What Is Beihilfe and Why Does It Matter?
Beihilfe (literally "assistance") is a German government subsidy that reimburses civil servants for a significant portion of their medical costs. Unlike GKV contributions, Beihilfe is not an insurance premium — it is a direct reimbursement scheme paid by your employer (the federal or state government).
Because Beihilfe already covers a large share of your costs, civil servants are required to take out private complementary PKV — not GKV — to cover the remainder. This makes civil servants one of the most natural PKV demographics in Germany.
Key point: Civil servants (Beamte) are exempt from compulsory GKV membership. Voluntarily joining GKV is technically possible but almost always financially unfavourable, because Beihilfe is not paid out to GKV members.
Beihilfe Reimbursement Rates
The reimbursement rate you receive depends on your personal circumstances:
Your PKV tariff must be specifically designed to cover the residual percentage not paid by Beihilfe. These tariffs are called Beihilfeergänzungstarife (Beihilfe top-up tariffs). A standard PKV tariff covering 100% of costs would overinsure you and is neither necessary nor cost-effective.
What Does Beihilfe Actually Reimburse?
Beihilfe covers medically necessary treatments based on the GOÄ (doctors' fee schedule) and GOZ (dental fee schedule). Typical eligible expenses include:
- GP and specialist visits (up to GOÄ 2.3× multiplier)
- Hospital stays (general ward by default)
- Prescription medications approved in the German formulary
- Dental treatment including basic crowns and dentures
- Glasses and contact lenses (with limits)
- Physiotherapy, ergotherapy, and speech therapy
- Psychotherapy (limited sessions approved in advance)
Important: Beihilfe does NOT automatically cover alternative medicine, premium hospital rooms, chief physician treatment, or treatments billed above the standard GOÄ rate. Your PKV top-up tariff can cover these extras.
Choosing the Right PKV Beihilfe Top-Up Tariff
Since you only need to cover the gap between Beihilfe and 100%, your PKV premium is substantially lower than for a non-civil servant. A single Beamter in their 30s typically pays €90–€160/month for a comprehensive Beihilfe top-up, compared to €350–€600 for a full PKV tariff.
| Feature to Check | Why It Matters |
|---|---|
| Covers the exact residual percentage | 50-residual, 30-residual, or 20-residual must match your Beihilfe rate |
| Chief physician treatment (Chefarztbehandlung) | Hospitals bill differently for senior consultants; standard GOÄ only covers juniors |
| Private room (1-bed or 2-bed) | Beihilfe only covers standard multi-bed ward |
| Dental prosthetics above GOZ | High-quality crowns and implants exceed what Beihilfe reimburses |
| Overseas coverage | Beihilfe does not cover treatment outside Germany and the EU |
| Premium rate lock on entry age | Entry age determines base premium for life — join young to lock in low rates |
Beihilfe-Eligible vs. Beihilfe-Ineligible Expenses
Not all medical expenses qualify for Beihilfe reimbursement. Knowing the distinction helps you select a PKV tariff with the right supplementary benefits.
| Expense Type | Beihilfe-Eligible? | PKV Can Cover? |
|---|---|---|
| Standard GOÄ doctor visit | Yes (50–80%) | Residual % |
| GOÄ 3.5× specialist invoice | Only up to 2.3× | Yes, excess above 2.3× |
| Single hospital room | No | Yes |
| Chief physician surcharge | No | Yes |
| Dental implants (per tooth) | Partly (GOZ standard) | Residual + upgrade |
| Laser eye surgery | No | Sometimes (add-on) |
| Psychotherapy (approved sessions) | Yes | Residual % |
| Treatment abroad (non-EU) | No | Yes (with add-on) |
Expat Civil Servants: Special Considerations
If you are an international hire who has been appointed as a Beamter (e.g., a professor at a German university, a federal agency employee), you enjoy the same Beihilfe entitlement as German nationals. Key points:
- Language barrier: Beihilfe claim forms are exclusively in German. Keep receipts and ensure invoices are in German or have certified translations.
- Claim submission: Submit Beihilfe claims to your department's Beihilfestelle within the statutory deadline (usually 12 months from invoice date).
- PKV with English service: Some providers (AXA, Allianz) offer English-language customer service and bilingual claim portals — a meaningful advantage for expats.
- Pre-existing conditions: As with all PKV, a health declaration is required. Supplements or exclusions may apply for ongoing conditions.
What Happens at Retirement?
On retirement, your Beihilfe rate automatically rises to 70%. Your PKV insurer will need to be notified so they can switch you to the appropriate 30-residual tariff. Premiums typically drop at this point, though you will also lose employer contributions to your PKV premium.
Some states top up the Beihilfe rate to 80% at retirement depending on their Beihilfeverordnung (state subsidy regulation). Always check the regulation for your specific employer state.
Compare PKV Tariffs for Your Situation
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