Under the lump-sum Beihilfe (pauschale Beihilfe), your employer does not reimburse every medical bill. Instead, it contributes to the cost of a comprehensive private health insurance policy (Krankenvollversicherung). The term comes up during your trainee period (Referendariat) when you decide whether to use the standard Beihilfe or the lump-sum model.
Short answer: Under the lump-sum Beihilfe, your employer covers half of the cost of a comprehensive health insurance policy, instead of reimbursing individual bills at the eligibility rate. The model is not available everywhere. In Bremen, it is governed by a circular from the Senator for Finance (No. 11/2019), and other states have their own rules. Stand: October 2026. Check the details against the current state law before you decide.
Key points at a glance
- The lump-sum Beihilfe does not replace every bill. Instead, your employer contributes to the costs of your health insurance.
- The basic rule in the Bremen model is a contribution of half the cost of comprehensive health insurance.
- The model only applies where state law provides for it. Not every state has it.
- The choice can be binding in the long run. Check the rules before you apply.
- The basic rule comes from a circular issued in 2019 and must be confirmed under current law.
What does lump-sum mean in this context?
With the classic Beihilfe, the Beihilfe office settles every bill. Your employer pays a percentage of the eligible costs, and you need supplementary private cover for the rest. The lump-sum model works differently. You hold comprehensive health insurance, and your employer contributes a fixed share of its costs. The Beihilfe is therefore not calculated bill by bill.
How do the two models differ?
The following comparison shows the basic differences. The exact arrangement depends on state law.
| Feature | Classic Beihilfe | Lump-sum Beihilfe |
|---|---|---|
| Settlement | Bill by bill at the eligibility rate | Fixed contribution toward insurance costs |
| Employer pays | A percentage of the eligible costs | Half of the costs of comprehensive health insurance |
| Remaining costs | You have to insure them or pay them yourself | Covered by the comprehensive policy, subject to the tariff rules |
| Access | Standard route | Only where state law provides for it |
Who can use the lump-sum Beihilfe?
Whether the lump-sum model applies to you depends on your state and your status. Many trainees and probationary civil servants (Beamte auf Widerruf) check whether the lump-sum model fits their situation, or whether the classic Beihilfe with supplementary cover works better. You can only make this comparison properly with your actual contributions and the figures from state law.
What are the advantages and disadvantages?
- Advantage: comprehensive cover pays for treatment without you having to check each item against remaining amounts.
- Advantage: your employer’s contribution makes monthly costs easier to plan.
- Disadvantage: you are bound to the tariff rules of the comprehensive policy, and changing tariffs is not unlimited.
- Disadvantage: many state rules make the choice irrevocable. Check this before you apply.
What remains open: depending on the contribution level and the benefits, the classic route can lead to a different result.
Frequently asked questions
Is the lump-sum Beihilfe the same as the eligibility rate?
No. The eligibility rate (Bemessungssatz) applies to each individual bill. The lump-sum Beihilfe is a contribution toward a comprehensive policy. Whether both models can be combined is determined by state law. As a rule, they exclude each other.
Can I switch between the two models later?
That depends on the state regulation. Many rules provide for a one-time decision that cannot easily be reversed later. Ask the Beihilfe office before you apply which deadlines and commitments apply.
Where do I find the rules for my state?
In your state’s Beihilfe regulation or state civil service act, and in your employer’s information sheet. For Bremen, you will find the circular No. 11/2019 in the Bremen Transparency Portal (Transparenzportal Bremen). Legal positions change, so always read the current text.
Do I have to take out private insurance to get the lump-sum Beihilfe?
The lump-sum Beihilfe requires a comprehensive health insurance policy to which your employer contributes. Which policies are permitted is set out in state law. For a personal assessment of your situation, you can contact Academycon, see how we work (in German).
What you should do now
- Check whether your state provides for the lump-sum Beihilfe at all.
- Read the regulation or the information sheet from your employer on requirements and election deadlines.
- Compare the contribution burden of both models using your actual figures, not average values.
- Only submit your application after this check, because a choice can be binding in the long run.
Related reading
- Glossary: Eligibility Rate for Beihilfe, classic model
- Glossary: Beihilfe, with the basic terms (in German)
- Civil Servant Health Aid During Training: Rates and Claims
- Health Insurance for Referendare in Germany
- Beihilfe in North Rhine-Westphalia: eligibility rates, remaining share and suitable PKV for civil servants
Sources: Circular of the Senator for Finance No. 11/2019, State of Bremen (dated 29 July 2019) · Information sheet on lump-sum Beihilfe, State of Bremen (Stand: July 2019)
Stand: October 2026. This guide is general information, not individual advice.
