Health Insurance for Children
Everything You Need to Know About Health Insurance for Children at a Glance
- Whether a child is covered by public or private health insurance depends on the parents’ insurance status, income, and marital status.
- If both parents have public insurance, the child is covered under their family plan at no cost; if both parents have private insurance, the child must also have private insurance.
- If one parent has private health insurance and the other has public health insurance, the options depend on the parents’ marital status and income.
- There are separate rates for privately insured children; a later switch to public health insurance is possible under certain conditions, but there is no entitlement to sick pay for children.
Private or Public? Questions and Answers About Health Insurance for Children
Health insurance is mandatory in Germany. This also applies to children. However, whether your newborn child is automatically covered by public health insurance, whether you must purchase private health insurance, or whether you have a free choice depends on various factors. We’re here to help clarify things and have compiled the most important questions and answers about health insurance for children in an easy-to-understand format.
When is my child covered under family health insurance?
If both parents have statutory health insurance, the child can, under certain conditions, be covered under the family plan at no cost.
Important to know: Parents with statutory health insurance can voluntarily take out private health insurance for their child if they want more comprehensive coverage. However, this requires the payment of premiums.
When does my child need to have private health insurance?
If both parents have private health insurance, the child cannot be enrolled in the public health insurance system. In that case, the child must also be enrolled in a premium-based private health insurance plan.
One parent has private health insurance, and the other has public health insurance: How is the child covered?
It depends on whether the parents are married or unmarried:
If the parents are not married, they can choose between:
- free family coverage under the statutory health insurance system or
- private health insurance for the child.
If the parents are married, the following applies:
The child’s family coverage generally depends on the income of the parent who has private health insurance.
If this income exceeds the annual income threshold (2026: €77,400 gross annually / €6,450 monthly) and exceeds that of the parent with statutory insurance, the premium-free family insurance is not available. The child must then be insured either privately or “voluntarily” under the statutory system—and is therefore subject to premiums.
How much does private health insurance for children cost?
Private health insurance premiums vary by provider. There are usually separate plans for children that are less expensive than those for adults. The costs depend on the selected plan and scope of coverage, as well as the child’s age and health status. It’s worth comparing prices and plans to find the right insurance package.
Does my child have to undergo a medical exam to get private health insurance?
It depends: For a newborn, a health examination is generally not required, and enrollment is granted under simplified conditions if the child is enrolled in private insurance within two months of birth.
If private insurance is obtained at a later date, questions about the child’s health are usually asked. Pre-existing conditions or disabilities may result in higher premiums, risk surcharges, exclusion from coverage, or a denial of enrollment in private health insurance.
Does the employer contribute to private health insurance for children?
Parents with private health insurance who are employed receive an employer subsidy. The employer covers up to 50% of the premiums, including those for the children’s insurance. However, the subsidy is capped. In 2026, the maximum total subsidy for the employee and any co-insured children will be €508.59 per month. Parents must pay any amount exceeding this themselves, regardless of whether the costs are for themselves or for their children.
Self-employed individuals, freelancers, and business owners must pay the premiums for their children in full themselves. They do not receive a subsidy.
My child is sick: Am I eligible for sick child benefits if my child has private health insurance?
Most parents do not receive pay from their employer when they care for their sick child at home. If the child has statutory health insurance, parents with statutory health insurance receive child sickness benefits. However, if the child has private health insurance, there is no entitlement to child sickness benefits—unless this benefit was explicitly agreed upon. This applies even if one parent has statutory health insurance.
Can I claim my private health insurance premiums as a tax deduction?
Yes. Health insurance premiums for children are tax-deductible as long as the parents are responsible for their support.
Can my child switch from private health insurance to public health insurance?
A switch from private to public health insurance for children is only possible if they become subject to mandatory insurance, such as when they begin vocational training, college, or employment subject to social security contributions.
In general, switching from private to public family health insurance for children is only possible if the income of the privately insured parent is permanently below the annual income threshold or is consistently lower than the income of the publicly insured parent.
What happens to my child's private health insurance in the event of a separation or divorce?
In the event of a separation or divorce, private health insurance remains in effect for the time being. Depending on the terms of your policy, it may be possible to switch to the premium-free family coverage of a parent with public health insurance, subject to certain conditions. Please consult your insurance provider for advice on this matter.
Where can I get help and advice?
You can seek personalized advice from insurance brokers. It’s a good idea to schedule a personal consultation before the birth so you’ll have plenty of time to make a well-considered decision.
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