Private Health Insurance for Families and Children in Germany (2026)

Families are where the private-or-public decision gets most expensive to get wrong. This guide explains how children and partners are covered, which parent's insurance counts and how to register a newborn in time. It is general information, not individual advice.

Is family cover free in private health insurance?

No. Private cover is a contract for one person. A spouse without income and each child need their own policy, and each pays a premium priced on age, health and tariff. Public insurance works differently: spouses, partners and children of a GKV member are covered at no extra premium if they meet the conditions in § 10 SGB V.

The GKV conditions include residence in Germany, no exemption or main-occupation self-employment and a total income that does not regularly exceed one seventh of the monthly Bezugsgröße. Minijobs are allowed up to the marginal-earnings limit. This is why a family with one earner and several children can find private cover costly. Our public vs private comparison sets out the trade-off.

Which parent's insurance counts for the child?

It depends on the parents' status. If a GKV-member parent qualifies the child under § 10 SGB V, the child can usually be family-insured. If both parents are GKV members, the member chooses the fund (§ 10 Abs. 5 SGB V). If neither parent is in GKV, the child needs private cover.

Under § 10 Abs. 3 SGB V, children are not family-insured if the related spouse or registered partner of the member is not a member of a Krankenkasse, regularly earns more than one twelfth of the income threshold and regularly earns more than the member. For pensions, the payment amount counts. The comparison is made on income, so a pay rise or a drop in hours can change the result. Check it whenever either parent's pay changes. The rule names only a spouse or registered partner, so it does not cover parents who are not married to each other. Confirm your case with the Krankenkasse.

The income threshold is €77,400 a year in 2026, so one twelfth is €6,450 a month. A figure of €84,150 a year is planned for 2027, but the Bundesrat has not yet approved it (Bundesrat-Drs. 576/26). See our 2027 threshold guide.

How does cover work for different family set-ups?

It depends on who is insured where. If both parents are private, every child needs their own policy. If one parent is in GKV, the child can usually join that parent's family cover, unless a privately insured spouse earns more than €6,450 a month and more than the GKV member. Unmarried parents fall outside that exclusion (§ 10 Abs. 3 SGB V).

Scenario 1: both parents privately insured

Each child needs a separate private contract and premium. A newborn can be registered with the parent's insurer within 2 months of birth, without risk surcharge or waiting period (§ 198 VVG). There is no family cover to fall back on, so budget one premium per child.

Scenario 2: one parent in GKV, one privately insured, married

The test in § 10 Abs. 3 SGB V compares the two incomes. All figures below are hypothetical.

• Illustrative example, child covered: the privately insured spouse earns €5,000 a month and the GKV member €3,000. €5,000 is below the €6,450 monthly limit, so the exclusion does not apply and the child can be family-insured through the GKV parent, if the other § 10 conditions are met.
• Illustrative example, child excluded: the privately insured spouse earns €8,000 a month and the GKV member €3,000. €8,000 is above €6,450 and above the GKV member's pay, so the child cannot use family insurance and needs its own cover, in practice private.

The limit is one twelfth of the €77,400 income threshold for 2026 (Deutsche Rentenversicherung). Check again whenever either parent's pay changes.

Scenario 3: unmarried parents, one in GKV

The exclusion in § 10 Abs. 3 SGB V names only a spouse or registered partner. For unmarried parents it does not apply, so the child can generally be family-insured through the GKV parent if the other § 10 conditions are met. Confirm this with the Krankenkasse before you rely on it.

How do I insure a newborn with a private insurer?

Apply within 2 months of the birth. If at least one parent is insured with that insurer on the birth date, the insurer must cover the newborn without risk surcharges or waiting periods, and cover starts at birth (§ 198 VVG). This is the Kindernachversicherung. Miss the window and ordinary health questions can apply.

• Level of cover: not higher or broader than the parent's.
• Waiting time for the parent: the insurer may require the parent to have been insured for up to 3 months.
• Adoption: counts like birth for a minor child. A risk surcharge is allowed only up to the single premium.

Because the newborn mirrors the parent's cover, choose the parent's tariff with that in mind. A parent with a thin tariff cannot pass on better cover through § 198. Tell your insurer about the pregnancy early, and ask what it needs for the registration.

What if we arrive in Germany with children?

Children need cover from the first day, because everyone resident in Germany must be insured (§ 193 Abs. 3 VVG). The 2-month registration rule in § 198 VVG covers newborns and adopted minors. For other children, ask the insurer whether health questions apply, and check what your immigration office or mission requires.

Newborns and adoption

• Newborn: register within 2 months of birth. Cover cannot go beyond the parent's, and the insurer may require the parent to have been insured for up to 3 months (§ 198 Abs. 1 and 3 VVG). AXA, for example, states the same: within 2 months of birth if a parent has had its cover for at least 3 months (AXA).
• Adoption: an adopted minor child is treated like a newborn (§ 198 Abs. 2 VVG). Register within 2 months and the insurer must accept the child without waiting period. If the risk is higher, a surcharge is capped at 100 percent of the premium (§ 198 Abs. 2 VVG).

Documents and residence rules

• Berlin immigration office: as a rule, private cover must have a deductible of no more than €300 a year, no cap on reimbursed costs, no major exclusions and no expiry clause tied to age, end of job, change of residence purpose or loss of status. This applies to issuing and extending residence titles for everyone not in German statutory insurance. It is a Berlin rule, not a nationwide one (LEA leaflet 4326, 12/2024).
• Insurer confirmation: Berlin asks for written confirmation that the contract meets the § 257 Abs. 2a SGB V conditions. For extensions you also need a certificate that cover was continuous and never cancelled. Fixed-term policies that do not renew automatically get no such BaFin confirmation.
• Visas: German missions require lasting cover comparable to statutory insurance, with an open-ended contract and no expiry clauses. Travel insurance or the EHIC is not enough. For family reunion, the sponsor's GKV membership plus a letter confirming family insurance on entry is accepted (mission leaflet, Tallinn, September 2024). Requirements can vary by mission.
• Ask the insurer which documents it needs for each child before you apply.

Do privately insured mothers get maternity pay?

Women who are not GKV members can receive Mutterschaftsgeld of at most €210 in total, paid as one lump sum by the Federal Office for Social Security (BAS) on application (§ 19 Abs. 2 MuSchG).

The BAS asks for an exemption notice (Befreiungsbescheid) only from privately insured women who earn below the income threshold, who must have been exempted under § 8 SGB V when they started the job. Above the threshold it is not needed (BAS FAQ).

What do child premiums look like?

Each child pays their own premium. The amount depends on the insurer, the tariff and the child's age group, so a quote is the only reliable number. For a family of four, add up four premiums and compare the total with GKV, where children and a non-earning partner cost nothing extra.

For the Basistarif, the law provides a separate variant for children and young people, and no ageing provisions are built up until age 21 (§ 152 VAG). Check whether your insurer applies similar rules in its normal tariffs. Our cost guide explains premium drivers.

How long can children stay in family insurance?

Up to 18 without further conditions, up to 23 if the child is not working and up to 25 in school, vocational training or a voluntary social or ecological year. Service periods can extend the 25 limit. Children with a disability who cannot support themselves have no age limit, if the disability began within the earlier age limits (§ 10 Abs. 2 SGB V).

For privately insured families there is no such limit, because the child already has a contract. The question is cost: you keep paying until the child can afford their own policy.

When is public insurance the better fit for a family?

Public insurance (GKV) is often the better fit for a family with one earner and several children, if you are allowed to be a member. Spouses and children are insured free if their income is at most €565 a month, or €603 for a mini-job (§ 10 SGB V, Berlin circular on 2026 figures). Only GKV pays Kinderkrankengeld (§ 45 SGB V).

• Free family cover: the €565 limit is one seventh of the 2026 reference value of €3,955. It covers a partner without income and children, so the saving grows with each family member.
• Child sick pay: in 2026, § 45 Abs. 2a SGB V sets 15 working days per child (30 for single parents) and a maximum of 35 (70). Privately insured parents have no claim, but can still take unpaid leave under § 45 Abs. 5.
• The catch: GKV is open only if your status allows it. Many expats earning above the income threshold stay exempt. See who qualifies for private health insurance and public vs private.

What should I check before the birth?

1. Confirm each parent's insurance status and income, and test the § 10 Abs. 3 rule.
2. Ask your private insurer in writing how the 2-month newborn registration works, and which documents it needs.
3. Choose the parent's tariff with the child's level of cover in mind.
4. Calculate the total family cost, public versus private, over 10 years, not just the first year.
5. Diarise the 2-month deadline from the birth date.

Frequently asked questions

Sources

• § 10 SGB V (family insurance, children, age limits, choice of fund)
• § 198 VVG (Kindernachversicherung for newborns and adopted children)
• § 193 VVG (insurance duty)
• § 152 VAG (Basistarif for children and young people)
• Deutsche Rentenversicherung: Rechengrößen 2026 (income threshold, Bezugsgröße)
• § 45 SGB V (child sick pay, GKV only)
• § 19 MuSchG and BAS FAQ on Mutterschaftsgeld (maternity pay for women outside GKV)
• Berlin Senate Finance circular: calculation bases 2026 (family insurance income limits of €565 and €603, reference value €3,955)
• Berlin immigration office, leaflet 4326 (12/2024) and German mission leaflet on health insurance for visas (Tallinn, 9/2024)
• AXA: private health insurance (newborn registration example)

Rules checked in October 2026. This guide is general information, not individual advice. Confirm your family's status with your Krankenkasse or insurer.