Beihilfe: what the public employer pays and what civil servants insure themselves

Unlike employees, civil servants receive no employer contribution to their health insurance. Instead, their public employer pays a direct share of their medical costs. You submit each doctor's bill twice. The Beihilfestelle (i) reimburses its percentage, and the private Restkostenversicherung (i)Restkostenversicherung · RestkostentarifA private plan that covers the share of medical costs that Beihilfe does not pay. Together with Beihilfe it gives civil servants full cover.More about Restkostentarif → pays the rest.

At federal level, the legal basis is the federal ordinance BBhV. The states have their own ordinances with mostly the same rates. Costs that are medically necessary and reasonable are eligible. Anything beyond that, for example fees above the maximum rates of the GOÄ, is paid by the civil servant or by a supplementary plan.

At federal level and in most states, the rates follow a uniform pattern:

Some states differ. Baden-Württemberg, Bremen, Hesse and Saxony run their own systems, some with different rates and rules. Before any plan decision, look at your specific public employer, not the federal average. A worked example shows how the parts fit together. For treatment costs of €1,000, Beihilfe (i) pays €500 at the 50% rate and the private cover for the rest pays the other €500. For a child with 80% Beihilfe, only €200 is left for private health insurance.

The private cover for the remaining costs mirrors the Beihilfesatz (i). If you have 50% Beihilfe, you insure a 50% share. Retired civil servants and civil servants with several children only insure 30%. The premiums are low to match. A young civil servant often pays well below €300 per month for strong cover of the remaining costs. Trainee civil servants with the special training terms pay considerably less. The premiums mentioned are guide values.

On top of this comes the Öffnungsaktion (i)ÖffnungsaktionA one-off entry offer of private insurers for new civil servants. Applicants are accepted despite pre-existing conditions, with a capped risk surcharge. of the insurers for new civil servants. It lowers the hurdles for acceptance with pre-existing conditions. Its deadlines are tight, so check them early. For old age, civil servants face the same mechanics as everyone with private insurance, only cushioned. In retirement the rate rises to 70%, the share you need to insure falls and the premium falls with it.

Civil servants who stayed in statutory health insurance traditionally paid the full contribution on their own, because the classic allowance only worked with private cover for the remaining costs. Several states now offer the pauschale Beihilfe (i), originally known as the Hamburg model. The public employer pays civil servants with voluntary statutory insurance a subsidy of half the statutory contribution.

This decision is usually irrevocable, so you should do the math carefully. For young and healthy civil servants, the classic combination of the allowance and private cover for the rest usually remains much cheaper. For civil servants with large families or pre-existing conditions, the flat rate can be attractive. Whether your own state offers the flat rate has become part of the question of where you work.

In our advice work, the civil servant situation is the most rewarding of all. At the same time it has the most formal errors: rate changes not reported after the birth of the second child, full plans instead of shares that match the allowance, and missed deadlines of the opening offer for trainee civil servants.

We recommend that you plan your cover along the phases of your life. As a trainee civil servant, use the low-cost training plans and the opening offer. When your family grows, adjust the shares. Before retirement, prepare the switch to 70%. Set up correctly, the combination of Beihilfe (i) and private cover for the rest is the cheapest full cover the German system has.

No, as a rule they do not. Beihilfe (i) is reserved for civil servants, judges, recipients of civil service pensions and in some cases their dependents. Public sector employees under collective agreements are normal employees. They receive an employer contribution to statutory health insurance, or a contribution to private health insurance if they earn above the Versicherungspflichtgrenze (i)Versicherungspflichtgrenze · JahresarbeitsentgeltgrenzeThe annual income threshold in Germany. Employees who earn more than this per year may leave statutory health insurance and switch to private health insurance.More about JAEG →.

Eligibility ends with the entitlement to child benefit, so usually at the end of training or at the 25th birthday. After that, the children need their own insurance. An option plan agreed in good time secures their move into private health insurance without new health questions.

This differs by public employer. The federal government only reimburses optional services such as treatment by the chief physician and a two-bed room in return for a monthly contribution of your own. Some states do not reimburse them at all. Exactly this gap is the core purpose of the supplementary plan for civil servants.