Compulsory insurance

Statutory insurance obligation

The statutory insurance obligation refers to the fact that certain groups of people in a country are legally obliged to take out a certain form of health insurance. In Germany, statutory health insurance is an example of compulsory insurance.

In Germany, most employees whose income is below a certain threshold are required by law to take out statutory health insurance. This obligation also extends to other areas of social insurance such as pension insurance and long-term care insurance. The compulsory insurance threshold, above which employees have the option of taking out private insurance, is regularly adjusted.

Compulsory insurance ensures that a broad section of the population has access to adequate healthcare and that the financial burden of healthcare is spread across many shoulders.

The statutory insurance obligation also applies to pensioners, the unemployed and other groups of people.

Statutory health insurance vs. private health insurance

Statutory health insurance and private health insurance are two different health insurance systems in Germany. The choice between the two depends on individual circumstances, income, state of health and personal preferences. 

Here are the main differences between the two:

• Target group:
  • Statutory health insurance is compulsory for the majority of the population. Employees with an income below the compulsory insurance threshold are insured under the scheme.
  • Private health insurance is aimed at people who meet certain requirements, such as the self-employed, freelancers, civil servants or people with an income above the compulsory insurance limit.
• Payment of contributions:
  • Contributions to statutory health insurance are paid half by the employee and half by the employer. The amount of the contribution depends on income.
  • In private health insurance, the premium depends on individual factors such as age, state of health and the selected scope of cover. Insured persons pay their premiums directly to the private insurer.
• Services:
  • The benefits provided by statutory health insurance are defined by law and include defined basic cover. There is little scope for individual design.
  • With private health insurance, policyholders can customize their insurance cover. The tariffs can include different benefits, extras and deductibles.
• Insurance term and change:
  • Membership of statutory health insurance is generally permanent as long as the requirements are met.
  • Switching between private and statutory health insurance is possible under certain conditions, but requires careful consideration of individual circumstances.
• Family insurance:
  • Spouses and children can be insured free of charge under statutory health insurance if certain conditions are met.
  • In private health insurance, family members must be insured separately and the premiums are based on age and state of health.

Under what conditions can you be exempted from the statutory insurance obligation and remain privately insured, for example?

In Germany, employees are generally required to have statutory health insurance. However, there are certain conditions under which you can be exempted from the statutory insurance obligation. Here are some of the most important exceptions:

• Income above the compulsory insurance limit: If an employee's income exceeds the compulsory insurance limit (also known as the annual income limit), they can be exempted from compulsory statutory health insurance. For 2023, this limit was an annual gross income of 66,600 euros.
• Self-employed persons and freelancers: Self-employed persons and freelancers are generally not subject to statutory insurance. They have the choice of either taking out voluntary statutory health insurance or taking out private health insurance.
• Civil servants and certain professional groups: Civil servants and some professional groups that have special pension schemes (such as doctors or pharmacists) are exempt from compulsory statutory health insurance.
• People in marginal employment (mini-jobbers): People who are in marginal employment (mini-job) and whose income does not exceed the applicable limit are exempt from compulsory statutory health insurance. In 2022, this limit was 450 euros per month.
• Family insurance: People who are not in full-time employment can be insured through their family under certain conditions. This applies, for example, to spouses and children whose income does not exceed a certain limit.

Are working students exempt from the statutory health insurance obligation?

As a rule, working students are exempt from compulsory statutory health insurance. The working student regulation enables students who work in a working student job alongside their studies to be exempt from compulsory statutory health insurance. Working students who meet certain requirements and are exempt from the statutory health insurance obligation have the option of taking out private health insurance. This regulation applies under certain conditions. Here are the most important points:

• Income limit: Working students must not exceed a certain income limit in order to be exempt from compulsory insurance. This income limit is adjusted regularly. For 2023, the monthly income limit is €1,160 gross.
• Student status: The working student regulation only applies to enrolled students. The working student must continue to be enrolled at a university during their employment as a working student.
• Working hours: Working students are generally allowed to work a maximum of 20 hours per week during the semester in order to be exempt from compulsory insurance. There is often no limit on working hours during the semester break.
• Insurance options: Working students have the option of taking out student health insurance during their time as a working student, which is generally cheaper than regular statutory health insurance.