Family insurance: Where is the income limit?

Family insurance is a special feature of public health insurance: Under certain conditions, you can also insure children and partners without any extra cost. But what are the income limits for family insurance? Up to what age may children remain in the family insurance?

Medizinisch geprüft - Siegel
Reviewed by our insurance experts

Table of content:

Family insurance: What income limits apply to children and partners?

The family insurance of the public health insurance is intended for children and partners who earn little or nothing. It is therefore intended to relieve the families' purse, so that at the end of the month is not too much money left. This means you can insure yourself, your partner and your children simultaneously, usually with the same level of cover.

Of course, the exact scope of cover (in terms of the illnesses and injuries included and treatments offered) differs from one insurance provider to the next. It is up to you to find a policy that meets the needs of you and your family.

In Germany, spouses and children of people with public (statutory) health insurance are automatically co-insured free of charge.

This is often not the case in the private health insurance system. Private insurance providers usually require a new or separate policy to extend cover to additional persons.

How much can you earn to still be covered by family insurance?

Children and partners may earn a maximum of 470 euros per month. The income limit for family insurance changes every year because it depends on the average salary of Germans and this fluctuates year by year.

Mini-jobs and many student jobs are therefore not a problem if a woman, man or child wants to be included in the family insurance. At least most of the time.

In addition to gross salary, total income includes:

Important: The income after deduction of expenses applies. So if you rent out an apartment, you can first deduct all expenses such as craftsmen's costs. Only what remains after that counts as income. You can also deduct the employee lump sum of 1,000 euros from your salary. If there are higher income-related expenses, you can also deduct more. If you include the employee lump sum in the income calculation, the amount increases to 553.33 euros per month (470 euros plus 1,000 euros divided by 12 months).

So if you don't work much but have inherited an apartment, for example, and regularly collect rental income, you will quickly slip above the income limit for family insurance. Even an increase in hours with marginal earnings can quickly lead to a husband, wife or child having to insure themselves.

You can find more information about what exactly counts as income, and what does not, in the PDF of the "GKV-Spitzenverband". If you have any questions, you can also contact your public health insurance company directly.

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Income limit for family insurance exceeded - what now?

If the income limit for family insurance is exceeded once, this is not a problem at first. At least if the higher income was not foreseeable and it is not permanent income. Otherwise, a small irregularity would lead to having to change an insurance relationship that may have existed for years.

Outliers are tolerated as long as they do not last longer than three months. If you receive more income over a longer period, you must insure yourself.

How does fluctuating income of self-employed persons affect the income limit?

Let's say Susanne has just started her own business as a freelance artist. Her income fluctuates greatly: some months she earns hardly anything, while in others a major order keeps the cash register ringing. Susanne has family insurance with her husband and is now wondering how to deal with these irregularities.

Normally, the calculation works by estimating the expected total income. Of course, since Susanne doesn't have a crystal ball at home, this estimate is vague. But once she's been in business a few years, she can at least refer to last year's income. In fact, the income tax assessment of the last year is decisive for the health insurance. Whether the income limit for family insurance is exceeded is therefore assessed annually and not monthly.

Unfortunately, it always arrives quite late in the mail. It is best to submit it to your health insurance company as soon as you receive it. If the notice documents a higher income and you exceed the income limits, you may have to leave the family insurance retroactively. It is best to take action yourself as soon as your situation changes, otherwise you may have to pay additional contributions.

Can the child also be insured as a family member if one partner is in private health insurance?

Let's assume that Carla, a specialized saleswoman, is publicly insured and employed on a part-time basis. Her husband Thomas is an entrepreneur with private insurance. In this case, Carla can only insure their child Paul under certain conditions.

The conditions for family insurance are met if

In the most cases the privately insured partner earns a higher income than the publicly insured person.

In this case, the family insurance of public health insurance does not apply to the child. The child must then be insured separately either by public or private insurance and pay a separate premium. So it makes more sense to insure the child in PKV, because so you guarantee the best health care for your child.

What other requirements apply for family insurance?

Income is not the only factor that determines whether your child or partner can be insured with you for free. The person you want to co-insure must also live in Germany and you must be responsible for this person.

This is the case, for example, for the following persons:

By the way: For unmarried couples or single persons, family insurance automatically takes effect when the child is born. If a man and woman live together without a marriage certificate, however, one of the two cannot be insured as a family member. A marriage would be necessary. 

Our conclusion:

In principle, it is of course practical to quickly include the child in the family insurance. But family insurance has very narrow income limits that can quickly be exceeded. If this is the case, for example because the self-employment suddenly goes really well after a poor initial phase, a separate insurance is required. Self-employed people basically have a choice and can also take out private insurance if they wish. This applies right from the start of the business!

Espen Markus Mjøs
HIER SCHREIBT Espen Markus Mjøs

Espen Markus - originally from Norway - is sales agent in ottonova's English sales team. He's in contact with potential customers every day and answers Expats' questions about German health insurance.

ottonova sales experts
HIER SCHREIBT ottonova sales experts

Our ottonova team of experts has over 40 years of experience in private health insurance and answers questions about it every day. What are old-age provisions and for whom does private health insurance make sense? What is the actuarial interest rate and which tariff is right for you? They know!

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