A health insurer may raise its additional contribution (Zusatzbeitrag) in the middle of the year under certain conditions. This is rare but regulated by law: section 242(2) of Book V of the Social Code (SGB V) provides for an in-year increase if the insurer’s funds do not suffice for the current year. This guide explains when this is permitted, who has to approve it and what you can do as a member.
In short: Yes, a statutory health insurer may raise the additional contribution during the year if its operating funds, including a withdrawal from its reserve, do not suffice for the current year (section 242(2) SGB V). A provisional increase by the insurer’s board needs the supervisory authority’s approval. You then have the special right of termination under section 175(4) SGB V. Last updated: November 2026.
Key points
- The additional contribution is an insurer-specific percentage set in the insurer’s statutes (section 242(1) SGB V).
- An increase during the year is permitted only if operating funds, including a withdrawal from the reserve, do not suffice (section 242(2) SGB V).
- Where action is urgent, the board can decide on a provisional increase, which the supervisory authority must approve.
- The supervisory authority can order a necessary increase. A legal challenge does not suspend it.
- For any increase you may terminate your membership until the end of the month from which the contribution rises. The usual 12-month lock-in does not apply then (section 175(4), sentence 6 SGB V).
When may an insurer raise the additional contribution during the year?
The normal case is a rate set for the turn of the year. Under section 242(1) SGB V, the statutes must provide for an income-related additional contribution if the insurer’s financing needs are not covered by allocations from the health fund (Gesundheitsfonds). The rate is meant to cover, together with allocations and other income, the expected expenditure of the budget year and the required reserve.
An increase during the current year is the exception. Section 242(2) SGB V allows it in two cases. First, if operating funds, including a withdrawal from the reserve, do not suffice for the current year, the rate must be raised by amending the statutes. Second, if the insurer must secure its solvency at short notice, the board can decide on a provisional increase until the statutes are amended. The law ties the provisional increase to approval by the supervisory authority.
Who has to approve an in-year increase?
For an increase during the year, the law provides three routes that differ by urgency.
| Route | Who decides | What the law requires |
|---|---|---|
| Amendment of statutes | The insurer through its statutes | Operating funds including reserve withdrawal do not suffice for the current year |
| Provisional increase | The insurer’s board | Short-term securing of solvency, approval by the supervisory authority required |
| Order | Supervisory authority | No decision by the insurer is reached, the authority orders the necessary increase |
The insurer can challenge an order in court. By law the challenge has no suspensive effect, so the increase applies in the meantime. For you as a member the point is that an insurer cannot simply add to the rate at will. The legislator ties an in-year increase to a financing need and to supervision.
What role does the insurer’s reserve play?
The reserve under section 261 SGB V is meant to absorb fluctuations. Under section 261(3), the insurer may transfer reserve funds to its operating funds if fluctuations in income and expenditure within a budget year cannot be balanced otherwise. The reserve is to be used where this avoids in-year increases of the additional contribution. The legislator thus sees the reserve as a buffer before a contribution increase. More in our guide (in German): Mindestrücklage der Krankenkassen.
Conversely, section 242(1) SGB V limits increases while the insurer has plenty of money. It may not raise the rate while its freely available funds (operating funds, reserve and certain other funds) exceed 0.5 times the average monthly expenditure according to its latest quarterly accounts. An insurer with large reserves therefore cannot ask for a higher rate without using those funds first.
What does an increase cost you per month?
The additional contribution is a percentage of your income subject to contributions, so the calculation depends on your type of income. The example below shows the order of magnitude for students in the student health insurance scheme. According to the GKV-Spitzenverband (national association of statutory health insurers), the assessment base in 2026 is 855 euros a month, and the additional contribution is added in full.
| Assumption: increase of | Calculation (assessment base 855 euros) | Extra cost per month |
|---|---|---|
| 0.3 percentage points | 855 euros times 0.3 percent | about 2.57 euros |
| 0.5 percentage points | 855 euros times 0.5 percent | about 4.28 euros |
| 1.0 percentage points | 855 euros times 1.0 percent | 8.55 euros |
Assumption: the increase applies from July. At 0.5 percentage points, six months add up to about 25.65 euros. For employees the additional contribution is based on gross pay, so the extra cost rises with income. The Federal Ministry of Health gives the average additional contribution rate for 2026 as 2.9 percent, and the estimators’ forecast for 2027 is also 2.9 percent. Your insurer’s rate can differ.
What can you do if your insurer raises the rate mid-year?
The law gives you a special right of termination when the rate goes up. Under section 175(4), sentence 6 SGB V you can terminate until the end of the month from which the additional contribution is first charged or increased. The usual 12-month lock-in does not apply then. The regular notice period runs to the end of the second calendar month after the month in which you give notice. Details are in our glossary entry (in German): Sonderkündigungsrecht bei Zusatzbeitrag. For students, see Switching Health Insurer as a Student: Deadlines and Rules.
- Read your insurer’s notice and note from which month the higher rate applies.
- Compare the new rate with other insurers. The overview is kept by the GKV-Spitzenverband (section 242(5) SGB V).
- Decide by the end of the month from which the higher rate applies whether to terminate.
- The new insurer registers you, and that registration replaces the termination with the old insurer (section 175(4), sentence 4 SGB V).
Frequently asked questions
May the insurer raise the rate retroactively?
The law regulates the increase for the period after the amendment of the statutes or the provisional increase is decided. For individual cases, your insurer’s notice and its statutes apply. If in doubt, the insurer’s supervisory authority can help.
Does the increase apply to students too?
Yes. The insurer-specific additional contribution is added in full to the contribution at the reduced student rate. The special right of termination applies to them as well.
How often may an insurer raise the rate mid-year?
The law names no fixed number. Each increase must meet the conditions of section 242(2) SGB V, and provisional increases must be approved by the supervisory authority.
Where can I see my insurer’s current additional contribution?
Under section 242(5) SGB V the GKV-Spitzenverband keeps a continuously updated online overview of the insurers and rates. Your insurer also states its rate on its website.
What to do now
- Read your insurer’s notice on the increase and record the date it takes effect.
- Check whether the notice mentions the special right of termination and note the deadline.
- Compare insurers by additional contribution rate and by the benefits that matter to you.
- Terminate by the end of the month from which the rate rises, or let the registration with the new insurer replace the termination.
- If you want to review your health cover as a whole, a personal consultation with Academycon is possible: How we work (in German).
Related guides
- Krankenkasse 2027: Was sich für Versicherte und Studierende ändert (in German)
- Zusatzbeitrag der Krankenkassen 2027: Warum die Spanne so groß ist (in German)
- Additional Contribution 2027: What Students Can Do Now
- Krankenkasse Mindestbindung (in German)
- Health insurance additional contribution
Sources: Section 242 SGB V, gesetze-im-internet.de; Section 261 SGB V, gesetze-im-internet.de; Section 175 SGB V, gesetze-im-internet.de; Federal Ministry of Health, contributions in statutory health insurance (as of 3 September 2026).
Last updated: November 2026. This guide is general information, not individual advice.
