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Health insurance for German civil servants: insuring the share your employer does not pay

If you become a Beamter in Germany, your public employer reimburses a fixed percentage of your medical bills. This is called Beihilfe. You insure the remaining share yourself, usually with a private plan sold in percentages that match your Beihilfe rate. A supplement plan covers what the Beihilfe rules cut or cap.

The question almost everyone asks first

What health insurance do I need as a civil servant in Germany?

One that matches your Beihilfe rate. For federal civil servants, Beihilfe pays 50 per cent of eligible costs while you are in service, and 70 per cent once you have two or more eligible children or retire. You insure the other 50 or 30 per cent privately. Each federal state has its own rules, and some rates differ. Staying in public insurance is allowed, but unless your state offers a flat-rate allowance you pay the full contribution with no employer share.

How Beihilfe and the private plan fit together

Beihilfe is not insurance. It is part of the duty of care your public employer owes you, and it reimburses a percentage of the costs that its regulation recognises as eligible. Under the federal regulation that is 50 per cent for civil servants in service, 70 per cent for pensioners and eligible spouses, and 80 per cent for children. With two or more eligible children your own rate rises to 70 per cent.

The private plan is therefore bought as a percentage, not as full cover: 50, 30 or 20, depending on what Beihilfe leaves open. When your rate changes, the contract has to change with it. The rate that counts is the one on the day of treatment. In practice you pay the doctor, then send every invoice twice, once to the Beihilfe office and once to the insurer.

Where Beihilfe leaves gaps, and what the supplement plan does

Not everything on the invoice is eligible. The rules set ceilings, for example for therapies, glasses, and dental materials and laboratory work, and they recognise doctors' fees only up to certain multiples of the German fee schedule. Some states also deduct a yearly flat amount from your Beihilfe, graded by pay group, and not every state pays for a senior consultant and a two-bed room in hospital.

The percentage plan usually follows Beihilfe: where Beihilfe cuts, the cut stays with you. The Beihilfeergänzungstarif, a separate supplement plan, picks up that difference as far as its terms name the item. Whether it requires Beihilfe to have paid something first, or also pays when Beihilfe refuses entirely, is written in the policy terms and is one of the main differences between insurers.

Health conditions, the flat-rate allowance and moving from abroad

A pre-existing condition does not lock you out. Under the industry's admission scheme, the Öffnungsaktion, participating insurers accept new civil servants and their eligible dependants within six months of appointment, with no refusal, no exclusions and a risk surcharge of at most 30 per cent. Since 2019 this also applies to trainees with civil servant status. Supplement plans are generally not part of the scheme, so normal health questions apply there.

Several states, among them Hamburg, Bremen, Berlin, Brandenburg, Baden-Württemberg and Lower Saxony, offer a flat-rate allowance as an alternative: the employer pays half the contribution to a full insurance, typically a public fund, and individual Beihilfe falls away. The choice normally cannot be reversed and does not carry over to an employer without this model. The federal government does not offer it. If you are appointed after years abroad, your treatment history from other countries belongs in the health questions too.

What is covered

  • Outpatient treatment at the insured percentage
  • Medicines, therapies and medical aids under the plan's rules
  • Hospital treatment, depending on the plan with a one-bed or two-bed room and senior consultant
  • Dental treatment, dentures and orthodontics at the plan's reimbursement rates
  • Psychotherapy, in basic plans with a limit on sessions
  • Check-ups and vaccinations
  • In the supplement plan: costs left over after Beihilfe and the percentage plan
  • Compulsory private long-term care insurance, taken out alongside the plan

What is not covered

  • The share Beihilfe pays: only the agreed percentage is insured
  • Cuts made by Beihilfe if you have no supplement plan
  • Treatment that is not medically necessary
  • Fees above the multiples of the fee schedule named in the plan
  • Conditions not disclosed in the application, which can lead to the insurer withdrawing
  • Treatment during waiting periods unless they are waived

Who needs it

  • Civil servants with permanent or probationary status at federal, state or municipal level
  • Trainee civil servants and trainee teachers, who get special training plans
  • Retired civil servants, whose Beihilfe rate rises
  • Spouses and children who are eligible under the Beihilfe rules
  • Police officers and others with free medical care in service who need to secure later entry

Who does not need it

  • Public sector employees without civil servant status: they have no Beihilfe and are insured like any other employee

Wheel of misfortune

Spin the wheel of bad luck

Six things that really happen. The wheel picks yours and shows who pays.

See all six cases
  1. Varifocal glasses, several hundred euros. Budget policy: pays in part, Strong policy: pays. Beihilfe limits visual aids tightly and the percentage plan usually follows. Only the supplement plan names its own amount for lenses and frames.
  2. Consultant in a state with no extras, consultant fees on top of the hospital bill. Budget policy: does not pay, Strong policy: pays. Where the state's Beihilfe pays no hospital extras, a basic plan leaves all of it open. Strong plans insure room and consultant at 100 per cent.
  3. Dentures with high lab costs, quickly four figures. Budget policy: pays in part, Strong policy: pays. Materials and laboratory work are eligible only up to a limit. A supplement reimburses the difference up to its own rate.
  4. Yearly deduction by the state, flat amount graded by pay group. Budget policy: does not pay, Strong policy: pays in part. Basic plans do not know this item. Some supplement plans refund it, often up to a fixed amount.
  5. Flight home after an accident abroad, five figures depending on distance. Budget policy: does not pay, Strong policy: pays. Beihilfe converts foreign costs to German levels and pays no repatriation. Good supplement plans include it.
  6. Regretting the flat-rate allowance, full contribution, no way back. Budget policy: does not pay, Strong policy: does not pay. This is not an insured event. Once chosen, the flat-rate allowance normally cannot be swapped back for individual Beihilfe.

What it costs

The premium does not depend on your salary. It depends on your age at entry, your health and the percentage you insure. Because only the share next to Beihilfe is insured, it is well below the price of full private cover. Every family member has a separate contract and premium.

What drives the premium

  • Insured percentage: 50, 30 or 20 per cent
  • Age when you join
  • Health status, surcharge, or entry through the admission scheme
  • Hospital extras and level of dental cover
  • Supplement plan as an additional module
  • Annual deductible and premium refund for claim-free years

We do not show example premiums because age, health and Beihilfe rate move them too much for a guide value to be useful. Your premium is fixed in the quote, after the health questions have been reviewed.

The policy levels on the market

01

Basic percentage plan

Outpatient, hospital and dental cover at Beihilfe level, shared room, no supplement plan. Meets the legal requirement but leaves every Beihilfe cut with you.

02

With supplement plan

Percentage plan plus supplement for therapies, glasses, dentures and fees above the eligible rates, with two-bed room and senior consultant. The usual choice for permanent civil servants.

03

Comfort cover

One-bed room, open list of medical aids, high dental benefits, a supplement that pays even when Beihilfe pays nothing, and worldwide cover with repatriation.

How to recognise a good policy

CriterionMinimum standardStrong policyWhy it matters
Reimbursement levels 50 and 30 per cent available all common levels, switch without health check when your rate changes Your rate changes with children, retirement or a new employer, and the contract must follow.
Supplement plan not included or only for single items separate supplement for outpatient, hospital and dental Without it, every Beihilfe cut is your own cost.
Prior Beihilfe payment supplement pays only if Beihilfe paid something also pays when Beihilfe refuses entirely Items with no Beihilfe at all are the expensive gaps.
Fee schedule up to the maximum multiples above them with a fee agreement Beihilfe recognises fees only up to set multiples.
Medical aids closed list open list New technology is not on an old list.
Hospital extras without Beihilfe insured only where Beihilfe pays for them room and consultant also in states with no Beihilfe for them If you move state, you would otherwise lose them.
Loss of Beihilfe continuation not regulated top-up to full cover without health check within a deadline If you leave civil service you need 100 per cent at once.

Insurers on the German market

Most German private health insurers offer Beihilfe plans, and some have their roots in the public service. The differences lie in the supplement plan, medical aids and the rules for trainees. This is a market overview, not a statement about which insurers we work with.

InsurerBackground
Debekamutual insurer with a focus on civil servants and its own sales force, does not work with brokers
AXAsells its civil servant plans under the DBV brand, agents and brokers
HUK-COBURGfounded as a self-help organisation for civil servants, mainly direct sales
Bayerische Beamtenkrankenkassehealth insurer in the Versicherungskammer group, also sold through savings banks
Signal Idunamutual insurer, agents and brokers
Barmeniapart of Barmenia Gothaer group, agents and brokers
Allianzhealth insurer of the Allianz group, agents and brokers
Halleschemutual insurer in the ALH group, broker distribution

Compare the wordings of all tariffs Civil servant health cover 52 tariffs from 16 providers, as of 24 October 2026

From the BaFin register

42

42 insurers supervised by BaFin, the German regulator, are licensed for this class of insurance.

(Krankenversicherer)

Show all 42 names from the register
  • Allianz Private Krankenversicherungs-Aktiengesellschaft
  • ALTE OLDENBURGER Krankenversicherung AG
  • ALTE OLDENBURGER Krankenversicherung von 1927 Versicherungsverein auf Gegenseitigkeit
  • ARAG Krankenversicherungs-Aktiengesellschaft
  • Augenoptiker Ausgleichskasse VVaG (AKA)
  • AXA Krankenversicherung Aktiengesellschaft
  • Barmenia Krankenversicherung AG
  • Bayerische Beamtenkrankenkasse Aktiengesellschaft
  • Concordia Krankenversicherungs-Aktiengesellschaft
  • Continentale Krankenversicherung a.G.
  • Debeka Krankenversicherungsverein auf Gegenseitigkeit Sitz Koblenz am Rhein
  • DEVK Krankenversicherungs-Aktiengesellschaft
  • DKV Deutsche Krankenversicherung Aktiengesellschaft
  • ENVIVAS Krankenversicherung Aktiengesellschaft
  • ERGO Krankenversicherung AG
  • Generali Deutschland Krankenversicherung AG
  • Gothaer Krankenversicherung Aktiengesellschaft
  • Hallesche Krankenversicherung auf Gegenseitigkeit
  • HanseMerkur Krankenversicherung AG
  • HanseMerkur Krankenversicherung auf Gegenseitigkeit
  • HanseMerkur Speziale Krankenversicherung AG
  • HUK-COBURG-Krankenversicherung AG
  • INTER Krankenversicherung AG
  • Landeskrankenhilfe V.V.a.G.
  • LIGA Krankenversicherung katholischer Priester Versicherungsverein auf Gegenseitigkeit…
  • Lohnfortzahlungskasse Leer VVaG
  • LVM Krankenversicherungs-AG
  • Mecklenburgische Krankenversicherungs-Aktiengesellschaft
  • MÜNCHENER VEREIN Krankenversicherung a.G.
  • NÜRNBERGER Krankenversicherung Aktiengesellschaft
  • ottonova Krankenversicherung AG
  • praenatura Versicherungsverein auf Gegenseitigkeit (VVaG)
  • Provinzial Krankenversicherung Hannover AG
  • R+V Krankenversicherung Aktiengesellschaft
  • SIGNAL IDUNA Krankenversicherung a.G.
  • SONO Krankenversicherung a.G.
  • Süddeutsche Krankenversicherung a.G.
  • UNION KRANKENVERSICHERUNG AKTIENGESELLSCHAFT
  • uniVersa Krankenversicherung a.G.
  • Versicherer im Raum der Kirchen Krankenversicherung AG
  • vigo Krankenversicherung VVaG
  • Württembergische Krankenversicherung Aktiengesellschaft

Source: BaFin company database, 18 September 2026; EU insurers without a German office excluded.

Legal basis and sources

Products and add-ons

Percentage plan (Beihilfetarif)

The core: outpatient, hospital and dental cover at the percentage Beihilfe leaves open.

Supplement plan (Beihilfeergänzungstarif)

Add-on for the cuts and ceilings in the Beihilfe rules, with some insurers including repatriation from abroad.

Trainee plan

Reduced-price plan for trainees with civil servant status, usually with an age limit and conversion after training.

Entitlement cover (Anwartschaft)

Freezes your health status or entry age while you have free medical care in service or the contract is dormant.

Hospital extras plan

One-bed or two-bed room and senior consultant where your employer's Beihilfe pays nothing or only part.

Myth or truth

True or false?

Five things people say about this insurance. Guess first, then see the answer.

Beihilfe always pays exactly half the bill.

This is false.

It pays your rate on the eligible part only. What the rules cut stays open, and the rate depends on family, status and employer.

New civil servants with a health condition can still get private cover.

This is true.

Participating insurers accept them within six months of appointment, with a surcharge of at most 30 per cent and no exclusions.

You can drop the flat-rate allowance later.

This is false.

The decision is normally irrevocable, and it only applies with employers that offer the model.

The plan gets cheaper in retirement.

This is true.

At federal level the Beihilfe rate rises to 70 per cent, so only 30 per cent is insured once the contract is adjusted.

Spouse and children are covered automatically.

This is false.

Each person needs a contract and premium of their own, and dependants get Beihilfe only if they are eligible.

Common mistakes

  • Buying the percentage plan without a supplement and treating Beihilfe as full cover
  • Missing the six-month admission window after appointment
  • Choosing the flat-rate allowance without realising the decision is binding
  • Not adjusting the contract when the Beihilfe rate changes
  • Leaving out treatment received abroad in the health questions

Frequently asked questions

Questions and answers

Frequently asked

What is Beihilfe?

A reimbursement of medical costs by the public employer.

It covers a percentage of eligible costs for civil servants, their eligible spouses and children.

It exists for Beamte, judges and similar groups,

not for public sector employees on ordinary contracts.

How much does Beihilfe pay?

Each employer sets its own rules.

For the federal government it is 50 per cent for civil servants in service,

70 per cent for pensioners and eligible spouses,

and 80 per cent for children.

With two or more eligible children your own rate is 70 per cent.

States have their own regulations, so ask your Beihilfe office.

What is the Öffnungsaktion?

A commitment by participating insurers to accept new civil servants and eligible dependants within

six months of appointment into Beihilfe plans, with no refusal,

no exclusions and a surcharge of at most 30 per cent.

Not every insurer takes part, and supplement plans are generally outside it.

What is the flat-rate allowance (pauschale Beihilfe)?

A subsidy from the employer towards the contribution for a full health insurance,

in practice mostly a public fund, in place of individual Beihilfe.

Only some states offer it, first Hamburg,

and also Bremen, Berlin, Brandenburg, Baden-Württemberg and Lower Saxony among others.

The choice is normally final.

Can I stay in public health insurance?

Yes, as a voluntary member.

Without the flat-rate allowance you pay the whole contribution yourself because there is no

employer share,

and Beihilfe adds little next to the benefits in kind of a public fund.

What happens when I retire?

The federal Beihilfe rate rises to 70 per cent.

You reduce the plan to 30 per cent and the premium falls accordingly.

Good terms allow the switch without a new health check if you apply in time.

How are my spouse and children covered?

Everyone needs a contract of their own, there is no free family cover in private insurance.

Children get 80 per cent Beihilfe at federal level, so 20 per cent is insured.

Spouses are eligible only while their income stays below a limit set by the employer.

I am a police officer with free medical care. Do I need this?

Free medical care (Heilfürsorge) applies only in active service,

and whether you get it depends on the state.

On retirement Beihilfe takes over and you need a percentage plan.

Entitlement cover secures entry without a new health check.

You need long-term care insurance of your own even before that.

Is the policy available in English?

Policy documents and terms are in German, and German law applies.

We explain the terms to you in English and compare the points that matter before you sign.

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