Germany's statutory health insurance (GKV) covers more than 73 million people — by far the largest pillar of social insurance. It costs every employee just over 8 % of gross pay, and the employer matches that contribution. Our health insurance calculator instantly shows your contribution, the employer's share and the impact of your fund's Zusatzbeitrag in 2026.

How GKV works

Statutory health insurance is governed by SGB V. Anyone employed below the insurance threshold (€73,800/year in 2026) is mandatorily covered. About 95 approved Krankenkassen receive risk-adjusted allocations from the central health fund (Gesundheitsfonds), funded primarily by your contributions, a flat federal subsidy and family-related transfers.

Contribution rates 2026

The standard rate (§241 SGB V) has remained 14.6 % of contributable gross pay since 2015. Anyone without an entitlement to statutory sick pay (Krankengeld) — for example pensioners or voluntarily insured self-employed who opted out of sick pay — pays the reduced rate of 14.0 % (§243 SGB V).

Both rates are augmented by the Krankenkasse-specific Zusatzbeitrag (§242 SGB V). It bridges the gap between what a fund receives from the central pool and its actual outlays. In 2026, the average Zusatzbeitrag is 2.5 % — individual funds can be higher or lower.

The 50/50 split — also for the Zusatzbeitrag since 2019

Until 2018 employees alone bore the Zusatzbeitrag. With the 2019 GKV-Versichertenentlastungsgesetz the paritätisch (equal) split was extended to the supplement as well. The full contribution is now divided 50/50:

ComponentTotalEmployeeEmployer
Standard rate14.60 %7.30 %7.30 %
Zusatzbeitrag (2026 avg)2.50 %1.25 %1.25 %
Total burden17.10 %8.55 %8.55 %

Contribution assessment ceiling 2026

Contributions are not levied on every euro of gross pay. The contribution assessment ceiling (Beitragsbemessungsgrenze) sits at €5,512.50 per month (€66,150 per year) in 2026. Above that threshold, no additional GKV contribution accrues — someone earning €8,000 pays exactly the same as someone earning €5,512.50.

Distinct from this is the insurance threshold (Versicherungspflichtgrenze) of €73,800/year (€6,150/month): employees who consistently exceed this can switch to private health insurance (PKV).

Worked example: €4,000 gross, standard rate, 2.5 % Zusatzbeitrag

  • Income subject to contributions: €4,000
  • Standard rate: 14.60 %
  • Zusatzbeitrag: 2.50 %
  • Total rate: 17.10 %
  • Total contribution: €4,000 × 17.10 % = €684 / month
  • Employer share (8.55 %): €342 / month
  • Employee share (8.55 %): €342 / month
  • Annual employee cost: €4,104

Choosing a cheaper fund with a 1.5 % Zusatzbeitrag would save roughly €20 per month at the same gross — €240 a year. Switching Krankenkassen can pay off.

Above the ceiling (example: €8,000 gross)

  • Income subject to contributions: capped at €5,512.50
  • Total contribution: €5,512.50 × 17.10 % = €942.64 / month
  • Employee share: €471.32 / month
  • Effective GKV burden on gross: 5.89 %

Standard vs. reduced rate: who pays what?

The reduced rate of 14.0 % applies to people without a Krankengeld entitlement. Typical cases:

  • Voluntarily insured self-employed who explicitly opted for the rate without sick pay
  • Pensioners covered by the KVdR (Krankenversicherung der Rentner)
  • Pre-retirees without continued wage payment

Self-employed who pay the standard rate get genuine sick pay from day 43 of illness onward.

Comparing Krankenkassen — what really matters

Because the standard rate and the 50/50 split are fixed for everyone, the only variable in your hands is the Zusatzbeitrag. In 2026, the spread runs from about 1.2 % (TK and a few company funds) to over 3.5 % at smaller funds. On €4,000 gross, a 1.5-percentage-point gap means roughly €360 per year — net, because the employer carries half.

GKV vs. PKV: when is private insurance worthwhile?

Anyone who consistently earns above the insurance threshold (€73,800/year) can switch to private insurance. Pros: income-independent premiums, often broader benefits. Cons: no family insurance, rising premiums in old age, near-impossible return to GKV. A return back to GKV is realistic only when income falls below the threshold — for most mid- to high-earning employees that means the door stays closed once you walk out.

GKV in your tax return

Contributions to statutory health insurance are fully deductible as basic provision (Sonderausgaben, §10 (1) no. 3 EStG). The 4 % share attributable to sick pay is excluded because it covers a wage replacement.

  • Anlage Vorsorgeaufwand, lines 11/12 (your contributions / 4 % flat reduction)
  • Privately insured employees enter their premiums in line 13
  • Supplementary policies (Krankenzusatz, Pflegezusatz) count as other provision insurance — subject to the €1,900/€2,800 cap

Common mistakes

  • Wrong Krankenkasse — staying with a high-Zusatzbeitrag fund leaves money on the table every year. Use the special right of termination after a rate hike.
  • Forgetting family insurance — partners and children can be insured for free, as long as their income stays below €535 (€556 for mini-jobs).
  • Losing Krankengeld entitlement — switching to the reduced rate eliminates sick pay.
  • Underestimating contributions in salary talks — gross raises shrink considerably after GKV, long-term care, pension and unemployment insurance kick in.

Long-term care insurance comes on top

Anyone covered by GKV is automatically also covered by statutory long-term care insurance (SGB XI). The rate is 3.4 % plus a 0.6 % surcharge for the childless. See our article on long-term care insurance 2026 for details.

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