Unpaid contributions (Beitragsschulden) to a statutory health insurance fund (gesetzliche Krankenkasse) are a real risk for students. If you do not pay the monthly contribution for the student health insurance (studentische Krankenversicherung), your claim to benefits can be suspended. This guide explains when that happens, what it means in practice and how to clear the arrears.
Short answer: Your claim to benefits from the statutory health insurance is suspended (ruht) once arrears cover contributions for two months and you still do not pay after a reminder (§ 16 para. 3a SGB V). Some services stay protected, including preventive check-ups, care for acute illness and pregnancy. Benefits resume once the arrears are paid or a valid instalment plan is in place. Last updated: October 2026.
The most important points at a glance
- The arrears must cover contributions for two months, and the fund must have sent you a reminder (Mahnung) before the suspension applies.
- During a suspension only certain services are protected, such as preventive check-ups, care for acute illness, pain, pregnancy and maternity.
- Late payment surcharges also apply: 1 percent of the outstanding amount for each started month (§ 24 SGB IV).
- A valid instalment agreement (Ratenzahlungsvereinbarung) lifts the suspension as long as you pay the instalments as agreed.
- If you are in need under SGB II or SGB XII, the suspension does not apply or ends.
When is your claim to benefits suspended?
The rule is set out in § 16 para. 3a SGB V. It was originally written for members of the artists’ social insurance, but sentence 3 expressly applies it to other members as well. Three conditions must come together: arrears covering contributions for two months, a reminder from the fund, and no payment despite that reminder. The law does not name a fixed euro amount. The amount follows from your contribution.
The suspension ends as soon as all outstanding contributions for the suspension period are paid. The arrears are therefore not cleared automatically. They must be paid in full.
How high are the arrears in an example?
The contribution for students consists of the general health insurance contribution and the fund-specific additional contribution (Zusatzbeitrag). For 2026, the general contribution is 87.38 euros a month before the additional contribution. With the average additional contribution of 2.9 percent, the total comes to about 112 euros a month. Nursing care insurance is not included in this calculation, and the additional contribution of your own fund may differ.
| Item | Value (as of 2026) | Source |
|---|---|---|
| General health insurance contribution for students | 87.38 euros a month | GKV-Spitzenverband, fact sheet 2026 (German) |
| Average additional contribution 2026 | 2.9 percent (about 24.80 euros at a 855 euro assessment base) | Federal Ministry of Health (German) |
| Together, excluding nursing care insurance | about 112.18 euros a month | Calculated from the two values above |
Assumption: you owe two monthly contributions of 112.18 euros each, so 224.36 euros in total. After a reminder your claim to benefits is suspended until you clear the arrears. The late payment surcharge is 1 percent of the outstanding amount for each started month, which is roughly 2.24 euros per month. The exact calculation follows § 24 SGB IV. If family insurance is the question behind the arrears, read Family Insurance for Students Under 25: Income Limit.
What a suspension means in daily life
During a suspension the fund only covers services in the legally protected cases. These include preventive check-ups, care for acute illness and pain, and pregnancy and maternity. Everything else, such as planned treatment or aids, is not covered during that time. An untreated bill can quickly become expensive.
If you are in financial trouble, act early. Call the fund, ask for an instalment plan and make sure it is confirmed in writing.
How to clear the arrears
The fund must send a reminder before the suspension applies. Respond to the reminder rather than leaving it unanswered. A valid instalment agreement lifts the suspension as long as you pay the instalments as agreed (§ 16 para. 3a sentence 4 SGB V). Ask for the agreement in writing and check the amount of each instalment before you sign. For the key terms, see Health insurance for students: glossary from A to Z.
| Situation | Consequence | What you can do |
|---|---|---|
| Reminder received, arrears below two monthly contributions | No suspension yet, but a surcharge is possible | Pay now or ask for an instalment plan |
| Arrears of two monthly contributions after a reminder | Your claim to benefits is suspended | Pay the full arrears or agree instalments |
| Valid instalment plan agreed | Claim resumes as long as you pay the instalments | Pay on time and keep the proof |
| Need under SGB II or SGB XII | Suspension does not apply or ends | Check whether to apply at the Jobcenter or social welfare office |
Common causes and how to avoid them
Arrears rarely come from intent. Usually a routine breaks down without anyone noticing. Knowing the common causes helps you act before a reminder arrives.
- A direct debit fails, for example because the account is not covered. Check regularly that the monthly debits actually go through.
- Post from the fund goes unanswered. A reminder is a serious signal and should be answered promptly.
- Your situation changes, for example when family insurance ends or employment stops, and you do not clarify the consequences with the fund. Then the contribution no longer fits.
- A payment plan is promised by phone but never confirmed in writing. A verbal agreement helps little in a dispute.
Frequently asked questions
Can I still see a doctor while I have arrears?
It depends on the case. During a suspension, preventive check-ups and care for acute illness, pain, pregnancy and maternity remain protected. For planned treatment, ask the fund in advance before you book it.
When does my claim come back?
As soon as all outstanding contributions for the suspension period are paid. Alternatively, a valid instalment agreement is enough, as long as you pay the instalments as agreed.
Do I lose my insurance if I do not pay?
Your membership continues. Only the claim to benefits is suspended. That is why it is important to clear the arrears before more months accumulate. If you cannot pay in the long run, get advice on how to secure your cover.
Who can help if I have lost track of my debts?
A debt advice service can help with the overall plan when several debts add up. For the fund, what matters is that instalments are agreed and kept. Social counselling at your university or at the student services organisation (Studierendenwerk) can also help you prepare the conversation with the fund.
What to do now
- Check the reminder and the account statement from the fund and note which months are open.
- Contact the fund and ask for a written instalment agreement.
- Pay the instalments on time and keep every confirmation.
- If your income is low, check whether you are in need under SGB II or SGB XII and whether an application is possible.
- For a personal assessment of your situation, talk to an advisor. You can read how a personal consultation at Academycon works (in German): https://academycon.de/so-arbeiten-wir/
Related guides
- Health insurance for students: glossary from A to Z
- Switching Health Insurer as a Student: Deadlines and Rules
- Family Insurance for Students Under 25: Income Limit
- Student Health Insurance Germany 2026: Rates and Example
Sources (in German): § 16 SGB V, suspension of benefits (gesetze-im-internet.de, retrieved October 2026) | § 24 SGB IV, late payment surcharge (gesetze-im-internet.de, retrieved October 2026) | GKV-Spitzenverband, fact sheet on 2026 calculation values (as of 1 January 2026) | Federal Ministry of Health, contributions in statutory health insurance (status September 2026)
Last updated: October 2026. This guide is general information, not individual advice.
