Family insurance within the statutory health insurance scheme

Employees who exceed the income threshold for compulsory insurance can continue to insure their family members under voluntary health insurance. Co-insurance via family insurance remains a non-contributory insurance.

Voluntary statutory health insurance – often cheaper for families

Employees who exceed the income limit for compulsory insurance in the statutory health insurance fund have the option of choosing between voluntary membership of the SHI system and switching to private health insurance. The income limit for the compulsory insurance of the statutory health insurance funds is currently a monthly income of 60,750.00 euros per year or 5,062.50 euros per month. Even if you start your own business or work as a freelancer after having been previously insured with the statutory health insurance, you have a choice between voluntary health insurance and private health insurance.

Family insurance or private health insurance?

Advantage family insurance: relatives without income are also insured free of charge.

Even before the income situation or professional basis changes, it should be thoroughly considered which type of insurance is the cheapest and best option for the individual claim. If family members such as spouses and children without their own income were previously covered by the statutory health insurance with the compulsory insurance, they can remain in the family insurance at the usual conditions when changing to voluntary health insurance. Those who switch to the voluntary health insurance of a statutory health insurance fund only pay the contribution according to their own income. The relatives without income remain insured free of contribution, exactly as before in the compulsory insurance.

Family insurance is cheaper than private health insurance, especially for families with several children.

This may be more advantageous for families with several children than switching to private insurance, where each family member has to pay a contribution according to the contract concluded.

Also consider future family planning when deciding between private health insurance and family insurance

However, it is not only the current life situation that should be decisive for the question of whether voluntary health insurance or switching to a private insurer is more suitable. Future family planning should also be considered. Young insured persons whose profession changes or who exceed the income threshold for compulsory insurance must take into account how the financial situation will develop when starting a family, especially if children are added. What may seem favourable at the present time may become quite expensive for each family member as the family grows to raise the standard of living by taking out several individual insurance policies.

Who can apply for family insurance?

A family insurance can be applied for for:

  • the spouse and/or the same-sex life partner
  • the biological children
  • adoptive children and children whose adoption is planned and who are already in the care of the applicant family
  • stepchildren and grandchildren, most of whom are cared for by the requesting member
  • foster children living in a domestic community with foster parents applying for family insurance

Save money with a health insurance comparison

Even with the statutory health insurance, cash money can be saved through a health insurance comparison. Some health insurance companies offer additional services or are particularly financially stable. Our health insurance company comparison, with which the insurance switching takes place over AG, helps you with the selection of the suitable health insurance company:

Minor earnings do not play a role in family insurance

The definition “relatives without own income” does not always meet the requirements for a family insurance of voluntarily insured persons in the SHI system. Income from minor employment, the so-called 450 euro job, does not affect the entitlement to family insurance. Children over the age of 18 can also remain in the family insurance if they are in education.

Family insurance with Minijob

The basis for minijobs or 450 Euro jobs is that there is no social security obligation for minijob work for these minor jobs. The employer only pays a flat-rate social security contribution, but this does not entitle the employee to any insurance. However, since compulsory insurance applies in Germany, a mini-job, for example for a spouse without any other income, still entitles the employee to family insurance. This family insurance is perceptible, even if the main earner in the family is voluntarily insured in the statutory health insurance.

Check the benefits catalogue of the respective health insurance fund for voluntary health insurance

Insured persons who decide to remain voluntarily in the statutory health insurance system, particularly because of the advantage of family insurance, should take a close look at the benefits and tariffs of the individual statutory health insurance funds. Independent comparisons are available for this, just as for private health insurance. The possibility of the choice tariffs in the legal health insurance was substantially extended. Thus there are also for voluntarily health insured substantially larger choice possibilities. This is particularly important for relatives, especially children. The payment of sick pay can also be secured via optional tariffs for voluntarily insured persons.

Catalogues of benefits naturally limited compared to a private health insurance policy

As advantageous as the family insurance may be for the relatives in a voluntary health insurance of the statutory health insurance funds, it should not be forgotten that the benefit catalogues remain limited in some respects. If some of the benefits can be extended by corresponding optional tariffs, there are still a number of benefits that can only be covered by additional private supplementary health insurance.

Compare supplementary health insurance rates

Supplementary health insurance supplements the scope of insurance and the catalogue of benefits of the statutory basic cover and offers you individual benefit modules that are otherwise only available in private health insurance. You can request a free and non-binding offer for your desired supplementary health insurance here at AG, which also takes over the insurance brokerage:

Switching back from private health insurance to statutory health insurance is difficult

However, once the decision against voluntary health insurance has been made, the path from private health insurance back to statutory health insurance is hurtful. There are only few possibilities for a change back to one of the statutory health insurances. This goes only if the income sinks again under the obligation insurance border, the independence or freelance work is given up or the insured one by unemployment ALG II receives. Also these limited possibilities are not to be noticed beyond the 55th year of life any longer. If the family grows, then there is after a decision for the PKV therefore no way back to the GKV with family insurance.

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Christina Cherry
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