Definition of the family insurance income comparison
Under the family insurance income comparison in section 10(3) SGB V, children are not family insured if the spouse or registered partner who is their parent is not a statutory member, regularly earns more than one twelfth of the annual earnings limit, and has higher total income than the member. For pensions, the amount paid out is used.
Colloquially this is sometimes called the higher-earner rule, but the statute does not use this term. This page uses the factual term.
Value (as of 20 October 2026)
One twelfth of the 2026 annual earnings limit is 6,450 euros a month (77,400 euros a year). Status: official.
Example
The parents are married. The mother is statutorily insured and earns 3,000 euros, and the father is privately insured and regularly earns 7,000 euros. Both conditions are met, so the children cannot be family insured. If the father earns 6,000 euros, the rule does not apply. The rule only applies to spouses or registered partners, not to unmarried parents.
Related terms
Family insurance (Familienversicherung), health insurance income limit (Versicherungspflichtgrenze), total income (Gesamteinkommen).
Sources
Section 10(3) SGB V, gesetze-im-internet.de, retrieved 20 October 2026. Annual earnings limit 2026: GKV-SV fact sheet as of 1 January 2026. As of 20 October 2026.
Last updated: October 2026. This guide is general information, not individual advice. The German version is authoritative.
Editorial team: Academycon
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