Germany's Major Health Reform Slashes Prescription Costs, Tightens Family Insurance
The German government has passed sweeping cost-cutting reforms that raise prescription co-payments by 50%, trim dental subsidies, and tighten spousal coverage rules from 2027. The GKV-BStabG reform, approved by cabinet in April, aims to stabilize the system amid a €15-40 billion funding crisis.
The German government's most significant health insurance reform in over a decade is now headed to final parliamentary votes before the summer recess, with revised provisions that soften the initial proposals but still shift costs to patients.
What's Changing
Patient co-payments rise by 50%. The minimum prescription-medicine co-payment moves from €5 to €7.50; the maximum from €10 to €15. Dental prosthetic subsidies drop by 10 percentage points. The standard fixed subsidy for tooth replacement falls from 60% to 50% of the cost of the standard treatment option. Homeopathy and anthroposophic medicine are removed from GKV coverage entirely, including as optional benefits that individual Krankenkassen can previously add on top.
The new charge for covered partners will apply only to parents with children over 11 years old, not six as originally suggested. Parents will also benefit from a much wider exemption than first planned. Under the original proposal, co-insured partners would have remained exempt from the new charge only if there were children aged six or younger in the household. The revised plan raises that threshold to children up to and including age 11, meaning many more families would avoid the additional payment.
Income Thresholds and Contribution Ceilings
The JAEG (income threshold for PKV eligibility) is projected at approximately €84,800 in 2027, up around 9.6% in one year. The GKV maximum contribution jumps to approximately €1,394/month from January 2027 (€1,261/month in 2026), a €133/month increase. Most provisions are set to take effect from 1 January 2027.
What this means for you as a foreigner: If you earn just above the 2026 PKV threshold of €77,400, switching to private insurance now may protect your choice before the 2027 threshold rises sharply. If you're in statutory insurance (GKV), expect higher prescription costs and reduced dental coverage from next year. Families with non-working spouses and children over 11 will see new spousal contribution requirements—check with your Krankenkasse about exact amounts. The government has also committed additional funding for people receiving basic income support to prevent further cost-shifting to general contributors.
Sources
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