State health aid (Beihilfe) is the main element of illness-cost cover for civil servants in North Rhine-Westphalia. How much is reimbursed depends on family status, number of children and your status. This guide shows the rates the state publishes and explains how to calculate your share of costs in a traceable way.
Short answer: In North Rhine-Westphalia, state health aid reimburses a fixed share of eligible costs, based on family status and number of children. According to the NRW finance administration guidance (as of January 2026), the rate is 50 percent for eligible persons with no or one child, 70 percent with two or more children, 70 percent for spouses and 80 percent for children. You cover the rest yourself or insure it.
The most important points at a glance
- Principle: State health aid reimburses a share of costs, not the full amount. A tariff covers the rest, or you pay it yourself.
- Rates: 50 percent for eligible persons without or with one child, 70 percent with two or more children, for spouses and in retirement, 80 percent for children.
- Trainees: The guidance does not explicitly name trainees or civil servants on probation, so ask.
- Timing: What counts is when the costs arise, not when you receive the invoice.
- Tariff: A health aid tariff covers the share that is not reimbursed and should suit your situation.
What is state health aid and why are there reimbursement rates?
State health aid is the form of illness-cost cover for civil servants and their eligible dependants. The employer reimburses only part of the eligible costs. This share is the reimbursement rate (Bemessungssatz). The rest is usually covered by private health insurance with a health aid tariff.
Which reimbursement rates apply in North Rhine-Westphalia?
The guidance “Beihilfeanspruch und Antragstellung” of the NRW finance administration (as of January 2026) sets out the following rates as the general rule.
| Group | Reimbursement rate |
|---|---|
| Active eligible persons without a child or with one child | 50 percent |
| Active eligible persons with two or more children | 70 percent |
| Eligible persons in retirement | 70 percent |
| Retired university professors | 50 percent |
| Eligible spouses and registered partners | 70 percent |
| Eligible children and orphans entitled to aid | 80 percent |
| Trainees and civil servants on probation | Not named in the guidance |
What counts is the situation at the time the costs arise. Anyone who retires is reimbursed at 70 percent for costs incurred afterwards. Costs incurred during active service can still be reimbursed at 50 percent.
How do you calculate your share of costs?
Your share of costs is the amount that health aid does not reimburse. It is the eligible costs minus the portion that your rate covers. Three examples show the difference.
| Case (assumption) | Eligible costs | Rate | Health aid | Your share |
|---|---|---|---|---|
| Civil servant without children | EUR 1,000 | 50 percent | EUR 500 | EUR 500 |
| Civil servant with two children | EUR 1,000 | 70 percent | EUR 700 | EUR 300 |
| Eligible child | EUR 1,000 | 80 percent | EUR 800 | EUR 200 |
Assumption: the costs are fully eligible, and a tariff does not cover your share. In practice, maximum amounts and exclusions can change the result, so check every health aid notice carefully.
When does a health aid tariff make sense as a supplement?
A health aid tariff closes the gap that the reimbursement rate leaves open. How well it fits depends on your budget, your health and your plans for a family.
- A supplementary tariff suits you better if a share of costs for major treatment would be hard for you to carry.
- A combination makes less sense if you rarely use benefits and can comfortably pay your share yourself.
- Check before you sign: pre-existing conditions, planned children and retirement all change the rate and your tariff needs.
A personal assessment of your situation is possible. You can read more about our approach at So arbeiten wir (in German).
What changes with family and retirement?
The rate depends on your family situation. With two or more children, the active eligible person receives 70 percent. Eligible spouses receive 70 percent, and eligible children 80 percent. In retirement, costs incurred afterwards are reimbursed at 70 percent. Check whether your tariff still fits after every major change.
How do you apply for health aid?
The guidance “Beihilfeanspruch und Antragstellung” of the NRW finance administration describes the process. Submit invoices with all required details so the reimbursement runs without queries. Look up form, deadlines and documents in the guidance, because these requirements can change.
Frequently asked questions
How high is health aid in NRW for civil servants?
According to the guidance as of January 2026, civil servants without a child or with one child receive 50 percent of eligible costs. From two children onward, the rate rises to 70 percent.
Is there a separate rate for children?
Eligible children are rated at 80 percent. The rate for the eligible person themselves depends on the number of children and on retirement.
Can I combine health aid with private insurance?
Yes, this is the usual route for eligible civil servants. Health aid covers the reimbursement rate, and the tariff covers the remaining share. Which combination makes sense depends on your age, health and budget.
What happens when I become a civil servant on probation?
Once you are a civil servant, your health aid entitlement becomes relevant. The guidance sets rates for active civil servants but does not name trainees. Clarify your rate with the health aid office before you choose a tariff.
What to do now
- Find your group in the guidance: family status, number of children, and whether you are active or retired.
- Ask the health aid office in writing for the rate that applies to your status and keep the answer.
- Calculate your share of costs for typical expenses, such as dental treatment or glasses, using your rate.
- Compare tariffs only once your share of costs is clear, and clarify pre-existing conditions before you sign.
Related guides
- Civil Servant Health Aid: Rates and How It Works
- Civil Servant Health Aid During Training: Rates and Claims
- Beihilfe im Referendariat: Anspruch, Satz und Antrag (in German)
- Krankenversicherung im Referendariat: GKV, PKV und Beihilfe (in German)
- Beihilfe in Niedersachsen: Bemessungssätze, Eigenanteil und passende PKV für Beamte
Sources: NRW finance administration: guidance Beihilfeanspruch und Antragstellung (as of January 2026); Bezirksregierung Köln: health aid FAQ on reimbursement rates (dated 1 January 2020, for context only).
Last updated: October 2026. This guide is general information, not individual advice.
