GKV Increase in 2027: What Changes If You Earn Above the Contribution Ceiling

On Wednesday 29 April 2026, the German Council of Ministers approved a healthcare reform package that will have a very concrete effect on the payslips of those on the public system (GKV) who earn above a certain income level. The central measure affecting this group has a long, unfriendly name — Beitragsbemessungsgrenze — and boils down to something simple: from 2027, a larger share of salary will count towards GKV contributions.

It isn’t an increase in the contribution rate. It’s an increase in the ceiling up to which contributions are levied. The difference matters, and we’ll look at it with numbers.

What the German government approved on 29 April

The Bundeskabinett gave the green light to the Gesetz zur Stabilisierung der Beitragssätze in der gesetzlichen Krankenversicherung, known by its acronym BStabG. It’s a large package with many measures: caps on hospital spending, pharmacy cuts, removing homeopathy from the benefits catalogue, changes to sick pay, higher co-payments at the pharmacy and dentist, and other measures affecting the system as a whole. The ministry’s stated aim is to save between 16.000 and 17.000 million euros a year from 2027 to prevent the Krankenkassen from having to raise their Zusatzbeiträge again.

Of that whole package, two measures directly affect the pockets of those earning above the contribution ceiling:

• An additional increase in the Beitragsbemessungsgrenze of 300 € a month in 2027, on top of the regular annual increase.
• A surcharge of 2,5% from 2028 for those who co-insure a spouse on the GKV (this measure has its own analysis, which we cover in a separate article).

In this article we focus on the first. According to the official statement from the Bundesgesundheitsministerium, the measure aims to have employees earning above the ceiling contribute a larger share to GKV financing.

What the Beitragsbemessungsgrenze is (and why it isn’t the same as the Versicherungspflichtgrenze)

The German system has two different salary thresholds that are often confused. It’s worth being clear on them before going further.

Beitragsbemessungsgrenze (BBG): the ceiling up to which you contribute

The Beitragsbemessungsgrenze is the maximum gross salary on which contributions to the GKV and to long-term care insurance (Pflegeversicherung) are calculated. In 2026 it stands at 5.812,50 € a month (69.750 € a year), according to the data published by the Bundesregierung.

What does that mean? That if your gross monthly salary is 7.000 €, the Krankenkasse doesn’t calculate your contribution on the 7.000 €, but only on the first 5.812,50 €. The rest is left out. That’s why the GKV has a practical “ceiling” on contributions: however much you earn, you don’t pay beyond that cap.

Versicherungspflichtgrenze (JAEG): the threshold to be able to move to PKV

The Versicherungspflichtgrenze, also called the Jahresarbeitsentgeltgrenze or JAEG, is a different threshold. It marks the minimum income above which an employee is no longer required to be on the public system and can opt for private cover (PKV). In 2026 it stands at 6.450 € a month (77.400 € a year).

A quick summary to avoid confusion:

The draft the government approved in April touched only the first (BBG). But the law that finally emerged from Parliament ended up raising the second one too: from 2027, the threshold for choosing PKV will be considerably higher.

What exactly changes in 2027

The BBG is updated automatically each year in line with wage developments. That’s the regular increase. What the government approved on 29 April is something different: an extraordinary increase of an additional 300 € a month, on top of the regular increase.

In other words: in 2027 the BBG won’t rise only by what the usual wage dynamic would dictate. It will rise by that plus an extra 300 € a month. In practice, a larger share of the salary of those earning above the ceiling will become subject to contributions.

According to the ministry’s draft reported by Tagesschau and other media, the forecast is to raise around 1.200 million euros in additional annual revenue from employees, and another 1.200 million from employers (who pay the other half of the contribution).

How much more you’ll pay each month

This is where the abstract figure becomes something tangible. Let’s work it out.

The GKV contribution in 2026 is made up of the fixed general rate of 14,6% plus the average Zusatzbeitrag of 2,9%, according to the figure published by the Bundesgesundheitsministerium. In total, around 17,5% of gross salary, split equally between employee and employer. The employee’s share is therefore 8,75%.

On the additional 300 € that become subject to contributions, the calculation gives:

• 300 € × 8,75% = 26,25 € a month in additional contributions from the employee to the GKV.
• Another 26,25 € a month comes from the employer.
• In total: around 315 € a year in additional cost for the employee, and an equivalent amount for the company.

To this you have to add long-term care insurance (Pflegeversicherung), which is also calculated on the same base. For employees with children the increase is around an additional 5,40 € a month on the employee’s share; for employees without children over the age of 23, somewhat more, due to the Kinderlosenzuschlag surcharge.

To put the numbers in context, this table shows which employees are affected according to their annual gross salary:

Note a nuance: those just above the current ceiling (around 70.000 € gross a year) will see only part of the impact, because their salary doesn’t cover the full additional 300 €. From around 78.000 € a year the effect is complete.

The exact calculation will also depend on the specific Zusatzbeitrag of your Krankenkasse. Some charge below the 2,9% average and others above it. The GKV-Spitzenverband page publishes the up-to-date list.

Why this change hits close to home for many internationals in Germany

The typical professional profile of someone who moves to Germany for work often fits neatly into the salary range affected by this measure: engineers, STEM profiles, IT, technical or management positions in large industrial and technology companies. Many people who arrive in Munich, Stuttgart, Hamburg, Frankfurt or Berlin to work in sectors such as aerospace, automotive, chemicals, software or consulting already start above the ceiling or cross it within a few years.

In the consultations we see day to day, this is exactly the group that stays on the GKV thinking it’s the “neutral” or “default” option, without stopping to do the maths. They’re also the ones who feel the compound effect most when the BBG and the Zusatzbeiträge rise in the same year, as already happened in 2026 (the BBG went from 5.512,50 € to 5.812,50 €, and the average Zusatzbeitrag rose from 2,5% to 2,9%).

The 2027 reform adds another step to that dynamic. Anyone on the GKV with a salary above the ceiling will contribute more, without the benefits changing.

The package brings more changes worth knowing about

The BBG increase is just one of the BStabG measures. Others that directly affect those on the GKV:

• Co-payments for pharmacy and benefits: up by 50% on average. The minimum contribution per prescription rises from 5 € to 7,50 €, the maximum from 10 € to 15 €. Exemptions for family burden or chronic illness remain unchanged.
• Sick pay (Krankengeld): drops from 70% to 65% of gross salary from 2027.
• Dental prosthesis subsidy (Zahnersatz): the Krankenkasse’s contributions are reduced by 10%.
• Homeopathy and anthroposophic medicines: removed from the catalogue of reimbursable benefits.
• Cannabis-Blüten (cannabis flowers): no longer covered by the GKV; cover is limited to standardised extracts and finished medicines.
• Spousal co-insurance: from 2028, a 2,5% surcharge on the policy-holder’s salary for those who co-insure a spouse on the GKV (with exceptions, for instance for parents with children under 12 or people with a high care grade). We cover this topic in detail in another article.

The package as a whole represents a recalibration of the system that broadly translates into more contributions for the insured and fewer covered benefits.

What about those on PKV or considering it?

The Beitragsbemessungsgrenze doesn’t apply to PKV. In private insurance the premium isn’t calculated on salary, but on each insured person’s profile: entry age, health status, benefits taken out and other factors. So this specific increase doesn’t directly affect those already on PKV.

And with the new threshold now approved for 2027, that analysis makes more sense in 2026 than ever.

There is one aspect where there is a connection: the Arbeitgeberzuschuss (the employer’s maximum contribution towards the PKV premium) is calculated on the BBG. In 2026 it’s set at 508,59 € a month, according to the BMG data. When the BBG rises in 2027, the Arbeitgeberzuschuss will also rise proportionally. In other words: for those on PKV, this change adjusts their employer’s maximum contribution favourably.

Anyone still on the GKV with a salary above the Versicherungspflichtgrenze (6.450 €/month in 2026) legally retains the option to switch to the private system. It’s a decision that depends on many factors — age, health status, family situation, future plans in Germany or a return to your home country — and it’s worth analysing in detail, not as a reaction to a news item. But if you’ve never stopped to do that analysis and you’re in that salary range, now is probably a good time to do it.

Key dates: when it takes effect and what’s still pending

This is the reform’s timeline, now completed in its parliamentary phase:

• 16 April 2026: the ministry publishes the Referentenentwurf (initial draft).
• 29 April 2026: the Bundeskabinett approves the final version.
• 10 July 2026: the Bundestag and the Bundesrat pass the definitive law.
• 1 January 2027: most of the package takes effect, including the extra BBG increase.
• 1 January 2028: the measures on spousal co-insurance and the levy on sugary drinks take effect.

The law is now passed. There were adjustments between the initial draft and the final text (the spousal surcharge went from 3,5% to 2,5%, and the exception for children was widened to under-12s); the exact 2027 threshold figures will be fixed by government regulation in autumn 2026.

Frequently asked questions

Does this also affect those on PKV?

Not directly. The PKV premium isn’t calculated on salary and isn’t affected by the BBG. What does change is the company’s maximum Arbeitgeberzuschuss, which rises proportionally because it’s calculated on the BBG.

When will I notice it on my payslip?

From the January 2027 payslip.

What’s the difference between the Beitragsbemessungsgrenze and the Versicherungspflichtgrenze?

The BBG is the ceiling up to which you contribute within the GKV (5.812,50 € in 2026). The Versicherungspflichtgrenze is the salary threshold that allows you to opt for PKV (6.450 € in 2026). They’re two different figures — and the law passed in 2026 ended up raising both: the contribution ceiling and, through an extraordinary increase, also the PKV access threshold from 2027.

Can I switch to PKV now to avoid the increase?

Only if your gross salary exceeds the Versicherungspflichtgrenze (6.450 € a month in 2026 / 77.400 € a year). It’s a decision that depends on your situation — age, health, family, future plans — and deserves an analysis with real numbers, not a reaction to a headline. The BBG increase alone shouldn’t be the only reason to switch; it is, though, a good trigger to do that analysis now, while the access threshold is still the 2026 one.

If you’d like to look at it with real numbers, we’ll guide you with no obligation.

The law was passed in 2026. The exact 2027 threshold figures are pending the government regulation due in autumn 2026; we will update this article once it is published. For specific decisions about cover or changing insurance, it’s advisable to have personalised advice that takes your particular situation into account.