Until now, family insurance (Familienversicherung) for spouses and civil partners has been free of charge. That is changing: from 1 January 2028, health insurers will charge the member a surcharge of 2.5 percentage points on their contribution rate if their spouse or civil partner is covered free of charge through them. This is set out in the GKV-Beitragssatzstabilisierungsgesetz (§ 242b SGB V), which was promulgated in the Federal Law Gazette in July 2026. On the statutory pension and pensions from professional pension schemes (berufsständische Versorgungswerke), the surcharge is only charged from 1 July 2028. Children covered through family insurance remain free of charge.
What this means in euros (per month, on your contributory income up to the contribution ceiling): €75 at €3,000 gross, €100 at €4,000 gross, €125 at €5,000 gross. As a rule, you pay the surcharge alone – unlike the regular contribution, your employer pays nothing towards it.
No surcharge as long as one of these exceptions applies: A child under 12 lives in your partner's household (including stepchildren, grandchildren and foster children), or a child with a disability who cannot support themselves. Your partner cares for a relative with at least care level 2 at home, at least 10 hours a week on at least two days, or takes care leave. Your partner has reached the standard retirement age. Your partner has at least care level 3, a pension for full reduction in earning capacity, a degree of disability of at least 60, or receives basic income support (Grundsicherungsgeld) as a member of your household unit who is unable to work. The exception applies for the whole month in which it starts or ends. If your insurer knows about an exception, it must take it into account even without proof – if in doubt, let them know.
What this means for you: The surcharge is the same at every health insurer, so switching insurers does not change it. Differences remain in the additional contribution; benefits differ, so compare contributions and benefits. For long-term care insurance, the care reform plans its own changes to co-insurance of spouses – these have not been passed yet.
Source: GKV-Beitragssatzstabilisierungsgesetz, Federal Law Gazette (BGBl.) 2026 I No. 228, § 242b SGB V · Haufe: contribution surcharge from 2028 · Amounts: own calculation, without guarantee