German Health Patients Face Higher Copays and Fewer Extras as Insurers Slash Spending
Published on 06/17/2026 at 22:22 | Redaktion boerse-global.de
Germany’s public health system is heading for a collision with rising costs. The coalition government agreed on a reform package in mid-April 2026 aimed at stabilizing the statutory health insurance (GKV) funds, but experts and insurers alike warn the measures fall short of what is needed. A financing gap that could reach 40 billion euros by 2030 is forcing tough choices.
The reform package, which is expected to become law by the summer break in mid-July, introduces several painful adjustments. Copayments will climb to at least 7.50 euros per prescription. Sickness benefit — the wage replacement paid to workers on long-term sick leave — will drop from 70 percent to 65 percent of gross salary. Homeopathy will be removed entirely from the catalogue of covered services, and the long-standing option for spouses to be insured free of charge alongside a partner will be abolished.
Even before those federal changes take effect, individual insurers are moving on their own. IKK – Die Innovationskasse will cancel a range of voluntary supplementary benefits starting in July 2026. Policyholders will lose subsidies for professional teeth cleaning (100 euros), osteopathy (up to 120 euros per year), travel vaccinations, and fitness courses (130 euros twice a year). The mandatory core benefits remain untouched, but industry observers expect other funds to follow suit as their room for discretionary offerings shrinks.
The savings envisioned by the reform total 16.3 billion euros. Oliver Blatt, head of the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband), warned in mid-June that this will not be enough. For 2027 alone, an additional financing gap of 18.8 billion euros is expected. Spending is accelerating rapidly: in the first quarter of 2026, fund outlays rose 8 percent compared to the same period in 2025. The biggest drivers were hospitals, up 9.4 percent, and prescription drugs, up 6.4 percent.
Ulrike Elsner, chief executive of the Association of Substitute Health Insurance Funds (vdek), pointed out that hospital expenditure alone has leaped from 82 billion euros in 2020 to 112 billion euros now. In response, insurers are demanding more money from the federal government and steeper rebates from pharmaceutical companies.
Doctors are also feeling the pinch. Since April 1, 2026, psychotherapy fees have been cut by 4.5 percent. Professional associations warn that if budgeting constraints are tightened further, around 38 percent of therapy sessions could vanish starting January 2027. They say a wave of practice closures is looming.
Despite the reform, contribution rates are rising. Several major insurers have raised their supplementary contribution (Zusatzbeitrag) between 0.3 and 0.6 percentage points for July 2026. The average supplementary contribution now stands at 3.1 percent — a record high — while the government’s stated target is 2.9 percent. However, a mid-June analysis by Stiftung Warentest shows that switching insurers can still yield substantial savings. Total contribution rates range from 16.78 percent to 18.99 percent. For higher earners, the potential annual saving amounts to as much as 660 euros.
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