Beihilfe FAQ

Beihilfe is a state reimbursement system for civil servants. You pay your medical bills first, then submit them to your Beihilfestelle (Beihilfe office). The state reimburses a defined percentage — typically 50% to 80% depending on your status. The remaining portion is covered by your private Beihilfe-compatible insurance.

Importantly, the rules vary by federal state. Full explanation →

Because Beihilfe never covers 100%. Depending on your status, 20% to 50% of eligible costs remain with you. Without private residual-cost insurance, you would bear this gap entirely out of pocket — which can be very expensive for hospital stays, dental prosthetics, or specialist treatments.

This depends heavily on your federal state. Some states recognize hospital comfort benefits within Beihilfe, others require co-payments, and some exclude them entirely. BeihilfeBest covers standard ward treatment. For chief physician and 2-bed room, add BeihilfeKlinik. For single room, add BeihilfeEinbett.

Because many states cap the Beihilfe-eligible amount for glasses at a level well below actual market prices. Your Beihilfe percentage applies only to this capped amount — not to your real invoice. BeihilfeBest covers up to €600 within 24 months. For additional gap-closing, see BeihilfeErgänzungBest.

Spouses may receive 70% Beihilfe if their income stays below a state-specific threshold. Children typically receive 80%. Both need private residual-cost cover for the remaining portion. The eligibility rules and thresholds vary by federal state — there is no single nationwide figure. Full family coverage guide →

Your Beihilfe percentage can change due to life events: having a second child (50% → 70%), retirement (typically → 70%), or a spouse exceeding the income threshold (losing their Beihilfe). A well-structured Beihilfe-compatible tariff allows you to adjust the insured percentage without changing insurer or undergoing a new health assessment.

BeihilfeBest is the core residual-cost tariff — it covers the percentage of eligible costs not reimbursed by Beihilfe. BeihilfeErgänzungBest is a supplementary module that closes specific reimbursement gaps where Beihilfe considers costs only partially eligible — especially in optical, dental lab/material, and other categories where states set strict cost ceilings.

Heilfürsorge is full state healthcare provided to certain civil servants — primarily police, military, and fire service in some states — during active duty. It covers 100% of medical costs. When these individuals later transition to Beihilfe (e.g., upon promotion or retirement), they need Beihilfe-compatible private insurance. An Anwartschaft can preserve favorable entry conditions. Full guide →

An Anwartschaft is most valuable for civil servants currently receiving Heilfürsorge who will later transition to Beihilfe. It preserves your health status (kleine Anwartschaft) or both health status and entry age (große Anwartschaft), preventing premium surcharges or exclusions at the point of transition. Learn more →

Yes — BeihilfeBest includes a contribution refund (BRE) for claim-free years. However, the refund amount is not a fixed guarantee. It is determined annually by the insurer's board. Current practice allows refunds of up to several monthly premiums. Certain preventive services, vaccinations, and professional dental cleaning typically do not count as claims.

Waiting periods may apply depending on the tariff and the type of treatment. Certain benefits (e.g., LASIK, spa/rehabilitation) typically have initial limitation periods. The exact waiting periods are defined in the tariff conditions (AVB). For civil servants entering directly from Beihilfe eligibility, shorter or no waiting periods may apply in some cases.

Some federal states offer an alternative model called Pauschale Beihilfe — including, for example, Hamburg, Bremen, Niedersachsen, Schleswig-Holstein, Sachsen, and several others. Instead of the traditional percentage-based reimbursement, this provides a flat-rate employer subsidy toward health insurance. Because availability and rules differ by state, this always requires a state-specific review. We can advise you on which model fits your situation.

As a civil service pensioner (Versorgungsempfänger), your Beihilfe entitlement typically increases to 70%, meaning you only insure 30% privately. Your Beihilfe-compatible tariff adjusts to the new percentage — no insurer change is needed. Your premiums decrease accordingly, and aging reserves built during your active-service years help stabilize costs further.