Krankenkassen-Reform: DAS ändert sich für alle in 2027!

Summary

The video outlines planned changes to Germany’s statutory health insurance (GKV) and long-term care insurance, mainly from 2027. It focuses on higher contributions and out-of-pocket costs. Several measures are still proposals or require approval, so figures and start dates may change.

Contributions and income thresholds

• The statutory health-insurance contribution has a general rate of 14.6%, plus an insurer-specific additional contribution. Employees and employers generally split these contributions equally.
• The average additional contribution is forecast to remain at 2.9% in 2027, the same as in 2026. Insurers set their own rates and may raise them individually. The video says the actual average was 2.9% in 2025, despite a 2.5% reference rate, and reached 3.1% in Q1 2026, compared with a 2.9% reference rate.
• If an insurer raises its rate, members can use a special right to switch. The video cautions that rules about notifying members of increases have been changing; a Bundestag reversal still needed Bundesrat approval.
• The contribution assessment ceiling is set to rise from €69,750 in 2026 to €76,500 per year in 2027. People earning less than €69,750 are unaffected by this threshold change; those earning more will pay contributions on a larger portion of their salary.
  • At a 2.9% additional contribution, the video estimates the maximum contribution will rise by about €49 per month, or nearly €600 per year.
  • The increase is larger than a normal wage-linked adjustment: the reform adds a one-off €3,600 per year (€300 per month) to the ceiling.
  • At the maximum contribution, each 1 percentage point of additional contribution costs about €380 per year.
• The income threshold for opting out of compulsory statutory insurance and choosing private insurance is due to increase from €77,400 to €84,150 per year.

Long-term care insurance

• The stated standard long-term care insurance rate is 3.6%, generally shared between employer and employee.
• Childless people aged 23 or older currently pay a 0.6 percentage-point surcharge themselves, for a total rate of 4.2%. The surcharge is proposed to rise to 0.9 points in 2027, taking the total to 4.5%.
  • That would mean an extra €3 per €1,000 of gross monthly salary—for example, €12 per month on a €4,000 gross salary, or €144 per year.
  • The proposal still needs parliamentary approval.

Higher co-payments from 2027

• For medicines and medical aids, the co-payment remains 10% of the price, but the minimum rises from €5 to €7.50 and the maximum from €10 to €15.
  • A €30 medicine would cost €7.50 instead of €5 in co-payment; a €200 medicine would cost €15 instead of €10.
  • The video says there is no change for medicines priced between roughly €75 and €100.
• Hospital co-payments rise from €10 to €15 per day, for up to 28 days: a maximum of €420 instead of €280. A two-week stay would cost €210 instead of €140.
• For prescribed remedies such as physiotherapy, the co-payment will be 10% plus €15 per prescription, up from €10.
• For certain consumables, such as incontinence supplies, the monthly cap had already risen from €10 to €15 in July.
• Annual co-payments remain capped at 2% of household gross income, or 1% for people with chronic illnesses. The video gives examples of €800 and €400, respectively, on €40,000 of income.

Dental prosthetics

• The insurer’s subsidy for standard dental care is scheduled to fall from 60% to 50%.
• Bonus-booklet benefits would also be lower:
  • After five years of regular check-ups: 60% instead of 70%.
  • After ten years: 65% instead of 75%.
• The hardship provision remains: eligible people with low incomes can still receive full coverage for standard care.
• Practical suggestions in the video: Get a dental check-up this year to avoid a gap in the bonus booklet. If dental prosthetics are needed, submit the treatment and cost plan for insurer approval this year so the current subsidy rules apply, even if treatment takes place next year.

Coverage and preventive screening

• The video says cannabis flowers will no longer be available on prescription through the statutory system. They may still be prescribed privately, at the patient’s expense.
• From 2027, insurers would no longer be allowed to cover homeopathic or anthroposophic remedies or treatments.
• Whether coverage continues for skin-cancer screening every two years and general health checks every three years for people aged 35 and older remains under review. The relevant committee is to review these services by the end of 2027; until then, the video says current coverage continues.
• From August 2027, women aged 45 and older are expected to be eligible for mammography screening. The age range currently covered is 50–75.
  • Women aged 45–49 can register with the central office from 1 August 2027; personal invitations are expected from January 2028.
• For certain planned surgeries, a second medical opinion will become a condition for insurance coverage:
  • The first procedure under the rule is expected at the end of March 2027, with at least two additional procedures added each year.
  • Examples of procedures already eligible for a second opinion include knee or hip replacement, spinal surgery, tonsillectomy, and hysterectomy.
  • The second opinion must come from a different doctor. The operating doctor generally must inform the patient at least 15 working days before the procedure that surgery without the second opinion would have to be paid for privately.

Sick pay and later changes

• During the first six weeks of illness, the employer normally continues salary payments. After that, statutory sick pay is generally 70% of gross pay, capped at 90% of net pay.
• From 2027, if employment ends while someone is on sick leave, the video says sick pay will fall from the following day to 60% of net pay, or 67% for people with children.
• A pension-related loophole is also due to close: the video says sick pay will only be available if the person receives no more than two-thirds of their pension.
• Two further changes are scheduled for 2028:
  • Partial sick leave: For an illness expected to last more than four weeks, a doctor could certify someone as 25%, 50%, or 75% sick. The person would work part-time and receive proportional wages plus sick pay for the remainder, subject to agreement from both the employee and employer.
  • Non-working insured spouses or partners: Free co-insurance would be replaced by an additional 2.5% contribution, paid by the insured person. The video estimates €1,250 per year on €50,000 of income. A further 0.52% long-term-care surcharge is mentioned but not yet decided.
  • Exceptions are described for households with a child under 12, a partner providing qualifying care, a retired partner, or a partner meeting specified disability or care criteria.

Financial takeaways and cautions

• The biggest direct cost increases described are for higher earners affected by the assessment ceiling, childless people facing the proposed care-insurance surcharge, and patients with significant co-payments or dental costs.
• The video recommends checking insurer rates and comparing providers, while noting that individual insurers may set additional contributions above the average.
• No stocks, ETFs, bonds, commodities, cryptoassets, or other investment instruments are discussed.
• No “not financial advice” disclaimer appears in the subtitles.

Presenter and sources

Presenter: Markus, from Finanzfluss.

Sources or authorities mentioned: IW Cologne; the federal contribution estimators; the Bundestag; the Bundesrat; and the Federal Joint Committee (G-BA). The video also promotes Finanzfluss Copilot and its statutory health-insurance comparison tool.