The burden limit applies to the whole household
Many insured people believe each person has their own burden limit. That is not the case. Under § 62(2) SGB V, the co-payments and gross income of the insured person, their spouse or civil partner and the children in the joint household are added together. So there is one joint limit and one joint pot into which all receipts go.
For families this is usually an advantage. Although combining incomes raises the income base, generous allowances are deducted, and the co-payments of all family members count together. As a result, families often reach the limit sooner than expected.
Which allowances apply in 2026
The allowances are based on the social insurance reference value. According to the 2026 regulation on social insurance figures, it is €47,460 per year. This gives:
- First dependant (usually the spouse or civil partner): 15% = €7,119
- Each further dependant (excluding children): 10% = €4,746
- Each child: €9,756 — the sum of the child allowance (€3,414) and the allowance for care, upbringing or education (€1,464) under § 32(6) of the Income Tax Act, each doubled
For children only the child allowance is applied, not the 15% or 10% amount on top. Minor children and family-insured children count if they live in the household.
Example: family with two children
A married couple earns €60,000 gross per year together and has two children. The calculation:
- Gross income: €60,000
- minus partner allowance: €7,119
- minus child allowances: 2 × €9,756 = €19,512
- relevant income: €33,369
- burden limit (2%): €667.38
Without the allowances the limit would be €1,200. The allowances therefore save the family more than €500 in potential co-payments. If one family member is seriously chronically ill, the limit is even halved to €333.69.
Example: single parent
A single parent with one child earns €28,000 gross. There is no partner allowance, but the child allowance of €9,756 is deducted. That leaves €18,244; the limit is €364.88. Without the child it would be €560.
Receipts of all family members count
Because the limit applies to the household, all co-payments count together. If one partner paid €250 for medicines and the other €180 for physiotherapy and a hospital stay, there are €430 in the joint account. Children themselves make no co-payments for medicines, therapeutic remedies, medical aids or hospital while they are minors — but through the allowance they lower the family's limit.
So keep all receipts in one place, for example in a joint receipt booklet. When applying, submit the receipts of all family members together. The exemption certificate then applies to all household members taken into account.
Special case: partner in a care home
If a spouse or civil partner lives permanently in a residential care facility, § 62(2) SGB V still assumes a joint household. The income and co-payments of both partners continue to be added together, and the partner allowance is kept.
Calculate your family's figures now
Enter your joint gross income, your partner and the number of children in the co-payment exemption calculator. You will immediately see your limit, how much you have already paid and how much is left before exemption. If dentures are coming up in your family: own shares there do not count towards the burden limit — the dentures cost calculator shows what to expect.