Germany Raises Health Insurance Income Limits: What This Means for Expats

At the start of October, the German federal government approved key changes to social-security thresholds that will have major implications for health-insurance coverage in 2026. Two benchmarks have been raised substantially: the "compulsory insurance limit" (Jahresarbeitsentgeltgrenze) and the "contribution assessment limit" (Beitragsbemessungsgrenze). For employees with voluntary insurance, this means higher costs; for those hoping to switch to private health insurance, the path will become even more difficult.

What's changing

Under the draft Ordinance on Social Security Calculators 2026 approved by the Federal Cabinet, the compulsory insurance threshold will rise to EUR77,400 per year (from EUR73,800 in 2025) -- a 4.9 % increase. This is the income-level above which salaried employees can choose private health insurance (PKV) rather than being bound to statutory insurance (GKV). The government adjusts these thresholds annually in line with wage trends in Germany.
Meanwhile the contribution assessment limit for health insurance rises to EUR69,750 in 2026 (from EUR66,150 in 2025) -- this is the maximum annual income on which contributions to statutory health and nursing-care insurance are calculated. After this point, income above that limit does not attract further contributions for those insurances.

Why it matters for choice and cost

For expats working in Germany as salaried employees, these changes mean two things:

1. Switching to private health insurance becomes harder: Since you must earn above the compulsory insurance threshold to opt for PKV, the raise to EUR77,400 puts more of the workforce out of reach. Since 2013 the threshold has already climbed by more than 48% (from EUR52,200 to the forthcoming EUR77,400).

2. Statutory health insurance will cost more for middle-income earners: The contribution assessment limit governs up to what salary the GKV contribution is calculated. With this increased limit, those whose salaries push into higher brackets will see higher contribution bases, resulting in increased costs for both employees and employers. Analysts from ZEW and the German Economic Institute (IW) warn that this steep rise burdens middle-class employees and may reduce incentives to work.

Historical background and implications

Until the end of 2002, the compulsory insurance limit and the contribution assessment limit were identical. In 2003 the threshold was decoupled and raised disproportionately -- which critics say was a deliberate policy move to restrict the number of employees eligible for private coverage. Over time, this has taken the freedom of choice away from millions of employees, and disrupted competition between GKV and PKV providers.
Industry voices such as Florian Reuther, director of the PKV association, argue that the gap between the two limits (currently about EUR7,650 in favour of the threshold) distorts competition and weakens consumer choice. Calls persist to bring the threshold back down to the level of the contribution assessment limit.

What it means for expats in practice

If you are an employee in Germany and you earn below EUR77,400 in 2026, you will remain unable to opt for private insurance -- you will be obliged to have statutory insurance. If you already have PKV and your earnings drop below the threshold, returning to GKV may be difficult.
In addition, if your salary is near or above the contribution assessment limit, your contributions to statutory health insurance will increase -- reducing take-home pay. For employers, these changes may lead to rising payroll costs. For you, as an expat, the choice of insurer, coverage and future flexibility become even more important.
For freelancers, self-employed individuals or civil servants, the rules differ: many can still opt for private insurance regardless of salary thresholds, but the changes underscore how the system is increasingly skewed by income.

Take-away for expats

• If you anticipate salary growth in Germany, check early whether and when you may cross the threshold for private insurance eligibility.

• If you are below the threshold but aiming for private coverage, adjust your expectations: private plans may become accessible only at higher income levels.

• For those in statutory insurance, be aware that contribution bases are rising -- meaning higher cost exposure, especially if your salary is high.

• Consider consulting a German health-insurance advisor who understands expat issues: pre-existing conditions, minimum coverage required for visas, family dependents, and the future ability to switch back.

In short: the salary limits for choosing between public and private health insurance in Germany are going up again in 2026 -- making the system costlier for many and more restrictive in terms of choice. For expats, navigating this landscape will require careful planning.