Questions and Answers on the consequences of separation and divorce for health insurance
How do separation and divorce affect the health insurance of family members?
One of the most pressing questions that arise during a separation is how to secure continued health insurance coverage.
Different rules apply to the different insurance regimes for statutory health insurance, private health insurance and allowances for civil servants.
Does the separation already affect the health insurance cover of the family insured spouse in the statutory health insurance?
If one spouse is compulsorily insured in the statutory health insurance scheme, the insurance cover extends to the spouse and minor children of the insured in the family insurance scheme (§ 10 SGB V). This non-contributory family insurance of the spouse depends, among other things, on the amount of his or her total income, which may not regularly exceed one seventh of the monthly reference value according to § 18 SGB IV. In 2020, the monthly reference value is € 3,010 in the old federal states and € 3,185 in the new federal states, resulting in a limit of € 455 (= € 3,185 / 7) and € 430 (= € 3,010 / 7) respectively. From 2025, the reference value will be determined uniformly. Family insurance naturally also applies to same-sex spouses and partners in a registered partnership. This regulation is intended to ease the burden on low-income families (§ 10 SGB V, § 18 SGB IV).
The family insurance of minor children of the compulsorily insured spouse survives separation and divorce and does not depend on whether the children live in his or her household or in that of the other spouse. The family insurance of the spouse is not affected by the separation from the compulsorily insured spouse. Even if the separation lasts a long time (e.g. ten years), the spouse's family insurance remains unrestricted until the divorce becomes final, i.e. even during the ongoing divorce proceedings, which often take more than a year (see pension rights equalisation). For the economically weaker, family-insured spouse, who is often exposed to particularly serious economic uncertainties as a result of the separation, it is of particular importance that the previous non-contributory family insurance cover continues to exist during the separation period.
What happens with the family insurance after the divorce?
What applies to the civil servant's spouse after separation and divorce?
What happens to private health insurance after separation and divorce?
What can I do after the separation if I cannot afford to pay the private health insurance premiums myself?
Rechtsanwalt Wolfgang Sattler, Fachanwalt für Familienrecht und Fachanwalt für Sozialrecht
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