How to protect your loved ones through family insurance

How long are children actually covered by their parents’ health insurance?? These and other questions about the statutory health insurance we clarify in this article.

Who can be insured through the family insurance

In the statutory health insurance, all non-employed persons in the family are also insured via the standard contribution. Particularly in the case of co-insurance of children, there are always uncertainties about when and whether statutory or private coverage as family insurance is possible or not. it makes sense. In principle, certain age limits apply to children, stepchildren, grandchildren and foster children for the time being. This means that family insurance is generally possible until the child reaches the age of 18. age is possible. It will continue until you reach the age of 23. Continued until the child reaches the age of 18, if the child is not gainfully employed.

The same applies to children who are undergoing school or vocational training or are doing a voluntary social or ecological year (§ 10 para. 2 no. 3 SGB V). They are insured until they reach the age of 25. Family insured until the age of 18. This period is even extended accordingly if a statutory period of service, such as military or alternative service, interrupts or delays schooling or vocational training. Children who are insured according to § 2 para. 1 sentence 1 of the Ninth Book of the Social Security Code have a disability or are unable to support themselves are covered by family insurance without any age limit. However, this requires that the disability occurred at a time when the child was already covered by family insurance.

When coverage via family insurance is possible

If you live in a marriage or in a registered partnership and are a member of a GKV, you can only insure a child through you as a family member if

• the partner has statutory family insurance, or
• the total income of the partner regularly per month is not more than one-twelfth of the compulsory insurance limit (5.550 euros, as of 2023) or
• the total income of the partner is regularly as high as that of the member (§ 10 para. 3 SGB V).

If it’s a grandchild or stepchild, the health insurer must determine whether the member is providing him or her with what’s known as “predominant support”. This is always the case if the member himself contributes more than half of the living expenses to the grandson or granddaughter. Stepchild within the family given the economic given situation is entitled to.

But beware: as soon as the child has an income of more than 520 euros per month, he or she is no longer entitled to be covered by the family insurance.

If one parent has statutory health insurance and the other has private health insurance

As a rule, a child is always attributed to the parent who has the higher income. If the higher earner is in private health insurance (PKV), it makes sense to insure the child here as well. Because this is normally cheaper than an insurance in the GKV. The only thing to check here would be the risk classification. If this is overestimated by the private insurance company, then again, insurance through SHI makes more sense.

If the income of the privately insured parent is so low that it is below the compulsory insurance limit, the child can be co-insured with the other parent in the GKV free of charge. However, this parent must be employed for insurance purposes. It should also be noted that children can no longer be a member of private insurance through a parent as soon as they themselves start vocational training or a job that requires insurance coverage. In this case, the children themselves become members of the GKV.