The employer subsidy for private health insurance (Arbeitgeberzuschuss zur PKV) is often the biggest factor in what private cover really costs for people starting their first job. To calculate it you need two limits: the statutory ceiling of the employer share and half of your own premium.
Short answer: Employees with private health insurance receive a subsidy from their employer equal to the employer share they would pay under statutory insurance. The subsidy is also capped at half of your own private premium (§ 257 SGB V, last updated October 2026). In 2026 the ceiling for health insurance is about 508.59 euros per month. Assumption: additional contribution of 2.9 percent and contribution ceiling of 5,812.50 euros.
The Most Important Points at a Glance
- The subsidy applies only to employees who are privately insured because their salary is above the threshold (§ 257 para. 2 SGB V).
- The ceiling is based on 8.75 percent of salary up to the contribution ceiling of 5,812.50 euros per month (January 2026).
- The subsidy is also capped at half of your own private premium. The lower of the two amounts is paid.
- Long-term care insurance has its own subsidy, based on half the contribution rate of 3.6 percent (§ 61 SGB XI).
- You pay the remainder of your premium yourself, even when the subsidy reaches its ceiling.
Who Is Entitled to the Employer Subsidy?
You are entitled if you are an employee who is exempt from compulsory insurance only because your income exceeds the annual earnings threshold (Jahresarbeitsentgeltgrenze) and you hold private health insurance instead. The private policy must offer benefits that are equivalent in type and scope to those of the statutory scheme (§ 257 para. 2 SGB V). In 2026 the threshold was 77,400 euros per year, or 6,450 euros per month (GKV-Spitzenverband, last updated January 2026). Self-employed people and civil servants are not covered by this rule, and mini-job holders usually are not either. For the threshold rules see our guide on the 2026 health insurance income limit.
How Is the Subsidy Calculated?
The calculation follows five steps. All values apply to 2026 (GKV-Spitzenverband, last updated January 2026).
- Contribution base: your gross salary, capped at the contribution ceiling of 5,812.50 euros per month.
- Employer share for health insurance: half the general contribution rate of 14.6 percent gives 7.3 percent (§ 241 SGB V). Add half the average additional contribution of 2.9 percent, which is 1.45 percent. Together this makes 8.75 percent.
- Maximum subsidy: 8.75 percent times 5,812.50 euros gives 508.59 euros per month. From this salary onwards the ceiling no longer rises.
- Limit from your own premium: half of your monthly private premium for health insurance.
- Subsidy: the lower of the amounts from step 3 and step 4.
The law sets the limit explicitly: no more than half of the amount the employee pays for health insurance (§ 257 para. 2 SGB V). The subsidy therefore always follows the smaller of the two figures.
Worked Example: When Half Your Premium Is the Limit
The table shows how the subsidy changes with different premiums. Assumption: your salary is above 5,812.50 euros, so the ceiling of 508.59 euros applies.
| Your private premium for health insurance (assumption) | Half of your premium | Employer subsidy |
|---|---|---|
| 300 euros | 150.00 euros | 150.00 euros |
| 480 euros | 240.00 euros | 240.00 euros |
| 700 euros | 350.00 euros | 350.00 euros |
| 1,100 euros | 550.00 euros | 508.59 euros |
At a premium of 1,100 euros the ceiling applies. You pay the remaining 591.41 euros yourself.
Complete Example Including Long-Term Care Insurance
Assumption: your gross salary is 7,000 euros per month. Your premium is 480 euros for health insurance and 60 euros for long-term care insurance. The employer share for long-term care is 1.8 percent of salary up to 5,812.50 euros, which means at most 104.63 euros (§ 61 SGB XI).
- Health insurance: ceiling 508.59 euros, half your premium 240.00 euros. Subsidy: 240.00 euros.
- Long-term care insurance: ceiling 104.63 euros, half your premium 30.00 euros. Subsidy: 30.00 euros.
- Total: 240.00 plus 30.00 gives 270.00 euros per month. Your own share is 480 plus 60 minus 270, which is 270 euros per month.
What Applies to Long-Term Care and the Childless Surcharge?
The subsidy for long-term care insurance follows half the contribution rate of 3.6 percent and is capped at half of your own long-term care premium (§ 61 para. 2 SGB XI, accessed October 2026). The childless surcharge of 0.6 contribution points applies to childless members from the month after their 23rd birthday. Section 61 does not name it as part of the employer subsidy. Ask your payroll department how it is handled in your case. A rise of the surcharge to 0.7 points is planned for 2027 but has not yet been adopted (Federal Ministry of Health, last updated September 2026).
Does the Subsidy Apply to Part-Time Work or Several Employers?
The subsidy follows the salary you actually receive. For part-time work, the reduced salary is therefore the basis. If you work for several employers in the same period, they share the subsidy in proportion to their pay (§ 257 para. 2 sentence 4 in conjunction with para. 1 sentence 3 SGB V). A mini job with a second employer usually does not create its own subsidy. Your payroll department can confirm this for you.
When the Subsidy Falls or Ends
The subsidy depends on your employment and on your private cover. If your salary falls below the compulsory insurance threshold again, you usually return to statutory health insurance and the subsidy ends. A change of employer changes the calculation, because the salary changes. If your salary rises, the ceiling can grow, as long as you stay below the contribution ceiling. A premium refund also changes your own share, so take it into account in your calculation.
Frequently Asked Questions
Do I get the subsidy as a self-employed person?
No. The subsidy is tied to an employment relationship. As a self-employed person you pay your premium alone, so compare tariffs and premiums yourself before you decide.
Is my employer obliged to pay the subsidy?
Yes, if the conditions of § 257 SGB V are met. The law states that employees receive the subsidy, so the entitlement exists by law and is not a voluntary benefit.
How do I prove my private premium to my employer?
As a rule, a certificate from your insurer showing the monthly premium for health and long-term care insurance is enough. Your payroll department decides on the exact form. Submit the certificate before the subsidy payments start so that the amount can be calculated correctly.
What does a pay rise change?
A pay rise increases the possible ceiling until the contribution ceiling of 5,812.50 euros per month is reached. Above that, the subsidy stays the same. Your own limit changes when your private premium changes.
Does the subsidy continue during parental leave?
Without salary there is no basis for the subsidy. Ask your employer how it is handled during parental leave. The main points are explained in our guide on parental leave in your first job.
What to Do Next
- Ask your private insurer for a premium certificate covering health and long-term care insurance.
- Ask your payroll department to check your subsidy against your gross salary and the ceilings.
- Check whether your salary will stay above the compulsory insurance threshold before you choose private insurance.
- Compare your own burden with the statutory premium, including the additional contribution of your sickness fund.
Related Reading
- Parental Leave in Your First Job: Allowance and Insurance
- Private Insurance at Career Start: Advantages and Decision (in German)
- Health Insurance Income Limit 2026: What It Means
- Contribution Assessment Base 2026: Ceiling and Floor
- Premium Refunds in the PKV: When Not Using Benefits Pays Off (in German)
Sources: § 257 SGB V, employer subsidy (accessed October 2026), § 61 SGB XI, subsidy for long-term care insurance (accessed October 2026), § 6 SGB V, compulsory insurance and earnings threshold (accessed October 2026), § 241 SGB V, general contribution rate (accessed October 2026), GKV-Spitzenverband, fact sheet on 2026 reference values (status 1 January 2026).
Last updated: October 2026. This guide is general information, not individual advice.
