Earning €80,000 in Germany? What Public Health and Long-Term Care Insurance Could Cost in 2027

This AI-generated image is for illustration only. It does not show a real person, payslip or contribution calculation.

Your salary stays the same, but more money goes towards insurance.

For an employee earning €80,000 gross per year, the planned changes for 2027 could increase their own contributions to public health and long-term care insurance by approximately:

• €59 per month with one child
• €81 per month without children, from age 23

These examples use Techniker Krankenkasse, known as TK. Any increase in TK’s additional contribution rate would come on top.

For expats budgeting for rent, family support, savings and life in Germany, this is an expense worth planning for.

Updated: 8 October 2026. The 2027 social insurance thresholds below are based on a BMAS draft published on 21 September 2026. The Federal Cabinet has not yet approved that regulation; Bundesrat approval will also be required. Separately, the Federal Cabinet approved the Pflegeneuordnungsgesetz (PNOG) bill on 30 September 2026, but it is not yet law. The figures below are calculations based on these proposals, rather than confirmed final deductions.

First, understand the two deductions

If you work in Germany and have public health insurance, your payslip includes contributions for two separate types of insurance:

Public health insurance, or GKV: This covers healthcare such as doctor appointments, hospital treatment and prescription medicines, subject to the statutory rules.

Social long-term care insurance, or Pflegeversicherung: This provides financial support if you need ongoing care. It covers part of the cost, so you may still have expenses to pay yourself.

Your employer contributes towards both. The total insurance contribution is therefore higher than the amount deducted from your salary.

Why you could pay more without a salary increase

Germany limits the amount of income used to calculate these contributions. This limit is called the contribution assessment ceiling, or Beitragsbemessungsgrenze.

With an annual salary of €80,000, you are above the ceiling in both years.

In 2027, contributions would be calculated on an additional €562.50 of income every month. That makes your insurance more expensive even if your salary and the percentage contribution rates stay unchanged. The BMAS 2027 calculation values set out the proposed health insurance ceilings. The BMG’s PNOG information says the proposed care-insurance ceiling will align with the GKV ceiling.

Public health insurance: 2026 versus 2027

Our example uses TK’s 2026 contribution rates:

• Standard health insurance rate: 14.6%
• TK’s additional contribution, called Zusatzbeitrag: 2.69%
• Combined rate: 17.29%

You and your employer each pay half. For the 2027 comparison, we keep the additional contribution at 2.69%. This is a calculation assumption, not confirmation of TK’s actual rate for 2027. The TK contribution-rate overview gives the current baseline.

Your own health insurance contribution increases by approximately €48.63 per month.

Your employer pays approximately €48.63 more as well. You do not pay the full €1,102.24 yourself.

Long-term care insurance: Your parental status matters

The following examples apply to employees outside Saxony, where the employee and employer split is different.

For an employee with one child, the current total contribution rate is 3.6%. The employee and employer each pay 1.8%.

Employees without children generally pay an additional surcharge from age 23. In 2026, this makes their own contribution rate 2.4%.

Under the proposed reform, the childless surcharge would rise by 0.3 percentage points to 0.9%. Their own rate would therefore rise to 2.7% in 2027. The employer’s share would remain at 1.8%. The BMG’s PNOG announcement describes these proposed changes.

For employees without children, two changes would increase the cost: the higher income ceiling and the higher surcharge.

Parents with several children under 25 may qualify for reduced contributions. Make sure your employer or insurer has the correct information about your children. The TK overview explains the current contribution rules.

Your combined monthly deduction

Here is what you personally pay for public health and long-term care insurance combined:

Over a full year, this means approximately €705 more with one child or €975 more without children.

These are additional insurance contributions. The final effect on your take-home pay may differ because contributions are taken into account for income tax.

Figures are calculated before rounding. Small differences of one cent may occur.

Your health insurer’s additional contribution could also increase

The calculations above assume TK’s additional contribution stays at 2.69%. If your insurer increases its Zusatzbeitrag, you would pay more on top of the amounts shown above.

At the planned 2027 income ceiling, the effect would be:

Your employer pays the same additional amount. These are examples, not predictions of a particular insurer’s rate.

For example, if TK’s additional contribution increased by 0.5 percentage points, your combined monthly employee contribution would become approximately:

• €681.81 with one child
• €739.18 without children, from age 23

Does an €80,000 salary still allow you to switch to private health insurance?

This involves a different threshold.

The contribution assessment ceiling determines how much income is used to calculate public insurance contributions. The compulsory insurance threshold, called Jahresarbeitsentgeltgrenze or JAEG, determines whether an employee can generally choose between public and private health insurance.

An employee earning an unchanged €80,000 would be below the general threshold in 2027. A new switch from public to private health insurance would therefore generally no longer be available at that salary. Your employer must assess your regular annual employment income and insurance status. The PKV Serviceportal explains the different 2027 thresholds.

Different rules can apply to employees who already have private insurance. The 2027 figures include a special threshold of €80,550 for one group and €72,900 for certain long-standing privately insured employees. At €80,000, your income is below the first threshold and above the second. Which rule applies depends on your insurance history and status, not salary alone.

If the threshold increase makes you subject to public insurance, an exemption may be available under the legal conditions. The application deadline is three months, and the exemption is generally irrevocable. This requires an individual assessment. See Section 8 of Book V of the German Social Code and the PKV Serviceportal guidance.

What should expats check now?

Check your insurer’s announced contribution rate for 2027 and make sure your parental status is recorded correctly. Allow for the expected increase when planning your monthly budget.

If you are considering private health insurance, look beyond the current price. Your partner’s insurance, children, parental leave, long-term affordability and plans to stay in Germany all matter.

A higher public insurance contribution alone does not tell you which system is right for your family.

Explore your options

Start with our private health insurance guide to understand the differences between public and private cover and what to consider for your own situation.

When you are ready to compare cover, compare private health insurance options with NEOdirect.

If you would like to understand your options, book a consultation with NEOdirect. We can help you assess the changes in the context of your life and plans in Germany.

Sources and assumptions

• Federal Ministry of Labour and Social Affairs (BMAS): 2027 social insurance calculation values
• Federal Ministry of Health (BMG): PNOG cabinet announcement and its PNOG questions and answers
• Techniker Krankenkasse: 2026 social insurance contribution rates
• PKV Serviceportal: 2027 compulsory insurance thresholds

2027 amounts are estimates based on the official draft values and the proposed PNOG changes available on 8 October 2026. The TK additional contribution is held at 2.69% for comparison only. Individual status, Saxony rules, family circumstances and final legislation can change the result.