Adding a spouse to private health insurance: deadline, requirements and acceptance

When a spouse is added, the partner of a privately insured person can join that person's private health insurer after the wedding. The central advantage is that the general waiting periods no longer apply. These are the periods in which a new contract does not yet reimburse certain benefits.

What it does not provide is free cover. Unlike statutory family insurance, the spouse pays a premium of their own for a contract of their own. The clause only makes acceptance easier. It does not make it free.

The decisive difference from the Kindernachversicherung lies in the legal framework. The acceptance of newborns without health questions is guaranteed by law in § 198 VVG. There is no comparable right for spouses. Whether, within which deadline and on which conditions an insurer accepts the partner is set out only in its general insurance terms.

The exact conditions differ from insurer to insurer. Some requirements, however, come up again and again.

The first key point is the deadline. An application within two months of the wedding is common, with the marriage certificate as proof.

• Application within two months of the wedding, with the marriage certificate as proof.
• The spouse to be added often has no income of their own that is subject to compulsory insurance.
• The chosen plan often matches that of the partner who is already insured.
• In every case, the basic requirement remains that the spouse can be privately insured at all.

If you want to use the special conditions, you should proceed in a structured way and within the deadline.

• Step 1: Check the terms. Look in the insurance terms of the partner who is already insured to see whether adding a spouse is provided for, which deadline applies and whether health questions are required.
• Step 2: Submit the application on time. Submit the application within the stated deadline and enclose the marriage certificate. Some insurers also ask for a simplified health questionnaire.
• Step 3: Check the plan and premium. The special condition concerns acceptance, not the price. Which plan is possible at which premium depends on age, scope of benefits and the insurer's plan rules.
• Step 4: Conclude the contract. Once plan and premium are agreed, the contract starts on the agreed date. Keep proof that you applied on time.

From over 5,000 applications with health questions, we know a standard case. One partner is already privately insured. The other was covered by a statutory health insurance fund and switches to private health insurance after the wedding as a self-employed person or as an employee earning above the annual income threshold. The question of adding a spouse often only comes up after the wedding, when the deadline is already running.

We recommend that couples look for a clause on adding a spouse as early as the first insured partner's original choice of plan. If you paid attention to this early, you benefit from better conditions when you marry. The clause is especially valuable if the future spouse has pre-existing conditions, because then the waiver of waiting periods can make the difference.

Then there are no special conditions. The spouse is accepted in the regular way, with the usual waiting periods and the usual health questions. In this case, it can be worth looking at insurers with such a clause before the wedding.

Not necessarily. Only the waiver of the general waiting periods is certain. Whether the state of health is checked and whether this leads to a risk surcharge depends on the insurer's terms.

Many insurers now treat registered civil partnerships like marriages. Some deviate from this. Only the wording of the relevant terms is reliable.

Often not. Many insurers tie acceptance to a plan that matches that of the partner who is already insured. A different plan is then only possible through regular acceptance.

It is not free. The partner pays a premium of their own, which depends on age, plan and state of health. For adults, it is typically between €300 and €600 per month, depending on the plan.