Health insurance and divorce: what changes for ex-partners

Statutory family insurance under § 10 SGB V ends when the divorce becomes final. The date is the day on which the divorce decree becomes final, not the day of the court hearing. From this date, the ex-partner who was covered so far no longer has health insurance cover through the other spouse.

The duty to have insurance of their own arises immediately. After the family insurance ends, cover continues automatically under § 188 (4) SGB V as voluntary statutory membership with contributions of their own, and no separate application to join is needed. If they want private insurance instead, they must declare that they are leaving within two weeks of the fund's notice.

If you had a private contract of your own as a spouse, you keep this contract unchanged. In insurance law, a divorce is not the same as a marriage. It is no reason for termination and no trigger for a switch in private health insurance. However, the change in marital status must be reported to the private insurer, because plans can contain clauses on family members, beneficiary designations or premium arrangements.

When the divorce becomes final, the family insurance of the former spouse generally ends. Which cover applies afterwards depends above all on professional status and income.

After the family insurance ends, cover generally continues automatically as a voluntary membership in statutory health insurance. A separate application within three months is not required.

The statutory health insurance fund informs you about the option to leave. If you choose other health insurance instead, you must declare that you are leaving within two weeks of this notice and prove your new cover.

If you take up employment that is subject to compulsory insurance, you become a compulsory member of statutory health insurance in your own right.

A switch to private health insurance is an option if no compulsory statutory insurance applies and a private insurer accepts the application. This can be the case in particular for self-employed people, civil servants or employees above the Jahresarbeitsentgeltgrenze.

As a rule, health questions and an insurance contract of your own are required.

New family insurance is only possible through a spouse with statutory health insurance or a registered civil partner. A shared household or an unmarried partnership is not enough for this.

In addition, the income and status requirements of family insurance must be met. New employment, by contrast, may lead to compulsory insurance of your own and not to family insurance.

The children's health insurance does not automatically follow custody or their main residence. What counts are the requirements of statutory family insurance or the existing private insurance contract.

A divorce can change whether free family insurance in statutory health insurance is possible, so this should be checked again. An existing private contract for the child generally continues and is not automatically assigned to one parent.

Both parents should inform the statutory health insurance fund or the private insurer promptly about the changed family situation and clearly settle who pays the premiums and manages the contract from now on.

From over 5,000 applications with health questions, we know a common mistake in separations. In the rush of the separation phase, nobody actively arranges the children's insurance. Both parents assume that the other one is taking care of it. In the end, the child is left without clear insurance cover.

We recommend that separating parents clarify the children's insurance before reorganizing their own, because otherwise there is a risk of gaps at doctor's visits.

Self-employed people who are responsible for their own health insurance alone for the first time after a divorce often use this break to review their plan. If you were covered through your partner in statutory health insurance so far and now become self-employed, you can join private health insurance directly, without having to consider the Jahresarbeitsentgeltgrenze (i).

For ex-partners with pre-existing conditions, entering private health insurance after the divorce is often difficult, because the health questions can lead to risk surcharges or exclusions. For this group, voluntary insurance in statutory health insurance is often the more practical route, because there are no health questions there.

During the year of separation, the marriage formally still exists. Statutory family insurance continues until the divorce decree becomes final, as long as the requirements under § 10 SGB V are still met. The insurer does not have to be informed about the separation as long as the legal marriage exists. If you live apart but are still married, you remain insured as before.

A Krankentagegeld plan of your own in private health insurance is not affected by the divorce and continues. Marital status usually has no effect on these daily allowance benefits, because they cover your own inability to work. If you did not have a plan of this kind so far and become self-employed after the divorce, you should add this cover when you join private health insurance.

With significant pre-existing conditions, joining private health insurance comes with risk surcharges or benefit exclusions. In some cases, the insurer rejects the application. Voluntary insurance in statutory health insurance, by contrast, accepts everyone who meets the requirements, without health questions. For ex-partners with pre-existing conditions, voluntary statutory insurance is usually the only reliable route.

Ex-partners who are not in work and have no income of their own can take out voluntary statutory health insurance, even if they have no employment. The minimum contribution to voluntary statutory insurance is based on a minimum income set by law. Alternatively, free cover through a new spouse or registered civil partner with statutory health insurance is possible as soon as the requirements for statutory family insurance are met.

Health insurance contracts are not retirement savings products and generally do not fall under the pension rights adjustment. Private plans with a strong savings component can be an exception, but that is a rare case. For all questions about the pension rights adjustment, a specialist family law attorney is the right contact.