German Health Overhaul: Drug Co-Payments Jump 50% as Insurers No Longer Required to Notify Members of Premium Hikes

Germany's coalition approves health insurance overhaul with 50% higher drug co-pays, eliminates mandatory notification of premium hikes, and cuts subsidies, sparking consumer backlash.

Germany's coalition government has approved sweeping changes to the statutory health insurance system, introducing higher patient costs for prescription drugs while quietly eliminating insurers' obligation to personally inform members when supplementary premiums rise.

Patients will now pay between €7.50 and €15 per medication, up from the previous range of €5 to €10 — a 50 percent increase in co-payments. The reform, passed in late April, also cuts the statutory subsidy for dental prosthetics from 60 to 50 percent.

The most contentious change removes the requirement for health insurers to notify members directly — by mail or other direct channels — about increases to the supplementary contribution rate (Zusatzbeitrag). While the special termination right remains legally intact, consumer advocates argue it has been rendered practically meaningless.

"The coalition overshot the mark by abolishing this obligation," said Kai Behrens, spokesperson for the AOK Federal Association, which represents Germany's largest health insurance group. Ramona Pop of the Federation of German Consumer Organisations warned that many policyholders would only notice a rate increase belatedly — for instance, when checking their pay slip — effectively devaluing their right to switch providers.

The Techniker Krankenkasse is exploring alternative notification methods such as newsletters to bridge the information gap. Verena Bentele, president of the Social Association VdK, criticized the move as a rollback of consumer protections that disproportionately affects older policyholders. Within the SPD, there are already efforts to revise the legislation.

Beyond co-payments, the reform eliminates reimbursement for homeopathy and cannabis flowers prescribed on prescription. Skin cancer screening is also under review. The federal subsidy to the statutory health insurance system will drop by €2 billion, while insurers must cut their advertising spending in half. A new partial sick-note system has been introduced, allowing doctors to certify incapacity for work in increments of 25, 50, or 75 percent.

The forecasting panel projects an average supplementary contribution rate of 2.9 percent this year. Combined with the general contribution rate of 14.6 percent, the total contribution stands at 17.5 percent. Total health fund expenditures are expected to reach approximately €369 billion.

Higher earners face additional strain in 2027, when the contribution assessment ceiling rises by €300 per month. A more significant shift arrives in 2028: the previously contribution-free family insurance for spouses will become partially chargeable. Insured partners will then pay a surcharge of 2.5 percent.

Federal Health Minister Warken emphasized the goal of stabilizing premiums over the long term, stating that expenditures must be more tightly linked to revenues in order to protect the broader economy.