What is Beihilfe?
Beihilfe is a state reimbursement system for civil servants (Beamte) in Germany. It reimburses a defined percentage of eligible medical expenses. The remaining portion must be covered privately.
- It is not health insurance — it is a state benefit
- It does not pay 100% — a residual cost always remains
- It applies to civil servants only — employees and freelancers have no access
- Rules vary by federal state — each Bundesland has its own Beihilfeverordnung
Why Beihilfe does not pay 100%
The Beihilfe principle is based on co-responsibility: the state reimburses a significant portion (typically 50–80%) of eligible costs, but the civil servant bears a defined residual cost. This residual portion — 20% to 50% — must be privately insured.
Because the insured portion is smaller, premiums for Beihilfe-compatible tariffs are significantly lower than for full PKV coverage used by employees.
Common Beihilfe reimbursement percentages
Many states follow a structure broadly resembling these percentages, but important deviations exist:
| Category | Beihilfe % | You insure |
|---|---|---|
| Active civil servant (≤1 child) | 50% | 50% |
| Active civil servant (2+ children) | 70% | 30% |
| Eligible spouse | 70% | 30% |
| Children | 80% | 20% |
| Pensioners | 70% | 30% |
This is a common orientation model. It is not a universal nationwide rule. Your actual Beihilfe percentage depends on your federal state, personal status, and the applicable Beihilfeverordnung.
Why Beihilfe is fragmented by federal state
There is no single national Beihilfe law. The federal government and each of the 16 Bundesländer maintain separate Beihilfe regulations. This creates significant differences:
States close to the classic model
Many states broadly follow the 50/70/80 orientation for active servants, spouses, and children. Hospital comfort benefits may be partially recognized.
States with major deviations
Sachsen, Schleswig-Holstein, Hessen, and Bremen (among others) apply different percentages, additional co-payments, or restrict specific benefit categories substantially.
This is why any serious Beihilfe planning must start with your specific federal state, not with generic percentage tables.
Why 50% Beihilfe does not mean 50% of your real invoice is reimbursed
The Beihilfe percentage applies only to beihilfefähige (eligible) costs — not to your entire invoice. In practice, this creates gaps:
Glasses & optical aids
Many states cap the reimbursable amount for frames and lenses well below market prices. You may receive 50% of a €150 allowance instead of 50% of a €400 invoice.
Dental lab & materials
High-quality crowns, bridges, and implants often include lab and material costs that exceed what Beihilfe considers eligible. The unreimbursed portion can be substantial.
Hospital co-payments
Some states require daily co-payments for hospital stays — reducing the effective reimbursement below the headline percentage.
Hospital comfort benefits
Chief physician treatment and private rooms are excluded entirely in some states, partially recognized in others, or subject to separate daily surcharges.
This is precisely why private residual-cost coverage remains essential — and why supplementary modules like BeihilfeErgänzungBest exist to close these gaps.
Why civil servants don't compare GKV vs. PKV like employees
Employees weigh GKV against full PKV, factoring in employer subsidy, JAEG, and long-term costs. For civil servants, this comparison doesn't apply:
- You already receive Beihilfe — no employer subsidy exists in the employee sense
- Your insurance only covers the residual gap, not the full cost
- GKV would require you to pay 100% of contributions yourself
- The relevant decision: which Beihilfe-compatible tariff?
If you are an employee, see the GKV vs. PKV comparison →
Why spouses and children require state-specific review
Spouse and child Beihilfe eligibility is not uniform across Germany:
- Spouse eligibility thresholds vary significantly by state — there is no single nationwide income limit. Some states set it around €20,000, others apply different criteria entirely.
- Children typically receive high Beihilfe percentages (often 80%), but the actual reimbursement for specific items (glasses, dental, etc.) varies by what each state considers eligible.
- Some states apply age limits or education requirements differently for children's Beihilfe eligibility.
Need personal guidance?
We explain the Beihilfe system for your specific federal state — in English.
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