Lump-Sum Beihilfe for Referendare: Which States Offer It

Pauschale Beihilfe (a lump-sum version of the German civil servant health allowance, Beihilfe) is an alternative to the usual model in which every invoice is submitted. It has been introduced in several federal states, but not everywhere. If you are in the clerkship, you should know whether your state offers it, since when, and under which conditions. This guide gives an overview and shows how to check the details for your state.

The most important points at a glance

• A lump-sum Beihilfe means your employer pays a fixed share of your health insurance contributions instead of reimbursing individual invoices.
• According to the overview, eleven states offer the lump-sum model. The start dates range from 2018 to 2026.
• The decision is generally irrevocable. Exceptions must be checked in state law.
• The allowance does not cover long-term care insurance.
• The overviews do not set out a separate rule for referendare. Ask your employer.

What does lump-sum Beihilfe mean?

With individual Beihilfe, you submit each invoice and receive the share your employer covers. With lump-sum Beihilfe, there are no individual claims. Instead, your employer pays a fixed share of the health insurance contributions you can prove, usually together with your salary.

Important: lump-sum Beihilfe is not insurance cover in its own right. It reduces the contributions you pay yourself and assumes that you have health insurance. According to the leaflet of the city of Erfurt, it is aimed at Beihilfe-entitled people who are voluntarily insured in statutory or private health insurance. With individual Beihilfe, the state covers part of each invoice and the insurance covers the rest. Both models therefore require health insurance, but they differ in how your employer contributes.

The amount and conditions are set by the law of each state. For Thuringia, the leaflet of the city of Erfurt (status June 2024) describes an allowance of generally 50 percent of the contributions you can prove. For private insurance, it is capped at 50 percent of the basic tariff contribution. Other states may calculate differently, so comparing states can only be rough.

Which states offer lump-sum Beihilfe?

The following table comes from the Deutsche Beamtenversorgung and reflects the status of October 2026. It is not an official compilation, so check the start dates and restrictions against state law.

The overview mentions trainees and referendare but does not describe a separate rule for them. Whether you may choose the lump sum as a referendar, and under which conditions, is decided by the law of your state.

Which states do not offer it?

According to the same overview, lump-sum Beihilfe is currently not available at federal level or in Bavaria, Hesse, North Rhine-Westphalia, Rhineland-Palatinate and Saarland. For North Rhine-Westphalia, the overview notes that its introduction is anchored in the coalition agreement. According to the overview, whether other states will follow is politically open.

• No lump-sum Beihilfe: federal government, Bavaria, Hesse, North Rhine-Westphalia, Rhineland-Palatinate, Saarland.
• North Rhine-Westphalia: introduction anchored in the coalition agreement according to the overview, not yet in place.
• Hesse, Bavaria and Saarland: individual Beihilfe with their own rates.

Where the information is unclear

Not every detail is clear. For Saxony, the overview gives 1 January 2024, but another source disagrees. For Schleswig-Holstein, there is only a limited rule for certain groups, and the sources describe it differently. In Saxony-Anhalt, the option to withdraw with three months’ notice is an exception to the usual principle that the choice is irrevocable.

Rely therefore on the official source of your state, such as the Beihilfe office of your employer or the ministry responsible for you. A decision based on an overview alone is risky.

How do you calculate the allowance?

Assumed: You are voluntarily insured in statutory health insurance and pay the minimum contribution of 222.80 euros per month for health insurance (calculated for 2026). Thuringia pays 50 percent of the contributions you can prove. The allowance is then 111.40 euros per month. Long-term care insurance is not part of this allowance, so you need to budget for it separately.

For private insurance, the basic tariff is the upper limit. If your tariff is more expensive, the allowance stays capped at that level. Whether it pays off for you becomes clear when you compare it with your individual Beihilfe and your remaining costs.

Does lump-sum Beihilfe suit you?

Lump-sum Beihilfe tends to pay off when you have fixed contributions and your medical costs are predictable. It may be less suitable if you expect larger treatment costs, because individual reimbursement often pays more per invoice in that case. If you do not want to decide alone, you can have the choice reviewed in a personal assessment with Academycon (in German).

Frequently asked questions

Does the lump-sum Beihilfe also apply to referendare?

That depends on the state. The overview mentions trainees and referendare but describes no separate rule. Ask your Beihilfe office whether you can choose during the clerkship and from when the choice applies.

Can I switch later from individual to lump-sum Beihilfe?

Generally the decision is irrevocable. According to the Erfurt leaflet, Thuringia offers no way back to individual Beihilfe. According to the overview, Saxony-Anhalt allows withdrawal with three months’ notice. The question must therefore be answered for each state.

Does lump-sum Beihilfe also cover long-term care insurance?

No. According to the overview, the allowance does not apply to compulsory long-term care insurance. You need to plan for long-term care insurance separately.

Do I need full health insurance?

According to the overview, full statutory or private health insurance is a condition. The Thuringian leaflet requires proof for private insurance that the tariff meets the requirements of the basic tariff. A pure top-up to Beihilfe does not meet this condition.

What to do next

1. Check whether your state appears in the overview as a state with lump-sum Beihilfe.
2. Read the rule in state law and ask your Beihilfe office whether referendare may choose.
3. Calculate the allowance for your contributions with an example, and compare it with individual Beihilfe.
4. Submit the application only once you understand that the choice is irrevocable and what the deadlines are.

Related articles

• Health insurance during clerkship: GKV, PKV and Beihilfe
• Beihilfe in Thuringia
• Health insurance as a referendar: five-step decision guide
• Beihilfe during the clerkship (in German)
• Glossary: Beihilfe (in German)

Sources: Overview of lump-sum Beihilfe, Deutsche Beamtenversorgung (status October 2026, not official, in German); Leaflet on lump-sum Beihilfe in Thuringia, city of Erfurt (status June 2024, in German); Leaflet for civil service entrants with pre-existing conditions, PKV association (status September 2022, in German); Contribution rules, GKV-Spitzenverband (status 1 January 2026, in German).

Last updated: October 2026. This guide is general information, not individual advice.