Health insurance companies are threatened with high additional contributions: the financial situation is dramatic!

Health insurance companies are threatened with high additional contributions: the financial situation is dramatic!

Statutory insured people in Germany could soon face further burdens due to higher additional contributions. The background is financing problems that affect many health insurance companies. According to a report by the star The “Handelsblatt” refers to data from the Federal Office for Social Security (BAS), according to which the financial situation of 45 of the 58 supra-regional health insurance companies was alarming at the end of 2024. The majority of these funds had financial assets of less than 20 percent of monthly expenditure, while 22 even had no reserves left.

The general contribution rate for statutory health insurance is currently 14.6 percent of contributory income. But many health insurance companies are forced to increase their additional contributions, which average around 2.5 percent, in order to strengthen their financial resources. Six health insurance companies have already increased their additional contribution rates in 2025, and further adjustments are likely as the development of the financial situation remains uncertain.

Background of the additional contributions

The need for additional contributions is closely linked to the statutory health insurance system. With the introduction of full income equalization in 2015, the general contribution rate was reduced from 15.5 percent to 14.6 percent. Nevertheless, many health insurance companies face challenges in closing their financial gaps, which have to be covered by additional contributions for individual insurance companies. Since January 1, 2019, these have once again been made up of contributions financed on a parity basis.

According to the regulations, the health insurance companies receive income from the income-related additional contribution as if the contribution rate of their members corresponded to the average in statutory health insurance. This determines that Federal Office for Social Security the funds available to the health insurance companies based on the individual additional contribution rate, the average contributory income per member and the number of members. In particular, those health insurance funds that have below-average income receive more resources from the health fund than they pay out.

The billing process is designed as a monthly installment process that includes several structural adjustments and a final annual balance. In view of the new challenges facing health insurance companies, it is foreseeable that both insured persons and health insurance representatives will have to develop strategies to keep the health system financially stable.