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Which health insurance do civil servants in Germany need?

In short

Most civil servants in Germany need state aid (Beihilfe) plus a private insurance that covers the rest. Your employer reimburses 50 to 80 percent of medical costs, and at 30 the private part usually costs about EUR 250 to 400 a month. Public health insurance is mainly worth it in states with flat-rate aid, for single-earner families or with serious pre-existing conditions.

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Which health insurance do civil servants in Germany need?

What it costs

Guide values from published tariff examples, monthly premium for the private share.

Example	Typical range
Trainee, 22, 50 percent Beihilfe	about EUR 70 to 90 a month
Legal or teaching trainee, 25, 50 percent Beihilfe	about EUR 120 to 160 a month
Civil servant, 30, single, 50 percent Beihilfe	about EUR 250 to 400 a month
Spouse, 30, 70 percent Beihilfe	about EUR 180 to 240 a month
Child, 80 percent Beihilfe	about EUR 40 to 60 a month
Retired from 65, 70 percent Beihilfe	about EUR 150 to 230 a month

Guide values as of October 2026.

Your premium depends on entry age, health, employer and tariff; we obtain the exact quote after the health assessment.

Worked example

Teacher, 30, civil servant, single, healthy

This is how her cover adds up with 50 percent Beihilfe.

Beihilfe from the employer	50 percent of costs
Private Beihilfe tariff with single room and chief physician	about EUR 270 to 330
Private long-term care insurance, remaining share	about EUR 30 to 50
For comparison: public insurance without flat-rate aid at EUR 4,500 gross, with care	about EUR 950

Privately she pays around EUR 300 to 380 a month. With flat-rate aid her share of public insurance would be about EUR 480, without it around EUR 950.

How Beihilfe works

Civil servants (Beamte) do not get an employer contribution to health insurance. Instead, the employer (Dienstherr) reimburses a fixed percentage of your doctor, pharmacy and hospital bills through Beihilfe.

You cover the remaining share with a private Beihilfe tariff designed to fill exactly that gap. Because only part of the risk is insured, the premium is much lower than for employees or the self-employed.

The rates depend on your employer. The federal government and many states use 50, 70 and 80 percent; some states differ, for example with higher rates for families.

Person	Federal Beihilfe	Insured privately
Active, up to one child	50 percent	50 percent
Active, two or more children	70 percent	30 percent
Retired	70 percent	30 percent
Spouse with entitlement	70 percent	30 percent
Children	80 percent	20 percent

Public insurance and flat-rate aid

Without a special rule, civil servants in public insurance pay the full contribution alone, including the part an employer normally pays. That is almost always more expensive.

Several states therefore offer flat-rate aid, where the employer pays half of the public contribution. In early 2026 this applied in Baden-Württemberg, Berlin, Brandenburg, Bremen, Hamburg, Lower Saxony, Saxony, Saxony-Anhalt and Thuringia, and in Schleswig-Holstein with restrictions.

The choice is usually final. Check your state's rules carefully before you commit.

The opening offer for pre-existing conditions

Many private insurers accept civil servants without rejection within the first six months after their first appointment. The surcharge for pre-existing conditions is then capped at 30 percent.

This also applies to civil servants on revocation, meaning trainees. If you miss the deadline, you go through the normal health assessment.

When public insurance is the better fit

With flat-rate aid, public insurance can be cheaper if a partner without income and several children are covered free of charge.

It is also worth comparing if you have a serious condition or disability and even the capped surcharge is high. If you are not sure you will stay a civil servant for life, think about the way back.

Step by step

Look up your Beihilfe rate and your employer's Beihilfe rules.
Check whether your state offers flat-rate aid and whether the choice is final.
Work through your family situation: partner with or without income, planned children.
With pre-existing conditions, use the opening offer within six months of appointment.
Choose a Beihilfe tariff that closes the gap completely, including dentures and glasses.
As a trainee, clarify the later switch to the regular tariff.

Checklist

Beihilfe rate known for you, your partner and your children
Top-up tariff matches the rate without a gap
Supplementary tariff for benefits Beihilfe reduces
Tariff adjusts when the rate changes with children or retirement
Opening offer deadline noted
Decision on flat-rate aid made in writing and deliberately

Common mistakes

Staying in public insurance without flat-rate aid and paying the full contribution alone
Missing the opening offer deadline and then being rejected for a pre-existing condition
Not adjusting the tariff when the Beihilfe rate rises with the second child or in retirement
Choosing flat-rate aid without knowing that there is usually no way back

Questions and answers

Frequently asked

Which option suits most civil servants?

Beihilfe plus a private top-up tariff. Public insurance is mainly worth checking in states with flat-rate aid, for single-earner families or with serious pre-existing conditions.

Do civil servants have to be privately insured?

No. Everyone must be insured, but civil servants may stay in public insurance. Without flat-rate aid, however, they pay the full contribution alone.

What does private insurance cost for trainees?

In training tariffs usually about EUR 70 to 160 a month, depending on age and tariff.

What happens to my health insurance in retirement?

Federal Beihilfe rises to 70 percent. The private share falls to 30 percent and the tariff is adjusted.

How are civil servants' children insured?

Federal Beihilfe covers 80 percent; the remaining 20 percent usually costs around EUR 40 to 60 a month per child.

What is a Beihilfe supplementary tariff?

An add-on that pays for costs Beihilfe does not cover or only partly covers, such as dentures, alternative practitioners or hospital extras, depending on the employer.

Can I cancel flat-rate aid later?

Usually not. The decision generally applies for your whole career, so do the maths first.

Do all insurers take part in the opening offer?

No, not all private insurers take part. We check which tariffs are available to you.

Sources

NAMMERT insurance broker

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