Health insurance for the family: what applies to spouses and children

Whether a spouse can be privately insured depends on their own situation. Those in work need an income above the Jahresarbeitsentgeltgrenze (i)JAEG · 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 →. If they have a mini-job, do not work or receive Beihilfe as a civil servant, they can also join private health insurance, provided the other partner already has private insurance. Each partner still pays their own premium. Free cover does not exist.

If both parents have private insurance, the child needs a private contract of its own. If both have statutory insurance, the child is covered there through family insurance free of charge. With mixed cover, the income situation decides. If the privately insured parent earns more and is above the Jahresarbeitsentgeltgrenze (i), free cover is ruled out. Newborns join private health insurance without health questions if one parent has been insured there for at least three months.

For pregnancy and birth, private health insurance covers the benefits agreed in the contract, for example for preventive checkups, midwife care and delivery in hospital. During full parental leave, private cover continues. As a rule, however, you have to pay the premiums yourself, because the previous employer contribution usually ends.

Depending on the agreed plan, privately insured employees can receive Krankentagegeld during the maternity protection periods. If there is no such entitlement, a one-off maternity benefit of up to €210 from the Federal Office for Social Security may be possible under certain conditions. In addition, the employer pays a supplement where net pay exceeds €13 per day.

A statutory entitlement to child sick pay only exists if both the parent providing care and the child have statutory insurance and the other conditions are met. In 2026, as a rule, 15 working days per parent and child are available, or 30 working days for single parents.

In the case of marriage, separation or divorce, you should also check whether your insurance status, family insurance or the cover of your children changes.

Because each person pays their own premium, the total cost depends on the number of people insured. Employees receive an employer contribution of up to €508.59 towards health insurance and up to €104.63 towards long-term care insurance per month. From 2027, the maximum amounts are expected to rise to €557.81 and €114.75, according to the cabinet decision. As a guide value, children often cost between €130 and €200 per month. For families with a higher income and one or two children, private cover can be cheaper and offer better benefits. For large families with only one earner, the statutory health insurance fund usually remains the better option.

The detail pages explain each situation with the current values and our recommendations:

• Marriage: what changes when you marry.
• Children in private health insurance: insuring children privately.
• Kindernachversicherung: newborns without health questions.
• Child sick pay: when your child is ill.
• Adding a spouse: spouses without a new assessment.
• Divorce: insurance after separation.
• Double insurance: when two contracts overlap.
• Pregnancy: benefits and prenatal care.
• Birth: hospital, midwife and optional services.
• Parental leave: premium and cover during parental leave.
• Parental allowance: premium while you receive parental allowance.
• Maternity benefit: what you are entitled to.

No. Each family member has their own contract and pays their own premium. Free cover only exists in statutory health insurance.

Without health questions, if one parent has been privately insured for at least three months and the child is registered within two months of birth. The child then gets a contract of its own on the same acceptance terms.

Usually not, because no contribution is paid without wages. If you keep working part-time, you can keep the contribution. The premium itself continues during parental leave.