Health Insurance for Civil Servants in Germany
Private health insurance (PKV) for Beamte: how the Beihilfe allowance and your private complement fit together, what it costs, how to compare tariffs and where the lump-sum Beihilfe applies.
Health insurance for civil servants: the short answer
For most German civil servants (Beamte) private health insurance (PKV) with a civil-servant tariff is the most economical option. The employer covers at least 50% of medical costs through the Beihilfe allowance, and PKV insures only the remaining share - which keeps premiums comparatively low.
As a civil servant you face one core decision: private or statutory health insurance? Because Beihilfe is designed to work alongside the private system, the answer for most Beamte points towards PKV combined with Beihilfe - around 93% of civil servants are privately insured (PKV association). Without lump-sum Beihilfe, a voluntarily insured civil servant pays the GKV contribution largely alone. The exception: ten federal states now offer a lump-sum Beihilfe or have decided to introduce it - more on that below.
Good to know
Trainee tariffs ("Anwärtertarife") for civil servants on revocation are designed for the preparatory service and convert automatically into the full tariff on appointment - without a new health check. Illnesses that arise during this phase do not affect the conversion.
This guide explains how Beihilfe works, what PKV costs, how the opening campaign protects new appointees, how claims work and where the lump-sum Beihilfe applies. For the wider picture, see our overview of private health insurance in Germany. As a civil servant you also benefit from favourable financing terms - more on that in our guide to a loan for civil servants.
Key facts at a glance
- +Civil servants receive at least 50% Beihilfe from their employer (federal government or state); PKV insures only the remaining share
- +Entry premiums at a 50% Beihilfe share range from roughly 144 euros a month at age 20 to 340 euros at age 40 (Check24, as of January 2026); trainee tariffs are usually lower
- +Trainee tariffs convert automatically into the full tariff on appointment, without a new health check
- +Beihilfe usually rises to 70% in retirement, so your PKV premium tends to fall
- +Opening campaign: within the first six months after your appointment, participating insurers accept you without rejection and with at most a 30% risk surcharge
- +Ten federal states offer an alternative lump-sum Beihilfe or have decided to introduce it - that decision is irreversible
The Beihilfe system for civil servants
Beihilfe is a subsidy your employer pays towards your medical costs. The legal basis is the Federal Beihilfe Ordinance (BBhV) and the corresponding state regulations. The percentage depends on your family situation:
| Person | Beihilfe | PKV share |
|---|---|---|
| Single civil servant (or married, no children) | 50% | 50% |
| Civil servant with two or more children | 70% | 30% |
| Eligible spouse | 70% | 30% |
| Eligible children | 80% | 20% |
| Pensioner (retired civil servant) | 70% | 30% |
The 50% rate applies to civil servants with no or one child. From two eligible children it rises to 70% - including for civil servants with lifetime tenure. For spouses and registered partners the federal rules add an income limit: a partner only counts as eligible if their annual income stays below 22,648 euros (as of 1 January 2026, Federal Office of Administration). The states partly set their own limits.
Note: Beihilfe rates and the detailed rules can differ between the federal government and the individual states. Check the exact regulations of your employer, for example via the BBhV or the relevant state Beihilfe ordinance.
Lump-sum Beihilfe: the alternative in ten federal states
Since 2018 a second model has spread across the federal states, often called the "Hamburg model". With the lump-sum Beihilfe (pauschale Beihilfe) your employer does not subsidise individual invoices. Instead it pays half of your health insurance premium - either for statutory insurance (GKV) or for full private cover. For civil servants who want to stay in the GKV, this changes the maths fundamentally.
Ten federal states offer the lump-sum Beihilfe or have decided to introduce it (as of July 2026). Schleswig-Holstein grants it only to certain groups. The federal government and the remaining states - including Bavaria, Hesse and North Rhine-Westphalia - do not offer it:
Hamburg
since 2018
Brandenburg
since 2020
Bremen
since 2020
Thuringia
since 2020
Berlin
since 2020
Baden-Wuerttemberg
since 2023
Lower Saxony
since 2024
Saxony
since 2024
Saxony-Anhalt
since 2026
Mecklenburg-Vorpommern
introduction 2026
The decision is irreversible. Once you choose the lump-sum Beihilfe, you cannot return to individual Beihilfe later - not even if PKV would be cheaper in retirement. Long-term care insurance is not included in the subsidy. Run the numbers for both routes and check your state's rules before you commit.
Whether the lump-sum Beihilfe pays off depends on your health, family situation and career plans. Our guide to private health insurance in Germany compares both systems in detail.
Career phases: from trainee to pensioner
Your civil-service career runs through several phases - and your PKV tariff grows with it, usually without a new health assessment:
Civil servant on revocation (Beamter auf Widerruf)
Preparatory service / Referendariat · Beihilfe 50%
Low-cost trainee tariffs ("Anwärtertarife") with health questions at sign-up; the opening campaign helps if you have pre-existing conditions (see below)
Civil servant on probation (auf Probe)
After appointment · Beihilfe 50%
Automatic conversion into the regular civil-servant tariff without a new health check
Civil servant for life (auf Lebenszeit)
After probation · Beihilfe 50%
Stable tariff with ageing reserves; internal tariff switch under Section 204 VVG stays possible
Pensioner
In retirement · Beihilfe 70%
Beihilfe rises to 70%, so your PKV share and premium usually fall
Opening campaign: PKV despite pre-existing conditions
Pre-existing conditions are less of a barrier for new civil servants than many expect. The reason is the opening campaign (Öffnungsaktion) run by the private insurers: within the first six months after your first appointment, participating insurers accept every Beihilfe-eligible applicant. What counts is when your application reaches the insurer, not the later start of cover.
No rejection
Participating insurers may not turn you away on health grounds.
Capped surcharge
Risk surcharges are limited to at most 30% of the tariff premium.
No exclusions
Benefit exclusions for pre-existing conditions are not permitted.
The deadline is strict. Miss the six-month window and you go through regular medical underwriting - with uncapped surcharges or a possible rejection. The PKV association lists the participating insurers.
What does PKV for civil servants cost?
Premiums depend on the insurer, your age, health, tariff and Beihilfe rate. As a guide, the Check24 comparison lists these entry-level premiums for federal civil servants at a 50% Beihilfe share (rounded values without pre-existing conditions, as of January 2026):
| Entry age | Monthly premium (50% Beihilfe) |
|---|---|
| Age 20 | from 144 euros |
| Age 30 | from 303 euros |
| Age 35 | from 320 euros |
| Age 40 | from 340 euros |
Trainee tariffs for civil servants on revocation usually cost noticeably less. There is no upper limit either: comfort tariffs with senior physician treatment and single rooms cost considerably more. Your actual premium is only fixed after individual underwriting - always use a personalised quote rather than a headline number.
PKV with Beihilfe versus voluntary GKV
A civil servant who insures voluntarily in the statutory system without lump-sum Beihilfe carries the GKV contribution largely alone - PKV with Beihilfe usually wins by a clear margin. The picture changes in the states that pay a lump-sum Beihilfe: there the employer covers half of the GKV contribution.
For a full side-by-side of both systems, see our private health insurance guide.
Claims: one invoice, two reimbursements
As a privately insured civil servant you are a private patient. Doctors, hospitals and pharmacies bill you directly - and you claim the money back from two places:
Treatment and invoice
As a private patient you receive an invoice from the doctor, hospital or pharmacy. This invoice is the basis for both reimbursements.
Submit to the Beihilfe office
You submit the invoice with your Beihilfe application to the Beihilfe office of your employer. It reimburses your Beihilfe rate, for example 50%.
Submit to your PKV
The same invoice goes to your private insurer, which covers the remaining share within the agreed tariff.
Receive both reimbursements
Beihilfe and PKV together ideally cover the full invoice. Many Beihilfe offices and insurers accept digital submission via app.
Watch the deadlines: Beihilfe applications are subject to cut-off periods set by the relevant Beihilfe regulations. Submit invoices promptly or you lose the Beihilfe share.
Advantages of PKV for civil servants
Lower premiums than standard PKV
Because Beihilfe already covers at least 50% of costs, the private complement insures only the remaining share, which keeps the premium comparatively low.
No new health check on appointment
Trainee tariffs convert automatically into the full civil-servant tariff when you are appointed, without a renewed health assessment.
Ageing reserves from day one
Starting early builds the ageing reserves (Alterungsrueckstellungen) that help keep premiums stable later in life.
Coverage continues into retirement
Your contract carries over into your pension. Beihilfe typically rises to 70% in retirement, reducing the PKV premium you need.
Better-than-GKV benefits, depending on tariff
Depending on the tariff you may get senior physician treatment, single or twin rooms and shorter waiting times for appointments.
Optional add-ons
Dental upgrades, alternative medicine, private hospital rooms and higher daily allowances can be added to most base tariffs.
Risks and how to handle them
You are not kept on as a civil servant
If you do not become a permanent civil servant, returning to statutory health insurance (GKV) is possible in many cases, for example through a new compulsorily insured job. An individual review is needed.
The tariff does not match your Beihilfe rate
The PKV tariff must mirror your exact Beihilfe share (for example 50%). A mismatch can leave you under- or over-insured.
Health issues arise during the Referendariat
They do not affect the existing PKV contract or the later automatic conversion into the full tariff.
You chose a tariff that is too expensive
An internal tariff switch under Section 204 VVG with the same insurer can lower the premium without losing your ageing reserves.
You miss the deadlines for Beihilfe applications
Beihilfe applications are subject to cut-off periods set by the relevant Beihilfe regulations. Submit invoices promptly, otherwise you lose the Beihilfe share.
One more thing: as a civil servant you also tend to get favourable financing conditions. See our guides to a civil-servant loan and to a personal loan in Germany.
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Frequently asked questions
Should civil servants in Germany choose PKV or GKV?
For most civil servants (Beamte) private health insurance (PKV) with a civil-servant tariff is the more economical choice. The employer pays a Beihilfe allowance of at least 50% of medical costs, and PKV insures only the remaining share. Without lump-sum Beihilfe, anyone who insures voluntarily in statutory health insurance (GKV) pays the contribution largely alone. Ten federal states now offer a lump-sum Beihilfe or have decided to introduce it: there the employer pays half of the GKV contribution, which can tip the maths towards the GKV. An independent comparison should factor in pre-existing conditions, family planning and your federal state.
When should I switch to PKV as a new civil servant?
Arrange your cover within the first six months after your first appointment if possible. During this window the opening campaign (Öffnungsaktion) applies: participating insurers may not reject you on health grounds, risk surcharges are capped at 30% and benefit exclusions are not permitted. After that, regular medical underwriting applies. The later conversion from the trainee tariff into the full civil-servant tariff happens with the same insurer without a new health check.
How much does PKV for civil servants cost?
Premiums depend on your insurer, age, health status, chosen tariff and your Beihilfe percentage. In the Check24 comparison, civil-servant tariffs at a 50% Beihilfe share start at roughly 144 euros a month at age 20 and 340 euros at age 40 (rounded values without pre-existing conditions, as of January 2026); trainee tariffs are usually well below that. The exact figure is only fixed after individual underwriting, so always use a personalised quote rather than a headline number.
How does the Beihilfe system work?
Beihilfe is a subsidy your employer (the federal government or a state) pays towards your medical costs. The legal basis is the Federal Beihilfe Ordinance (BBhV) and the corresponding state regulations. A single civil servant usually receives 50%, rising to 70% with two or more eligible children. Eligible spouses receive 70% and children 80%. PKV insures the remaining percentage.
What happens to my PKV when I retire?
Your PKV continues with the same benefits. Your Beihilfe share typically rises to 70% in retirement, which means the portion covered by PKV - and therefore your premium - often decreases. There is no need to take out a new policy.
Can my family members also get PKV?
There is no family insurance in PKV the way GKV offers it. Each person needs their own contract. The advantage: eligible spouses receive 70% Beihilfe and children 80%, so the PKV premiums for family members are often low. Note the income limit: at federal level a spouse only counts as an eligible dependant if their annual income is below 22,648 euros (as of 1 January 2026); the states partly set their own thresholds.
What if I leave the civil service permanently?
If you leave permanently, your entitlement to Beihilfe ends. You would then need full PKV coverage or, under certain conditions, a return to statutory health insurance (GKV). The rules depend on your age, income and situation, so seek specialist advice before deciding.
Are there waiting periods for benefits?
Typically no waiting periods apply for accidents. For illness, general waiting periods of up to three months and special waiting periods of up to eight months are common depending on the benefit and insurer. Maternity benefits usually have a waiting period of around eight months. Check the exact terms in the tariff conditions.
What is an "opening campaign" (Öffnungsaktion) for civil servants?
In the opening campaign, participating private insurers accept new civil servants within the first six months after their first appointment - without rejection on health grounds. Risk surcharges are capped at 30% of the premium, and benefit exclusions for pre-existing conditions are not permitted. What counts is when the application reaches the insurer. The PKV association keeps a list of participating companies.
What is the lump-sum Beihilfe (pauschale Beihilfe)?
The lump-sum Beihilfe is an employer subsidy of 50% towards the premium of statutory or full private health insurance. Ten federal states offer it or have decided to introduce it - including Hamburg, Berlin, Baden-Wuerttemberg, Lower Saxony and Saxony; the federal government does not. It replaces the individual Beihilfe for single invoices. Important: the decision is irreversible, and long-term care insurance is not included.
Sources and References
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- •Federal Office of Administration (BVA) - Income limit for spouses in the Beihilfe- Bundesverwaltungsamt (BVA)Authority
- •PKV association - Health insurance for civil servants- Verband der Privaten KrankenversicherungStudy
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- •Verbraucherzentrale - Private health insurance- Verbraucherzentrale (German consumer organisation)Consumer Protection
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Last updated: 13 July 2026 | This guide provides general information and does not replace individual advice.