New rules for health insurance: What's changing?

The German job market is more attractive than ever for international professionals, but the conditions for living and working in Germany are constantly changing. Highly qualified expats, academics, and specialized young professionals who come to Germany particularly value the social security and the excellent healthcare system. However, this very system is facing a massive financial challenge . The cabinet recently passed the Contribution Stabilization Act, initiated by Health Minister Nina Warken . While politicians talk about stability, we as a law firm must state: For high earners and internationally mobile individuals, this is a significant challenge. For families , things will foreseeably become more expensive and bureaucratic . It is essential that employers and employees understand these changes in order to adjust their salary negotiations and life plans in a timely manner.

The increase in the contribution assessment ceiling and its consequences

A key aspect of the reform, particularly affecting academics, is a major focus. What affects skilled workers and managers is the significant increase in the contribution assessment ceiling . Previously, this threshold, up to which contributions to statutory health insurance were paid, was... Health insurance contributions (GKV) are currently levied on an income of €69,750 per year. According to the new plans, this amount will increase by €3,600 annually. For many expats, this simply means a lower net income, as a larger portion of their gross salary will be subject to contributions. We see this as a development that does not necessarily make Germany a more attractive location for top international talent.

At the same time, the income threshold for compulsory insurance is rising according to Section 6 Paragraph 1 Number 1 of the German Social Code, Book V (SGB V) . Those earning above this threshold theoretically have the freedom to choose between statutory and private health insurance. Private health insurance (PKV). However, raising this hurdle effectively "traps" many employees in the statutory health insurance system who would have preferred to switch to a private system to benefit from specific services or income-independent rates. From our perspective as corporate immigration experts, this is a critical issue, as freedom of choice is a key factor in international recruitment. If the government makes access to private health insurance more difficult, it indirectly interferes with the attractiveness of compensation packages that HR departments can put together.

The end of classic free co-insurance

Particularly impactful for Family insurance is the planned new regulation of family insurance according to § 10 SGB V. Previously, it was possible to... Spouses without their own income are currently covered free of charge – a model that many expats factor into their plans when moving to Germany. From 2028, this will end for certain groups of people. Those without a small income will be affected. Anyone who cares for a child under eight years of age, does not care for any relatives and is not retired, will in future have to make their own contribution or the insured partner will have to pay a contribution surcharge of 2.5 percent.

This regulation is politically justified as creating incentives to take up employment. However, in practice we observe that it is precisely those who are willing to cooperate who are being discouraged. spouse of a highly qualified Skilled workers often need time to gain a foothold in the German job market or to have their foreign qualifications recognized. The additional financial burden of an average of 80 to 90 euros per month may sound moderate, but it sends the wrong signal to international talent. Family n. It increases the financial pressure during the integration phase and burdens the household budget at a time when the cost of living is already rising.

Burdens on employers and international recruiting

The Contribution Stabilization Act also introduces new cost factors for companies and their HR departments. The increase in the assessment ceiling leads directly to higher payroll taxes . Furthermore, mini-jobs will become more expensive for employers, as the flat-rate insurance contribution is being raised from 13 percent to the average statutory health insurance rate of 17.5 percent. While this less frequently affects highly qualified specialists, it will significantly impact the operational areas of many companies that rely on flexible employment arrangements.

We criticize the fact that the burdens of system stabilization are primarily shifted onto contributors and businesses, while the federal subsidy for statutory health insurance is paradoxically decreasing. Non-insurance-related benefits, such as healthcare costs for recipients of basic income support, continue to be insufficiently covered by tax revenue, artificially inflating non-wage labor costs. For international recruiting, this means that Germany risks a further competitive disadvantage in the race for top talent due to higher labor costs and a lower net wage ratio.

Conclusion and outlook for expats and companies

The reform of Health insurance is a necessary but painful attempt to save the system from financial collapse. For foreigners For skilled workers and their employers, this means one thing above all: the costs of retaining or recruiting staff in Germany are rising. Increased co-payments for medications and hospital stays, as well as rising income thresholds, necessitate a thorough review of the... Employment contract and Posting guidelines. We recommend that companies adjust their budget plans for 2027 and 2028 now and inform foreign employees about the changes to the social security system at an early stage.