum possible employer’s share in the SHI.

If the child is to be legally insured voluntarily, there is no entitlement to employer subsidies. In this case, a low PKV tariff for children is recommended.


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Christina Cherry
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