Glossary: German health insurance terms explained in English

Jahresarbeitsentgeltgrenze, Anwartschaft, Zusatzbeitrag? Here are the German health insurance terms newcomers meet most often – explained in plain English, with the German word, the legal basis and current values. 2027 values are based on the Federal Cabinet decision of 7 October 2026 (Bundesrat approval pending). As of October 2026.

Additional contribution (Zusatzbeitrag): Fund-specific contribution on top of the general rate of 14.6% in public health insurance. The official average is 2.9% in 2026; funds actually charged 2.18% to 4.39% in October 2026. The average for 2027 will be announced by 1 November 2026 (§ 242a SGB V). Employees and employers each pay half. Learn more →
Ageing reserves (Alterungsrückstellungen): Savings built into private premiums to keep them more stable in old age. They are only transferred if you switch to another German private insurer at the same time, and then only the part that matches the basic tariff (§ 204 VVG); they can't be taken abroad. Learn more →
Anonymous pre-check (anonyme Risikovoranfrage): A broker submits your health details without your name to several private insurers before you apply, to learn whether they would accept you, add a surcharge or exclude something. It avoids a recorded rejection. We never ask health questions online – details in German at PKV-trotz-Vorerkrankung.de. Learn more →
Basic tariff (Basistarif): Private tariff with benefits comparable to public insurance that every private insurer must offer without risk surcharges (§ 152 VAG). The premium is capped at the maximum public contribution – €1,017.18 a month in 2026 (PKV association). A fall-back, not a bargain. Learn more →
Beihilfe (civil servants' allowance): Allowance from the state employer that pays a share of civil servants' medical bills. Civil servants usually insure only the remaining share with a private Beihilfe tariff. Learn more →
Blue Card (Blaue Karte EU): Residence permit for highly qualified workers (§ 18g AufenthG). Minimum salary 2026: €50,700, or €45,934.20 in shortage occupations (Federal Ministry of the Interior, December 2025). It says nothing about the choice of health insurance: most holders earn below the income threshold and are publicly insured. Learn more →
Chief physician treatment (Chefarztbehandlung): Treatment by the head of a hospital department. Not covered by public insurance as a standard benefit; included in many private tariffs or available as a supplementary policy – check your tariff. Learn more →
Civil servant (Beamter): Person in a public-law service relationship, e.g. many teachers, police officers and judges. Civil servants are exempt from compulsory public insurance and usually combine Beihilfe with a private tariff. Learn more →
Compulsory insurance (Versicherungspflicht): The legal obligation to be in public health insurance, e.g. as an employee earning below the income threshold (§ 5 SGB V). Everyone living in Germany must have some health insurance – public or private (§ 193 (3) VVG). Learn more →
Contribution ceiling (Beitragsbemessungsgrenze, BBG): Maximum income on which public health contributions are charged: €5,812.50 a month in 2026 and €6,375 in 2027 (draft: Federal Cabinet decision of 7 October 2026, Bundesrat approval pending). Income above it is contribution-free; that is why everyone above the ceiling pays the same maximum. Learn more →
Deductible (Selbstbehalt): Amount you pay yourself each year before a private policy pays. A higher deductible lowers the premium, but the employer doesn't contribute to it. For mandatory cover it may be at most €5,000 a year (§ 193 (3) VVG). Learn more →
Dormant policy (Anwartschaftsversicherung): Pauses a private policy, e.g. during a stay abroad. The small version keeps your health status, the large one also your entry age. According to Allianz it costs about 5 to 10% or 30 to 45% of the premium; insurers differ. In German: KV-Statuswechsel.de. Learn more →
E 104 / S041: Certificate of insurance periods in another EU/EEA country, Switzerland or the UK. It helps you prove prior public insurance, e.g. for voluntary membership after a return (Regulation (EC) 883/2004; DVKA). Learn more →
Employer contribution (Arbeitgeberzuschuss): Employers pay half of an employee's private premium, up to €613.22 a month in 2026 and about €672.56 in 2027 (scenario), including long-term care and dependants (§ 257 SGB V, § 61 SGB XI). Self-employed people get nothing. Learn more →
European Health Insurance Card (EHIC): Card on the back of the public health insurance card that gives access to necessary treatment during temporary stays in other EU/EEA countries and Switzerland under local rules. It is no substitute for insurance after a move. Learn more →
Exemption (Befreiung von der Versicherungspflicht): Application to be released from compulsory public insurance, e.g. if you become compulsorily insured only because the income threshold rises. It must be filed within three months and is generally irrevocable (§ 8 SGB V). Learn more →
Fall-back insurance (Auffang-Versicherungspflicht): Public insurance for people without other cover who were last publicly insured or never insured (§ 5 (1) no. 13 SGB V). Self-employed people and high earners who were never insured are not covered; non-EU citizens only with a residence permit of more than twelve months that doesn't require proof of secured livelihood (§ 5 (11) SGB V). Learn more →
Family insurance (Familienversicherung): Free public cover for the spouse or registered partner and children of a member, if they live in Germany and earn at most €565 a month (2026; €590 in 2027, draft) (§ 10 SGB V). From 2028 a surcharge of 2.5 percentage points applies for spouses, with exceptions such as a child under 12. Learn more →
General contribution rate (allgemeiner Beitragssatz): Uniform rate of 14.6% of income in all public health insurance funds (§ 241 SGB V), shared equally by employee and employer; 14.0% without sick pay entitlement (§ 243 SGB V). The additional contribution comes on top. Learn more →
Health insurance fund (Krankenkasse): Provider of public health insurance, e.g. TK, AOK or Barmer – 91 funds in October 2026 (GKV-Spitzenverband). Benefits are largely set by law; funds differ in their additional contribution and service. Learn more →
Health questions (Gesundheitsfragen): Questions about your health in a private insurance application. You must answer everything the insurer asks in text form (§ 19 VVG); the result can be acceptance, a risk surcharge, an exclusion or a rejection. Public insurance asks no health questions. Learn more →
Income threshold (Jahresarbeitsentgeltgrenze, JAEG): Salary above which employees are exempt from compulsory public insurance and may choose private: €77,400 in 2026 and €84,150 in 2027 (draft: Federal Cabinet decision of 7 October 2026, Bundesrat approval pending) (§ 6 SGB V). Also called Versicherungspflichtgrenze. Learn more →
Incoming insurance (Incoming-Versicherung): Private health insurance for foreign visitors and job seekers, often required as proof for a visa such as the Opportunity Card. It is no substitute for German health insurance once you live and work here; many policies exclude long stays. Learn more →
Limit for existing private cases 2027 (Bestandsgrenze): Lower income threshold of €80,550 for 2027 that applies to employees who are already exempt and privately insured on 31 December 2026 (§ 6 (8) SGB V as amended; draft value). Learn more →
Long-term care insurance (Pflegeversicherung): Compulsory insurance for long-term care, in the same system as your health insurance. Public rate 3.6%; childless people over 23 pay 4.2% in 2026 and 4.5% in 2027 (draft care reform) (§ 55 SGB XI). Private policyholders need a private long-term care policy. Learn more →
Minimum assessment base (Mindestbemessungsgrundlage): Minimum income on which voluntarily insured people, e.g. freelancers, pay public contributions: €1,318.33 a month in 2026 and €1,376.67 in 2027 (§ 240 (4) SGB V). Minimum contribution 2026: €286.08 (childless, with sick pay). Learn more →
Model terms (Musterbedingungen MB/KK): Standard terms published by the PKV association for private health insurance (MB/KK 2009, as of June 2024). Insurers' tariff terms build on them and may be more generous – your own terms always decide. Learn more →
No-claims bonus (Beitragsrückerstattung): Refund of part of your private premiums if you don't submit claims in a year. Whether and how much depends on the insurer and the tariff; it is not a legal entitlement. Learn more →
Opportunity Card (Chancenkarte): Residence permit for job search (§ 20a AufenthG), initially for up to one year, with work allowed up to 20 hours a week. German missions usually ask for incoming insurance valid in all Schengen states with at least €30,000 cover. Learn more →
Premium increase (Beitragsanpassung): Private insurers may only raise premiums if claims costs deviate by more than 10% (or a lower tariff threshold, often 5%) or life expectancy by more than 5%, and only with the consent of an independent trustee (§ 203 VVG, § 155 VAG). In 2026 about 60% of policyholders had an increase. Learn more →
Premium surcharge for late insurance (Prämienzuschlag): One-off surcharge if you take out mandatory private insurance more than one month after the obligation arises, e.g. after returning to Germany: one monthly premium per further month, from the sixth month one sixth (§ 193 (4) VVG). Learn more →
Private health insurance (private Krankenversicherung, PKV): Full health insurance with a private insurer that replaces public insurance. Premiums depend on entry age, tariff and health; every person needs a policy. 8.79 million people had full private cover at the end of 2025 (PKV association). Learn more →
Public health insurance (gesetzliche Krankenversicherung, GKV): The statutory system run by health insurance funds. Contributions depend on income up to the contribution ceiling; family members can be insured free of charge; benefits are set by law. Learn more →
Reimbursement principle (Kostenerstattungsprinzip): In private insurance you usually receive the doctor's bill, pay it and claim it back from your insurer. In public insurance the doctor bills the fund directly via your insurance card. Learn more →
Risk surcharge (Risikozuschlag): Extra premium a private insurer can charge for a higher health risk found in the health questions (§ 203 (1) VVG); alternatively it may exclude benefits or reject the application. Not allowed in the basic tariff. Learn more →
S1 form: EU certificate that lets you register for health care in the country where you live while you are insured in another country – e.g. cross-border commuters or pensioners (Regulation (EC) 883/2004). Cross-border commuters to Switzerland: Grenzgänger-PKV.de (in German). Learn more →
Sick pay insurance (Krankentagegeld): Private insurance that pays a daily amount if you can't work due to illness – important for freelancers. Employees in public insurance receive sick pay (Krankengeld) from their fund after their employer's continued pay ends. Learn more →
Statutory 10% surcharge (gesetzlicher Zuschlag): Extra 10% that privately insured people pay from the year after they turn 21 until the year they turn 60; the money is used to dampen premium increases from age 65 (§ 149, § 150 VAG). Learn more →
Voluntary membership (freiwillige Mitgliedschaft): Public insurance for people who are not compulsorily insured, e.g. freelancers or high earners. Joining requires prior insurance periods (24 months in five years or 12 months right before) – or, for a first job in Germany above the threshold, a notice within three months (§ 9 SGB V). Learn more →
Waiting period (Wartezeit): Period after the start of a private policy before certain benefits are paid: at most three months in general and eight months for e.g. childbirth, psychotherapy or dentures (§ 197 VVG). Previous insurance counts if you apply within two months of its end. Learn more →

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