Number continues to fall – more health insurance companies are considering mergers

600,000 insured people affected

Two other health insurance companies are considering mergers

The number of health insurance companies in Germany sometimes causes criticism. However, their numbers could fall further at the turn of the year.

The number of health insurance companies could decrease further by January 1, 2027. According to the Federal Cartel Office’s merger register, IKK Gesund Plus from Magdeburg is examining a merger with IKK Brandenburg and Berlin from Potsdam.

“Against the background of current political developments and the overall situation in the GKV, both health insurance companies will further intensify their cooperation,” explained a spokeswoman when asked by t-online. The advantages of merging the two funds will also be examined. A corresponding decision is to be made in July.

IKK Gesund plus was created through a merger of IKK Saxony-Anhalt and IKK Bremen and Bremerhaven and had around 412,000 insured people as of January 1st of this year. The IKK Berlin and Brandenburg currently has around 209,000 insured people. Through a merger, the merged fund would be one of the 25 largest health insurance companies in Germany with over 600,000 insured people.

At the same time, Warken emphasized that the administrative costs of the funds are not “the big problem in the system”. The health insurance companies themselves point to the falling administrative costs and the first catalog of recommendations from the Health Finance Commission. This had spoken out against the establishment of a single fund.

Instead, the experts referred to experiences from Austria. In 2020, nine regional health insurance companies merged to form the Austrian Health Insurance Fund. Contrary to expectations, however, administrative costs rose rapidly: by 25 percent from 2020 to 2024. In the German system, costs only rose by seven percent over the same period.

Regardless of the political debate, the number of health insurance companies has been falling for years. While there were 1,147 in 1990, the number fell to 420 by 2000. As of January 1, 2026, there were only 93 cash registers left. This number could continue to fall by 2027. In addition to the IKK Gesund plus and the IKK Berlin and Brandenburg, the Salus BKK and the BIG Direkt Gesundheit as well as the mkk and the BKK Pfalz are also examining a merger. The health insurance companies point out the increasing challenges, for example in the area of ​​digitalization and the shortage of skilled workers. You can read here what effects a merger of health insurance companies has for the insured.