The lump-sum benefit (Pauschale Beihilfe) under the Hamburg model is an alternative to the classic state health benefit (Beihilfe) that trainee civil servants in several German states can choose. This guide explains how the lump sum works, which states offer it and when the statutory health insurance (GKV) option may suit your situation. It does not replace an individual decision.
Short answer: Instead of submitting every medical bill for state health benefit, you receive a fixed monthly lump sum from your employer. Only some German states offer it, and in many of them the choice cannot be reversed. The GKV option mainly suits people who want to stay statutorily insured. Last updated: October 2026.
The most important points
- The lump sum replaces the classic state health benefit with a fixed monthly payment that is linked to your health insurance contributions.
- The model is named after Hamburg, where it applies since 01.08.2018. Other states have their own rules, which differ in detail.
- Whether you can choose the lump sum depends on your federal state. For trainees, the sources often do not clearly confirm access, so ask directly.
- In many states the choice is irreversible. Calculate in advance what the GKV option means for your contributions.
- Whether the GKV option fits depends on your health needs, your family situation and your contributions, not only on the amount of the lump sum.
What is the lump-sum benefit during civil service training?
Civil servants on revocable terms (Beamte auf Widerruf) usually receive state health benefit when they fall ill. The employer covers part of the costs, and you cover the rest through health insurance. Under the rules of the state benefit ordinances, the benefit rate for trainees without children is 50 percent. Hesse sets different official rates of 70 percent for outpatient and dental care and 85 percent for inpatient care.
With the lump sum, you give up the individual billing of each invoice. Instead, your employer pays a fixed monthly amount. The model is named after the Hamburg model because Hamburg has offered it since 01.08.2018. Other states adopted it with their own details on amount, conditions and withdrawal.
How is the lump sum calculated?
The calculation is set by law in each state. As an example, this guide uses the Bremen rules from circular No. 11/2019 of the Senator for Finance dated 29.07.2019. This is older than the date of this guide and serves only as an illustration. Under the Bremen model, with statutory health insurance the employer pays half of the contribution. With private health insurance, the lump sum equals half of the contributions for benefits that correspond to the statutory benefit catalogue, capped at half of the basic tariff.
Assumption: your statutory health insurance contribution is 300 euros per month. Under the Bremen model you would then receive a lump sum of 150 euros. Whether your state has a comparable rule and how high it is must be checked in the state ordinance or with the payroll office.
Under the Bremen model, long-term care insurance is not part of the lump sum. Entitlements to individual benefit for permanent need of care remain in place.
Which states offer the lump sum?
The table below summarises the status according to secondary sources, as of October 2026. It is not legal advice. The rules of your state apply, and you should ask the competent office. Where sources contradict each other, the table says unclear.
| Federal state | Lump-sum benefit | Note |
|---|---|---|
| Baden-Württemberg | Yes | According to secondary sources since 01.01.2023 |
| Bavaria | No | Benefit by individual billing |
| Berlin | Yes | According to secondary sources since 2020 |
| Brandenburg | Yes | According to secondary sources since 2020 |
| Bremen | Yes | Choice for trainees since 01.06.2019, irreversible |
| Hamburg | Yes | Hamburg model since 01.08.2018, choice irreversible |
| Hesse | No | Benefit with official rates of 70 and 85 percent |
| Mecklenburg-Western Pomerania | Yes | According to a secondary source since 01.05.2026 |
| Lower Saxony | Yes | Since 01.02.2024, binding choice, one-year exclusion period |
| North Rhine-Westphalia | No | According to secondary sources not available |
| Rhineland-Palatinate | No | Benefit by individual billing |
| Saarland | No | Benefit by individual billing |
| Saxony | Unclear | Sources contradict each other |
| Saxony-Anhalt | Yes | Since 01.01.2026, only for voluntarily insured members, withdrawable with three months notice according to one secondary source |
| Schleswig-Holstein | Unclear | Sources contradict each other |
| Thuringia | Yes | According to secondary sources since 2020 |
According to the sources, access for trainees is not separately confirmed in many states. Ask explicitly whether the lump sum also applies to your traineeship.
When does the GKV option fit, and when does it not?
A lump sum linked to GKV membership is no automatic win. It can pay off, but it does not have to. The comparison below shows typical trade-offs without making a recommendation.
| Aspect | Points to the GKV option | Points against the GKV option |
|---|---|---|
| Health needs | You rarely need services beyond the GKV catalogue. | You want services that go beyond the GKV catalogue. |
| Family | You have no children, and the benefit rate is low anyway. | You have children. In Saxony the rate rises to 70 percent with one child according to a secondary source. |
| Health insurance | You are or want to stay statutorily insured. | You already have private cover that you want to keep. |
| Administration | You do not want to file receipts or wait for reimbursements. | You want to check invoices yourself and steer reimbursements. |
| Relocation | You stay in the state whose rules you know. | A move to another state applies the benefit rules of the new employer. |
For comparison, the general contribution rate of statutory health insurance is 14.6 percent in 2026, and the average supplementary contribution is 2.9 percent (2026, German Federal Ministry of Health). Each health insurer sets its own supplementary contribution, so check the actual rate of the fund you consider.
How do you apply?
The procedure differs by state. The Bremen rules of 2019 again serve as the example.
- Check whether your state offers the lump sum to trainees, and confirm this with the payroll office or the training authority.
- Clarify whether you meet the prior insurance periods under section 9 of the Social Code Book V (SGB V). Under the Bremen model, full GKV coverage for new hires depends on such periods. Civil servants can then join voluntarily within three months of appointment.
- Submit the application in writing to the payroll office. Under the Bremen model, it includes a waiver of individual benefits and proof of comprehensive GKV cover.
- Watch the start of payment. Under the Bremen model, payment starts on the first day of the month after the application. Payments for past periods are excluded.
Frequently asked questions
Can I reverse the lump sum later?
It depends on the state. In Hamburg and under the Bremen model, the decision is irreversible, and switching between the lump sum and individual benefit is not possible. According to one secondary source, the rule in Saxony-Anhalt can be withdrawn with three months notice. Read the rule of your state in its full wording before you decide.
Does the lump sum still apply after appointment for life?
Under the Bremen model, a new decision is possible when moving from revocable terms to probation, but not when moving from probation to a permanent appointment. The next step after the traineeship is covered in our guide on health insurance after the probation appointment.
What happens if I move to another federal state?
The benefit rules of the new employer then apply. Under the Bremen model, the former state no longer contributes to health insurance costs afterwards. Plan a move early with the payroll office.
Do I still need health insurance?
It depends on your status. Under section 193 paragraph 3 of the Insurance Contract Act (VVG), residents in Germany must have health cost cover, but people entitled to state health benefit and statutorily insured people are exempt. Check with the payroll office whether the lump sum counts as such an entitlement. Even if you are exempt, cover for the costs that the benefit does not pay is worth considering.
Is the GKV option always worth it if it is offered?
No. There is no fixed answer, because contributions, benefit scope and family situation interact. Calculate with your actual contributions and your service needs. You can request individual advice on your situation from Academycon, and details are on the page how we work (in German).
What to do now
- Check the overview to see whether your state offers the lump sum, and confirm this with the payroll office.
- Compare your GKV contribution including the supplementary contribution with your private contributions, both with and without the lump sum.
- Clarify prior insurance periods and your family situation before you decide.
- Submit the application on time and keep the proof of comprehensive GKV cover.
Related reading
- Health insurance during the traineeship: GKV, PKV and benefit (in German).
- Health insurance between exams and the traineeship (in German).
- Legal traineeship in Hamburg: maintenance allowance and health insurance.
- State health benefit in Hamburg: rates and out-of-pocket costs.
- The big guide for aspiring lawyers (in German).
Sources: Circular No. 11/2019 of the Senator for Finance Bremen (dated 29.07.2019); Section 9 SGB V, gesetze-im-internet.de (retrieved October 2026); Federal Ministry of Health, contributions in the GKV (2026).
Last updated: October 2026. This guide is general information, not individual advice.
