Germany just passed its biggest health insurance reform in a decade
Germany’s Bundestag passed a major health insurance reform on Friday, 10 July 2026, ending one of the most heated healthcare debates in recent years. The new law officially the GKV-Beitragssatzstabilisierungsgesetz, or “law to stabilise statutory health insurance contribution rates” went through with 319 votes in favour, 286 against and four abstentions. WhatsUp Germany had covered federal cabinet’s first approval of the German health insurance reform back in April 2026. The reason for the push is Germany’s statutory health insurance system (GKV, gesetzliche Krankenversicherung) is heading into a funding gap of around 15 billion euros in 2027, and without this health insurance reform the shortfall could grow close to 40 billion euros by 2030. Health Minister Nina Warken (CDU) called the reform a milestone and admitted all sides would need to accept “noticeable changes”. Most of the new measures start on 1 January 2027. If you live in Germany and pay into a public health insurance fund (Krankenkasse) like TK, AOK, Barmer or DAK, this German health insurance reform will touch you.
Partial Sick Leave Under the New Health Insurance Reform
One of the biggest new ideas in this health insurance reform is partial sick leave, called Teilkrankschreibung in German. Until now, if your doctor signs you off, you are either 100 percent sick or 100 percent fit for work. From 2027, doctors can sign you off at 25, 50 or 75 percent capacity if you have a longer-term illness, so you can ease back into work while still getting sick pay for the hours you cannot manage. All three sides have to agree: your doctor, you and your employer. Your employer pays for the hours you actually work, and your Krankenkasse tops up partial sick pay (Krankengeld) for the rest. This option is only available to people who are legally insured through the GKV – private health insurance (PKV) members and mini-jobbers are not included. For internationals with chronic conditions, mental-health recoveries or slow post-surgery returns, this part of the German health insurance reform is a meaningful upgrade over today’s all-or-nothing system.
Family Health Insurance Cover Tightens From 2028
Free family health insurance (Familienversicherung) cover is being scaled back by this reform, but not as harshly as first planned. The cover for a non working spouse is a big draw for many international families moving to Germany. From 2028, if your spouse has no income of their own and you have no children under 12 at home, you will pay a top-up of 2.5 percent of your contribution-liable income to keep your partner insured with you on your public health insurance. The original draft asked for 3.5 percent and a child cut-off age of six, so this softening is real. Parents of children under 12, and couples where the non-working partner cares for a relative in need, keep the current free family cover . Children stay fully covered by their parent’s Krankenkasse. If you moved to Germany with a partner who does not work because they are studying, doing a language course or waiting on a work permit, plan for this change from 2028.
Health Insurance Reform Costs: Pharmacy, Dentist and High Earners
The health insurance reform also raises what you pay out of your own pocket. Prescription medicine co-payments (Zuzahlung) at the Apotheke go up from 2027, so regular medication will cost more each month, especially if you take something long-term. Dental reimbursement (Zahnersatzzuschuss) is also being trimmed. It is the share your Krankenkasse pays for standard tooth replacement falls if you have not been keeping a Bonusheft, and even those with a full ten-year Bonusheft receive a slightly lower percentage than before. If you are a high earner, the contribution-liable income ceiling (Beitragsbemessungsgrenze) is being lifted by an extra 300 euros a month on top of the usual yearly adjustment, so top salaries will pay a little more into the GKV every month. On the plus side, this German health insurance reform also caps board salaries at Krankenkassen, limits how fast admin costs can grow, and asks pharmaceutical companies to give bigger rebates, the aim being that not all savings come out of patients’ pockets. See also Germany July 2026: 7 Big Changes Coming Your Way
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