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BriefDiener
DE

Krankenkasse (health insurance fund)

Beitragsbescheid (contribution decision) from the Krankenkasse: what to check

What this letter means

A Beitragsbescheid (contribution decision) sets how much you pay to the Krankenkasse and usually also to the Pflegekasse (long-term care insurance fund). It mainly concerns voluntary members (freiwillig Versicherte), for example self-employed people, students without family insurance, or pensioners without compulsory insurance.

For voluntary members, the contribution depends on your total financial capacity (§ 240 Abs. 1 SGB V). If you do not prove your income, the fund assumes income at the level of the Beitragsbemessungsgrenze (contribution ceiling). If you send the proof within twelve months, it sets the contributions again.

For self-employed people, the fund first sets the contributions provisionally, based on the latest Einkommensteuerbescheid (income tax assessment). When the tax assessment for that year is available, the final assessment follows. This can lead to additional payments or refunds (§ 240 Abs. 4a SGB V).

A Widerspruch (objection) against a Beitragsbescheid has no aufschiebende Wirkung (suspensive effect) (§ 86a Abs. 2 Nr. 1 SGG). This means you have to pay for now.

What to do now

  1. 1Write down the date of the decision and the end of the deadline.
  2. 2Check which income the fund used and for which period.
  3. 3If the letter uses the Beitragsbemessungsgrenze because proof is missing, send the proof quickly.
  4. 4If you are self-employed, send your new Einkommensteuerbescheid as soon as you have it.
  5. 5File a Widerspruch if the income used is wrong.
  6. 6Keep paying the contributions that were set for now, or talk to the fund about a Stundung (deferral of payment).
  7. 7Write your reply in German. German authorities work in German, so a letter in German is the safest way to make sure your reply is understood and processed. The templates (Vorlagen) on this site are in German.

How you can reply

Send proof of income

Often the quickest way if the fund used the maximum amount because proof was missing.

File a Widerspruch (objection)

If the decision is based on the wrong income or the wrong period.

Template: Widerspruch gegen einen Bescheid der Krankenkasse oder Pflegekasse

Ask about a Stundung (deferral) or payment in instalments

If you cannot pay an additional demand in one go. Contact the fund early.

Common questions

Why do I suddenly have to pay the maximum contribution?

Usually proof of income is missing. In that case the fund assumes income at the level of the Beitragsbemessungsgrenze (§ 240 Abs. 1 SGB V). If you send the proof within twelve months, it calculates again.

Do I have to pay even though I filed a Widerspruch?

Yes. For contribution decisions, the Widerspruch has no suspensive effect (§ 86a Abs. 2 Nr. 1 SGG). You can apply to the fund to suspend enforcement (Aussetzung der Vollziehung).

What happens if I never send the tax assessment?

If you are self-employed and do not send the proof within three years after the end of the calendar year, the fund finally sets the contributions based on the Beitragsbemessungsgrenze (§ 240 Abs. 4a SGB V).

Sources (German law and official pages)

  1. § 240 SGB V: Beitragspflichtige Einnahmen freiwilliger Mitglieder
  2. § 86a SGG: Aufschiebende Wirkung
  3. § 84 SGG: Frist und Form des Widerspruchs
  4. § 37 SGB X: Bekanntgabe des Verwaltungsaktes

Research as of: 10 November 2026