Despite a savings package, the additional contributions for health insurance companies will increase next year. The insurance companies have to generate up to ten billion euros additionally. Things could get even tougher in 2027.
Health insurance companies spent 326.9 billion euros last year. This year it is estimated to be around 331 billion euros, and spending will continue to rise next year. “We are missing ten billion euros,” said the head of the Techniker Krankenkasse, Jens Baas, recently on ZDF.
This gap can probably only be closed in the short term through higher additional contributions. According to the federal government’s calculations, this should be 2.9 percent next year, after 2.5 percent this year. In fact, they are already at 3.2 percent and could rise even further. Here’s everything you need to know about it.
That’s why health insurance contributions are rising
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In general, the German healthcare system is becoming more expensive every year for three reasons: Firstly, the aging of German society means that there are more and more seniors who are by nature more susceptible to illnesses and injuries, especially cases that are expensive to treat. Secondly, demographic change means that expenses for more and more seniors have to be financed by fewer and fewer people in employment. This is only possible if every single contributor contributes more. Thirdly, ever better therapies for more and more ailments are unfortunately also becoming more and more expensive.
A special case will be added next year. Health insurance companies are legally obliged to keep at least 20 percent of their average monthly expenses as a minimum reserve. But this reserve has already been fallen short of several times this year. The coffers will have to be replenished again for the coming year. This contributes several billion euros to the ten billion euro hole outlined by Baas.
This is how high your contributions are likely to rise
The additional contributions currently average 3.16 percent. They range between 2.18 percent of the nationwide BKK firmus and the Bavarian BKK Faber-Castell & Partner and 4.4 percent of the Knappschaft.
Of the 94 health insurance companies in the country, only a few have already decided what their contributions will look like in the coming year. Almost all of the relevant board meetings will take place next week. Of the 19 funds that have already made decisions, three will reduce their additional contributions, nine will not make any changes and seven will increase the contributions. Overall, the average additional contribution has already risen to 3.2 percent.
But it shouldn’t stay that way. If all health insurance companies together have to collect an additional ten billion euros in the coming year, that corresponds to around three percent of all expenditure. If the contributions also increased by three percent, the new average additional contribution in the coming year would be 3.25 percent.
That’s why you have to pay so much more
On average, there is an increase in additional contributions of 0.09 percentage points. That doesn’t sound like much, especially since it is split equally between employees and employers. But small animals also make crap. For an average earner with an annual gross income of 52,000 euros, health insurance contributions will rise by 23.40 euros in the coming year. People with a low income of 30,000 euros gross per year pay an additional 13.50 euros.
For higher earners, the contribution assessment limits also increase. If the limit up to which contributions were due was 66,150 euros in gross income per year this year, next year it will be 69,750 euros. For top earners with salaries above 69,750 euros, this means an increase in contributions of 351 euros per year.
The federal government is doing this to combat rising contributions
The Federal Ministry of Health actually wanted to pass a savings package that would have brought the health insurance companies at least two billion euros. The money should have come from limiting hospital reimbursements to actual cost increases. A clause that would give them more money should not be applied in 2026. But the federal states stopped the law in the Bundestag and called the mediation committee. It is still possible that the federal and state governments will come to an agreement this year, but that will come too late for the coffers. As mentioned, they have to complete their calculations for 2026 next week.
Minister Nina Warken (CDU) convened a commission of experts for the long-term financing of health insurance companies. This should reveal the most urgent problems on the income and expenditure side by the end of March and then a final report with proposals for structural reform by the end of 2026. Since this can only be planned and decided afterwards, the financing dilemma will not change for 2027 either.
That’s why the health insurance companies are again expecting a deficit of more than ten billion euros for the year after next. In order to close this, contribution increases could be necessary again. “Things will continue to get worse,” says Baas. Without a thorough reform, the contributions for health and nursing care insurance together would rise to more than 25 percent by 2029, warns the TK boss. Currently the total is 21.9 percent.