Germany’s statutory health insurers are facing rising medical costs, limited reserves and higher supplementary contributions. In the first half of 2026, benefit expenditure increased by 7.4%, while revenue grew by 4.1%, according to the figures cited in a financial-strength rating by the German Financial Service Institute (DFSI) for Handelsblatt.

The funds nevertheless recorded a surplus of about €2.6 billion during the period. The article says this was mainly driven by higher contributions and is needed to rebuild reserves that have fallen sharply. At the middle of 2026, statutory insurers held around €7.5 billion in reserves—just over 0.2 months of expenditure, roughly the statutory minimum.

No insurer received the rating’s top grade, “excellent.” Among funds open nationwide, Tui BKK was the only one rated “very good.” Techniker Krankenkasse, Barmer, Audi BKK, HKK Krankenkasse, HEK Hanseatische Krankenkasse, MKK Meine Krankenkasse and SBK received “good” ratings.

Among regionally available insurers, BKK firmus, BKK SBH, BKK Public and BKK Faber-Castell & Partner were rated “very good.” The DFSI assessment gives liquidity and assets a combined 50% weighting, reflecting insurers’ need to meet obligations even when markets, interest rates or benefit costs fluctuate.

Insurers are now preparing their budgets for 2027. Each fund sets its own supplementary contribution, paid on top of the general contribution rate of 14.6%. The article reports that the average supplementary rate for 2026 is 2.9% according to Germany’s Federal Ministry of Health, while the DFSI’s calculation puts it above 3%.

The Techniker Krankenkasse’s supplementary rate is currently 2.69%. Its chief executive, Jens Baas, attributed the rate in part to lean administrative structures and efficient processes. The funds assessed with more than one million members had average administrative costs of about €198 per insured person; those with 500,000 to one million members averaged about €168. Smaller insurers were more efficient on average, the report says.

A forecast by the GKV estimation group suggests the mathematically required average supplementary contribution could remain stable in 2027, though the decision for each insurer is generally made by its administrative board in December.

Sources: Handelsblatt.