From 2028, co-insured spouses and registered partners in the statutory health insurance (gesetzliche Krankenversicherung, GKV) are meant to attract a contribution surcharge. Under the GKV Contribution Rate Stabilisation Act, it amounts to 2.5 percent of the contributory income of the main insured person. The Bundestag passed the law on 10 July 2026.
Short answer: Co-insured spouses are meant to trigger a 2.5 percent contribution surcharge from 2028, calculated from the contributory income of the main insured person. According to the Federal Ministry of Health (BMG), parents with children up to the age of twelve are exempt. The Bundestag passed the law on 10 July 2026. Last updated: November 2026.
Key points in brief
- The surcharge applies from 2028 to co-insured spouses and registered partners.
- It amounts to 2.5 percent of the contributory income of the main insured person.
- Parents with children up to the age of twelve are exempt.
- The Bundestag passed the regulation on 10 July 2026.
- Before you calculate your own contribution, check the final wording of the law and ask your health insurer for the calculation.
How the surcharge is calculated
The surcharge is not based on the income of the co-insured partner. It is based on the contributory income of the main insured person, the partner who is insured in the statutory system in their own right and includes the spouse through family insurance. The formula is simple: contributory income multiplied by 2.5 percent.
Assumption: the main insured person has a contributory income of 2,000 euros per month. The surcharge would then be 50 euros per month (2,000 times 0.025). The table applies the same logic to other amounts.
| Contributory income of the main insured person (assumption) | Surcharge per month (2.5 percent) | Surcharge per year (assumption: 12 months) |
|---|---|---|
| 1,500 euros | 37.50 euros | 450 euros |
| 3,000 euros | 75.00 euros | 900 euros |
| 4,500 euros | 112.50 euros | 1,350 euros |
These amounts are pure examples. Whether and how contribution assessment ceilings enter the calculation should be checked in the law itself or with your health insurer.
Who is affected and who is not?
Co-insured spouses and registered partners are affected. According to the BMG, parents with children up to the age of twelve are exempt. The age limit is therefore the twelfth birthday of the child, and it matters for many families when children are young.
Further exceptions may apply in specific circumstances, for example for people with full reduction of earning capacity. Read the wording of the law before you assess your own situation.
What does this mean for students with a spouse?
If you study and are co-insured through a spouse, you do not pay the surcharge yourself. The contribution burden lies with the main insured person, because the surcharge is calculated from that person’s contributory income. For the student, the key question remains whether family insurance exists at all. The current rules are described in Family insurance through a spouse during studies: requirements and limits (in German).
Family insurance is also subject to income limits. In 2026, the limit for total income is 565 euros per month. For 2027, the draft sets 590 euros. This value only becomes binding after the Bundesrat approves it, so treat it as a draft figure until then.
What has been passed and what is still open?
- Passed: the Bundestag adopted the GKV Contribution Rate Stabilisation Act on 10 July 2026.
- According to the BMG, the law also passes the Bundesrat. No date for this step is set out yet.
- Open: the exact date of entry into force and the details of the exceptions in the law text.
- Open: the effect on your own bill, because the level of your additional contribution is set by your health insurer.
The additional contribution as a second factor
Alongside the surcharge, the additional contribution (Zusatzbeitrag) matters. Each health insurer sets its own rate. The Schätzerkreis, the estimation body of the statutory health insurance, calculated in October 2026 a notional average additional contribution rate of 2.9 percent for 2027. This is an average and not a figure for your insurer. The current estimate is published by the Federal Social Insurance Office (Bundesamt für Soziale Sicherung, in German).
The surcharge does not depend on the additional contribution, because it is calculated from the income of the main insured person. Together, however, the two amounts shape the total burden of the family. For that reason, compare health insurers by their overall cost for the household and not by the additional contribution alone.
Frequently asked questions
Does the surcharge already apply in 2027?
According to the BMG, the surcharge starts in 2028. The regulation has been passed, and its start is given as 2028. No surcharge for co-insured spouses is planned for 2027.
Do I pay the surcharge myself if I am co-insured?
No. Under the formula, the contribution follows the income of the main insured person. The burden therefore lies with the partner whose income is used, not with the co-insured spouse.
Does the income limit for family insurance change?
The limit of 565 euros per month applies in 2026 to all family members under section 10 of the Social Code Book V (SGB V), which means spouses and children. The draft sets 590 euros for 2027. The limit works independently of the surcharge.
How do I find out my exact contribution?
Your health insurer calculates the contribution. Ask for a written calculation once the rule applies and ask to see the basis of the figures.
Prepare for the change
A good plan starts with the right documents. Anyone who wants to know how high the surcharge would be in their household needs reliable figures for the income of the main insured person. Three steps help.
- Keep the pay slips of recent months ready so that the contributory income can be determined cleanly.
- Note whether children live in the household and how old they are, because the exemption depends on it.
- Ask your health insurer which contribution it expects for your situation and keep the answer in writing.
The income of the main insured person can change during a year. A calculation based on a single month therefore only shows the order of magnitude. For annual planning, a projection with realistic fluctuations is more useful.
The surcharge is one building block among several. Together with the income limit for your own family insurance, the additional contribution of your insurer and any possible change of insurer, it gives a picture that makes a sound decision easier.
What to do now
- Check whether you are affected as a co-insured spouse or as the main insured person.
- Apply the 2.5 percent rate to the contributory income to work out the surcharge.
- Ask your health insurer which exceptions apply in your case.
- Follow the entry into force in the law text before you make decisions.
Related reading
- Health insurance 2027: what changes for insured people and students
- GKV reform 2026: what the contribution rate stabilisation act regulates
- Health insurance minimum commitment: how long you stay after a switch
- Student health insurance in Germany 2026: key figures
Sources: BMG: Bundestag passes GKV Contribution Rate Stabilisation Act, press release of 10.07.2026, BMG: FAQ on the GKV Contribution Rate Stabilisation Act, accessed November 2026, Section 10 SGB V, family insurance, gesetze-im-internet.de, accessed November 2026, Federal Social Insurance Office: Schätzerkreis estimate, October 2026.
Last updated: November 2026. This guide is general information, not individual advice.
