On 10 July 2026, the German Bundestag passed the Statutory Health Insurance Contribution Stabilisation Act — GKV-Beitragssatzstabilisierungsgesetz. The reform is intended to reduce the projected deficit of the statutory health insurance funds and limit further increases in supplementary contributions. At the same time, insured people will face higher co-payments and restrictions on certain benefits.

Higher co-payments for prescription medicines

The minimum co-payment for one prescription medicine is expected to rise from €5 to €7.50, while the maximum will increase from €10 to €15.

This is not a fee for the prescription itself. The co-payment generally applies to each medicine dispensed by a pharmacy. It will continue to equal 10% of the medicine’s price, subject to the new minimum and maximum amounts. It may not exceed the medicine’s actual price.

Annual financial limits will remain in place:

  • up to 2% of annual gross household income;

  • up to 1% for people with serious chronic illnesses.

Once the applicable limit has been reached, an exemption from further statutory co-payments may be requested from the health insurance fund.

Reduced subsidy for dental prostheses

The standard fixed subsidy for dental prostheses is expected to decrease from 60 to 50% of the calculated cost of standard care.

The change applies primarily to:

  • crowns;

  • bridges;

  • removable dentures;

  • certain implant-supported prostheses.

It does not mean that all dental treatment will be reimbursed at only 50%. Dental examinations, fillings and medically necessary treatment are governed by separate rules.

The subsidy is based on the statutory standard treatment, known as Regelversorgung, rather than on the patient’s full invoice. Patients choosing more expensive materials, implants or treatment beyond standard care must generally pay the additional costs themselves. A treatment and cost plan — Heil- und Kostenplan — should therefore be submitted to the health insurance fund before treatment begins.

Existing hardship provisions are expected to remain in place.

Exclusion of certain additional benefits

Homeopathic and anthroposophic medicines and related treatments will no longer be eligible for reimbursement as voluntary additional benefits offered by statutory health insurance funds.

The reform also provides for the exclusion of cannabis flowers from statutory reimbursement. This should not automatically be interpreted as a complete exclusion of all cannabis-based medicines.

Partial sick leave and sickness benefit

A new system of partial incapacity for work is to be introduced at levels of 25, 50 and 75%. Depending on the level assessed, a person may be able to work part-time while receiving a proportionate sickness benefit.

The detailed medical and administrative rules still have to be established by the Federal Joint Committee, or G-BA.

Changes to family insurance from 2028

Contribution-free family insurance for children will generally remain in place. However, free cover for spouses and registered partners will be restricted.

It is expected to remain available in certain circumstances, including where:

  • a child under the age of 12 lives in the household;

  • the family includes a child with a disability;

  • a close relative requires care;

  • other statutory social conditions are met.

In other cases, an additional contribution amounting to 2.5% of the employed partner’s assessable income may apply from 2028.

Additional measures

The reform also includes:

  • limits on health insurance funds’ administrative expenditure;

  • a 50% reduction in their advertising expenditure;

  • limits on certain executive remuneration;

  • higher contributions from pharmaceutical manufacturers and pharmacies;

  • mandatory independent second opinions for selected planned medical procedures.

Practical assessment

The effects will be particularly noticeable for people who regularly require prescription medicines or are planning dental prosthetic treatment. Insured people should retain proof of all co-payments, monitor their annual financial limit and obtain approval of dental treatment costs from their health insurance fund in advance.

Information correct as of 20 July 2026. The legislation had been passed by the Bundestag, but the formal legislative process had not yet been fully completed. Individual provisions may still change before the Act is officially promulgated.

Compiled by Anastasiia Malyshenko