Germany's health insurance change takes shape

Germany is weighing a change to statutory health insurance that would end free family coverage for many non-working spouses and civil partners. The proposal targets the Gesetzliche Krankenversicherung (GKV) system, where about 3 million spouses and partners are currently covered at no extra cost through a working partner.

One early version set a flat charge of €225 a month for health and long-term care insurance. Health Minister Nina Warken has since backed a different model, with a 3.5% surcharge on the primary earner’s gross income plus 0.7% for long-term care insurance. The government says it wants to avoid unfairly burdening lower-income households and the draft is still moving through the cabinet and parliament, with possible implementation in 2028.

Who would feel it first

The biggest impact would fall on expat families and digital nomads in Germany where one spouse doesn't work. Children would still stay in family coverage for free until age 18 and often longer if they are students or apprentices.

The draft also points to possible exemptions for spouses who are caring for children under 6, looking after relatives or unable to work because of childcare shortages or elder-care duties. The ministry says it won't adopt the commission’s ideas "one-to-one," and that "no one should be unduly burdened."

What to watch next

The plan still needs approval from the Federal Cabinet, the Bundestag and the Bundesrat. The government wants the wider package approved by summer 2026, before the health system faces a projected deficit of more than €15 billion by 2027.

Anyone relying on family coverage in Germany should follow the bill closely and check whether a spouse could move into a paid plan later. Read our full Germany guide for the complete picture and see more visa updates.