Beihilfe (the state health allowance for civil servants) in Hesse reimburses eligible costs under the Hesse Beihilfe Regulation (HBeihVO). The base rate is 50 percent and rises with eligible family members up to a maximum of 70 percent. This guide shows the rates, the main out-of-pocket costs and how to combine Beihilfe with a private supplement.
Short answer: Active civil servants in Hesse receive a base rate of 50 percent Beihilfe. Each eligible person adds 5 percentage points, up to 70 percent (section 15 HBeihVO). Trainees receive a uniform 70 percent. Out-of-pocket costs such as 4.50 euros per medicine pack remain. Last updated: October 2026, source: guidance of the Regierungspräsidium Kassel dated 24 November 2021.
The Key Points at a Glance
- The base rate is 50 percent. Eligible family members raise it to a maximum of 70 percent (section 15 HBeihVO).
- For inpatient hospital care or rehabilitation follow-up, trainees receive a uniform 85 percent (section 15 para. 6).
- From age 18 you pay 4.50 euros per medicine pack (section 6 para. 1 no. 2).
- For privately insured people with a contribution subsidy, the rate is reduced by 50 percent under section 15 para. 8.
- The guidance dates from November 2021. Check the current version of the HBeihVO before you decide.
What Is the Rate in Hesse?
The rate sets which share of your eligible costs is reimbursed. You pay the rest yourself or through a supplement. In Hesse the rule starts at 50 percent. Pensioners receive a surcharge of 10 percentage points, and widows and widowers receive an additional 5 percentage points.
| Group | Rate | Reference |
|---|---|---|
| Active civil servants without family | 50 percent | section 15 HBeihVO |
| Active civil servants with a spouse or one child | 55 percent (derived) | Step of 5 percent per person |
| Active civil servants with four or more persons | 70 percent (maximum) | section 15 HBeihVO |
| Trainees | 70 percent, uniform | Guidance, status 2021 |
The 55 percent step is our derivation from the 5 percent rule. It is not stated word for word in the guidance.
Which Out-of-Pocket Costs Apply in Hesse?
Beihilfe does not cover every expense. The guidance lists these out-of-pocket costs and reductions:
| Benefit | Rule | Reference |
|---|---|---|
| Medicines from age 18 | 4.50 euros per pack is deducted | section 6 para. 1 no. 2 |
| Travel for treatment | 10 euros per single journey, monthly limit 100 euros | section 6 para. 1 no. 9 |
| Two-bed room as optional service | Reduction of 16 euros per day | section 6 para. 1 no. 6 |
| Retention for optional services | 18.90 euros per month | section 6a |
| Minimum amount per claim | 250 euros | Guidance, no. 5.1 |
How Do You Work Through a Beihilfe Refund?
Assumption: you have a bill of 400 euros, everything is eligible, and your rate is 50 percent.
- Beihilfe: 400 x 0.5 = 200 euros.
- Remainder: 400 minus 200 = 200 euros, which you cover through insurance or yourself.
- With two medicine packs, add 2 x 4.50 = 9 euros of out-of-pocket costs.
Is Beihilfe Enough, or Do You Need a PKV?
Beihilfe is only one part. Many civil servants add a supplement or a private tariff. If you are privately insured and receive a contribution subsidy, your rate falls by 50 percent under section 15 para. 8. Whether the combination fits depends on health, family and tariff. For a personal assessment, see the advisory process at Academycon, how we work. We do not recommend individual insurers.
How this works during training is explained in our guide Beihilfe im Referendariat (in German).
A Worked Example With Family Members
Assumption: you are an active civil servant, your spouse and two children are eligible, so three persons in total. The five-percent rule gives 50 + 3 x 5 = 65 percent. This is our derivation from the guidance. On an eligible bill of 500 euros, Beihilfe pays 325 euros and 175 euros remain.
Frequently Asked Questions
Does the 50 percent rate also apply to trainees?
For trainees the guidance names a uniform 70 percent. Trainee teachers and legal clerks are not named explicitly, so clarify your status with the responsible office first.
Who counts as an eligible person?
According to the guidance, spouses and children count when they are included in the family allowance. The exact conditions are set in the HBeihVO.
Do I have to submit every bill separately?
Beihilfe is paid on application. Because a claim has a minimum of 250 euros, it can make sense to collect receipts rather than file every small bill. The form and deadlines are in the HBeihVO and the application form.
Where do I find the current version?
In the Hesse state law database. The guidance of the Regierungspräsidium Kassel helps you get started but does not replace the legal text.
What You Should Do Next
- Check your status and the number of eligible persons to find your rate.
- Read the current HBeihVO, especially section 15 and section 6.
- Work out your typical costs and fix the remainder.
- Clarify any supplement before you sign a contract.
Related Guides
- Beihilfe in Hamburg
- Teacher training in Hesse 2026/27
- Legal clerkship in Hesse
- Health insurance during clerkship: GKV, PKV and Beihilfe
Sources: Regierungspräsidium Kassel, guidance on the HBeihVO, 24 November 2021 (in German).
Last updated: October 2026. This guide is general information, not individual advice.
