That changes for privately insured people

From 2026

New compulsory insurance limit: Things are getting tight for these insured people

The so-called compulsory insurance limit will rise in 2026. This has consequences for privately insured people whose income is only slightly above the old limit.

When the cabinet decided on the new calculation figures for social insurance at the beginning of October, it was not just about higher contributions for high earners. The regulation also increases the so-called compulsory insurance limit. This has consequences for some privately insured people.

The compulsory insurance limit decides at what income employees can switch from statutory to private health insurance. If it increases from 6,150 to 6,450 euros gross per month in 2026, employees who regularly earn below this limit will automatically be insured again under statutory health insurance (GKV). The only exceptions are people over 55 who have already been privately insured for a long time.

An example: In 2025, a 45-year-old employee with a gross monthly salary of 6,300 euros could be privately insured because her earnings were above the old limit. In 2026 it will fall below the new limit and will automatically be subject to statutory health insurance. However, there is a way to still remain in private health insurance: those affected can apply for exemption from compulsory insurance.

This must be submitted to a statutory health insurance company within three months of the start of compulsory insurance. The applicants can give the reason that the annual salary limit has increased and their income is now lower. The health insurance company must approve this application if the applicant can prove that they have appropriate other insurance – for example, previous private health insurance.

With the calculation size regulation, the contribution assessment limit for the GKV was also adjusted. It determines the income up to which social security contributions are due. For those with private insurance, it decides the maximum amount the employer contribution to health insurance can be. It also regulates the maximum contribution in standard and basic private health insurance tariffs.