Private health insurance during parental leave: premium, employer contribution and cover

As a rule, private health insurance continues unchanged during parental leave. The insured person keeps their contractual benefits and continues to pay the agreed premium.

As a rule, this also applies to:

• the private Pflegepflichtversicherung (i)PflegepflichtversicherungCompulsory long-term care insurance. Everyone with health insurance in Germany must have it, privately insured people through their private insurer.,
• agreed risk surcharges,
• the statutory surcharge,
• additional plan modules.

Exceptions are possible if the plan explicitly provides a premium exemption or another special family benefit.

Parental leave therefore does not automatically end, interrupt or reduce the private contract.

During full parental leave without wages, privately insured people generally pay their full premium themselves. They must then also take over the share that the employer paid before.

Parental allowance contains no separate supplement for private health insurance. However, privately insured people often receive a higher parental allowance than comparable compulsorily insured members of statutory health insurance, because no flat rate for statutory social insurance contributions is deducted when their net income is calculated. This does not fully make up for the actual private premium, though.

The employer contribution usually ends if you do not work during parental leave, no wages are paid and the employment relationship is only suspended because of parental leave.

Parental leave alone does not create an entitlement to further payment of the previous contribution.

Yes. If you work part-time during parental leave and your private health insurance continues because of an exemption or continued exemption from compulsory insurance, an employer contribution can arise again from your part-time pay.

How high it is depends in particular on your pay, on your actual private premium and on the statutory maximum amounts.

Several private plans with strong benefits provide a premium exemption for a limited time while you receive parental allowance or after the birth of a child.

The exemption often applies for up to six months. Requirements and scope differ clearly, however. Depending on the plan, the following may be required, among others:

• an existing entitlement to parental allowance,
• a certain minimum period of insurance,
• the notice of your parental allowance,
• an application within a fixed deadline,
• cover in a plan that is explicitly eligible.

The premium exemption can also be limited to individual plan modules. It does not automatically include the private Pflegepflichtversicherung (i), Krankentagegeld (i) or all add-on modules.

Current examples are:

Which requirements apply in the individual case is set out in the insurance conditions of each plan.

An internal plan change can reduce the premium, but it should not be made only to bridge a parental leave of limited length.

A reduction in benefits is hard to reverse later. If you want higher benefits when you switch back, the insurer may under certain circumstances ask health questions for the additional cover.

Check the following with particular care:

• psychotherapy,
• medical aids,
• remedies such as physiotherapy,
• rehabilitation,
• inpatient benefits,
• dentures,
• benefits abroad,
• deductible.

The Basistarif (i)BasistarifA statutory social plan that every private insurer must offer. Its benefits are comparable to statutory health insurance, and its premium is capped at the statutory maximum contribution.More about Basistarif → is not a regular budget plan for parental leave. A switch to it should only happen after an individual legal and plan review.

A return to statutory health insurance during parental leave is only possible under certain conditions, for example if you take up part-time employment subject to social insurance. Without employment, the switch is usually ruled out.

If you have taken out an Anwartschaft (i)Anwartschaft · AnwartschaftsversicherungA dormant policy that keeps your rights in private health insurance while you do not need cover. It protects your health status for a later return.More about Anwartschaftsversicherung →, you return to your private plan after parental leave without new health questions. This is the decisive advantage over a termination.

Self-employed people have no statutory entitlement to parental leave, because they are not in an employment relationship. They can, however, reduce their work or let it rest for a while and receive parental allowance if they meet the statutory requirements.

Private health insurance generally continues during this time. Because self-employed people already received no employer contribution before, the way the premium is paid does not change. You still pay the full premium yourself, unless a premium exemption in your plan applies.

Our advice work and more than 5,000 applications with health questions show that an Anwartschaft (i) for the whole contract is not a standard solution for parental leave. As long as private health insurance continues unchanged, the premium generally continues as well.

This is why we first check whether your existing plan provides a premium exemption for a limited time, how high the burden is without the employer contribution and whether part-time work changes your insurance status. An Anwartschaft (i) only becomes relevant if you temporarily have other full health insurance and want to secure a later return to private health insurance.

Parental leave is the right to be released from work under employment law for up to three years. Parental allowance is the state benefit, usually for twelve to fourteen months. For private health insurance, parental leave is relevant because the employer contribution ends then.

Depending on the insurer and the plan, it is about 5 to 20 percent of the normal premium. With a monthly premium of €500, the small Anwartschaft (i) therefore costs around €25 to €100.

With the large Anwartschaft (i), they are kept. With the small Anwartschaft, they can be frozen. The exact conditions differ depending on the insurer and the plan.