Overview

• Federal Beihilfe spending reached €6.6 billion in 2024, up 14.8% from 2022, according to a Bundestag scientific-services report commissioned by Green lawmaker Linda Heitmann.
• Länder outlays rose from €11.3 billion in 2022 to €13.8 billion in 2024, putting combined annual support for civil-servant health costs at roughly €22 billion.
• The report cites demographic aging, medical progress and broader health-care price increases as the main drivers of the surge.
• Under the current system, the state covers a portion of civil servants’ medical, long-term care and preventive costs, with most beneficiaries insuring the remainder through private policies.
• Heitmann advocates a flat-rate subsidy model used in Hamburg and Bremen, where the employer pays 50% of statutory premiums for those staying in the GKV, and the analysis notes rising take-up among younger staff, including Hamburg choice rates of 16.5% for new hires and 24.6% for trainees between 2018 and 2023.