2% – for everyone
In a calendar year your household pays co-payments of at most 2% of its gross income for living expenses. This includes the income of you and the relatives who live with you – such as wages, pensions or rental income.
Co-payment exemption
You never pay more than 2% of your income in co-payments.
There is a cap on co-payments for prescriptions, physiotherapy, hospital stays and medical aids: 2% of your household's gross annual income, 1% with a chronic illness. Your health insurer refunds anything above that – you just have to apply. Co-payments rise in 2027, so more people will reach the limit.
Key facts at a glance
How the co-payment limit works
1% – with a chronic illness
If you have been treated by a doctor for the same illness at least once a quarter for at least a year and another condition applies – such as care level 3, a degree of disability of 60 or more, or treatment that is permanently necessary – the limit falls to 1%. Your doctor confirms this.
Allowances for families
If your spouse or civil partner lives with you, €7,119 is deducted first in 2026, and €9,756 for each child. This makes the limit considerably lower for families.
Citizen's income, basic income support, social assistance
Then only the standard rate counts: in 2026 you pay at most €135.12 a year in co-payments, €67.56 with a chronic illness. This applies to the whole household receiving benefits.
What counts – and what doesn't
Statutory co-payments count: medicines, dressings, therapeutic treatments and medical aids, hospital, rehabilitation, transport costs, home nursing care and household help. Not included: your own share of dentures, glasses, over-the-counter products you buy yourself, extra costs above the fixed amount and private services.
The same at every insurer
Co-payments, the limit and the allowances are set by law and are the same at all health insurers. Children and young people under 18 generally pay no co-payments, except for transport costs.
Calculate your limit
What is the most you have to pay in co-payments?
Enter your household's gross annual income – everything you and your partner earn or receive as a pension. The calculator deducts the allowances and shows your limit for 2026.
Income taken into account–
Your co-payment limit 2026–
That is roughly per month–
How to get money back →Without guarantee. 2026 values: partner allowance 15% of the annual reference value (€47,460) = €7,119, per child €9,756 (child allowance under § 32 (6) EStG), citizen's income/basic income support/social assistance: standard rate €563 × 12. Your health insurer decides exactly which income counts and whether you qualify as chronically ill. The reference value and allowances change for 2027.
Step by step
How to get the exemption
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1. Collect receipts
- Keep all receipts for co-payments – with your name on them. Many pharmacies will print an annual summary if you use a customer card or receipt booklet there.
- Receipts from family members in your household count too.
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2. Apply to your health insurer
- Once you reach the limit, apply with your receipts and proof of income, such as a payslip, pension notice or tax assessment. Most insurers have a form for this, often online too.
- With a chronic illness, add your doctor's certificate.
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3. Money back and exempt until the end of the year
- The insurer refunds what you paid above the limit and issues an exemption for the rest of the year. You show it at the pharmacy and the practice.
- The exemption always applies for one calendar year – you apply again in the new year.
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Tip: pay in advance or claim later
- If you already know you will reach the limit – for example with a chronic illness – many insurers let you pay the limit amount at the start of the year and you are exempt straight away.
- If you exceeded the limit in an earlier year, you can also claim the refund afterwards. Claims usually expire after four years.
From 2027 you pay more: at least €7.50 instead of €5 per medicine, €15 instead of €10 per hospital day and per physiotherapy prescription. The limit stays at 2% or 1% – so it becomes more important. All changes in 2027 →
Frequently asked questions
Questions about the co-payment exemption
How high is the co-payment limit in 2026?
2% of your household's gross annual income for living expenses, 1% for people with a serious chronic illness. €7,119 is deducted first for a partner in the household and €9,756 per child. With citizen's income, basic income support or social assistance it is €135.12 a year, €67.56 if chronically ill.
Who counts as chronically ill?
Anyone who has been treated by a doctor for the same illness at least once a quarter for at least a year and also has care level 3 or higher, a degree of disability or reduced earning capacity of at least 60, or for whom a life-threatening deterioration, reduced life expectancy or a permanent impairment of quality of life would be expected without continuous treatment. The doctor issues a certificate for this. For younger age groups, counselling on early-detection screenings may also be required – ask your insurer.
Which costs count towards the limit?
Statutory co-payments for medicines and dressings, therapeutic treatments such as physiotherapy, medical aids, hospital, rehabilitation, transport costs, home nursing care and household help. Not included: your own share of dentures, glasses, over-the-counter products, extra payments above the fixed amount and private services.
Do I have to apply for the exemption every year?
Yes. The exemption applies until the end of the calendar year. In the new year you collect receipts again or pay the limit amount in advance if your insurer offers this.
Can I get co-payments refunded retrospectively?
Yes, also for past years, if you exceeded the limit then and still have the receipts. Claims usually expire after four years. Ask your insurer which proof it needs.
What changes for co-payments in 2027?
Co-payments rise by around half: medicines cost at least €7.50 and at most €15, a hospital day €15, therapeutic treatments €15 per prescription plus 10%. The limit of 2% or 1% stays.
Do I save on co-payments with another health insurer?
No, co-payments and the limit are the same at all insurers. You can save on the additional contribution – it differs by more than 2 percentage points depending on the insurer. Benefits differ too, so compare both.
Sources: § 62 SGB V (co-payment limit), § 61 SGB V (co-payments), chronic illness guideline of the Federal Joint Committee, § 45 SGB I (limitation period), Verbraucherzentrale: co-payments and exemption, GKV contribution rate stabilisation act (co-payments from 2027). As of 4 November 2026.