Health Insurance during Legal Clerkship
Health insurance during the legal clerkship (Referendariat) is a central aspect of social security throughout the legal or pedagogical preparatory service in Germany. This article explains the legal framework, special features, and the various types of health insurance available for legal clerks (Referendarinnen und Referendare). The aim is to provide a comprehensive overview of all relevant legal, practical, and financial aspects.
Legal Basis for Health Insurance during Legal Clerkship
Compulsory Insurance and Legal Provisions
Legal clerks are subject to different social security regulations depending on the federal state and the type of preparatory service (for example, teacher trainees or legal clerks). The key legal bases are especially the Fifth Book of the Social Code (SGB V) as well as the aid regulations (Beihilfevorschriften) of the federal states and the federal authorities. Particularly relevant is the status as a civil servant on revocation, which applies to many clerks during their training period.
Legal clerks as civil servants on revocation are generally not subject to compulsory statutory health insurance (GKV) (§ 5 Section 1 No. 2 SGB V). Instead, they have the option to take out private health insurance or, under certain conditions, voluntarily remain in the statutory health insurance system.
Aid Entitlement during Legal Clerkship
Civil servants on revocation are entitled to aid (Beihilfe) during the legal clerkship. This state support usually covers between 50% and 80% of eligible medical expenses. The exact aid rate varies depending on the federal state, family status, and other individual factors. However, Beihilfe does not cover all costs, which is why supplementary health insurance is required.
Options for Health Insurance during Legal Clerkship
Private Health Insurance (PKV)
Legal clerks in a civil servant relationship can voluntarily opt for private health insurance. The PKV offers special tariffs for civil servants on revocation (so-called Anwärtertarife), which usually provide comprehensive coverage at comparatively favorable rates. In conjunction with the aid entitlement, only the remaining personal share needs to be insured with the respective private insurer.
Specific features of PKV during Legal Clerkship include:
- Trainee Tariffs (Anwärtertarife): Time-limited tariffs with improved price-performance ratio for the duration of the preparatory service.
- Individual Tariff Choice: Needs-based adjustment possible, for example with regard to deductible and scope of benefits.
- Health Check: Admission to PKV is usually subject to a health check.
Statutory Health Insurance (GKV)
Under certain conditions, it is possible to remain in the statutory health insurance scheme. This mainly applies to clerks who were already compulsorily insured in the GKV before starting their service. They can apply for voluntary continued insurance (§ 9 SGB V).
Unlike PKV, the GKV does not only cover a part of the costs; it generally offers comprehensive basic protection. The entitlement to Beihilfe remains, but is reduced in scope since the statutory fund already covers the primary expenses.
Special Cases and Options
For teacher trainees, the same general conditions usually apply. In the federal state of Bavaria, for example, clerks are classified as employees during the preparatory service and are subject to compulsory statutory health insurance (GKV). In other federal states, international health insurance is generally relevant for foreign clerks, provided they do not have civil servant status.
End of Legal Clerkship and Change of Health Insurance
Upon completion or discontinuation of the legal clerkship, the civil servant status on revocation usually ends. Those affected must normally choose new health insurance, especially if entering public service or employment subject to social insurance contributions. Switching to statutory health insurance is possible under certain conditions (§ 9 SGB V, § 10 SGB V).
Premium Amount and Scope of Benefits
The amount of health insurance contributions during legal clerkship varies considerably between private and statutory insurance. The key factors include:
- Age of the insured person
- Health condition (for PKV)
- Choice of tariff
- Level of aid assessment rate
- Co-insurance of children or spouse
The entitlement to health insurance coverage extends to both outpatient and inpatient medical treatment, doctor visits, medication, and dental services. The exact scope of benefits depends on the chosen insurance tariff or the statutory benefits catalog.
Proof Obligations and Registration Deadlines
Civil servants on revocation are required to provide proof of continuous health insurance. When switching between GKV and PKV, relevant evidence of insurance periods must be supplied. Registration for PKV must take place no later than commencement of service; otherwise, exclusion from favorable trainee tariffs (Anwärtertarife) is possible.
Conclusion
Health insurance during the legal clerkship is characterized by particular legal and practical conditions. The choice between private and statutory health insurance depends on individual status, federal state-specific regulations, and personal life circumstances. The employer’s aid (Beihilfe) is a key component of health insurance coverage during the clerkship. Legal clerks should carefully examine the different legal insurance options and the resulting financial and insurance law consequences.
Further Legal Sources
- Fifth Book of the Social Code (SGB V)
- Federal Aid Ordinance (BBhV)
- Aid Regulations of the Federal States
- Civil Servant Status Act (BeamtStG)
Frequently Asked Questions
Do I basically have to take care of my own health insurance during my legal clerkship?
During the clerkship, there is a compulsory health insurance obligation for legal clerks according to § 5 Section 1 No. 13 SGB V, unless insurance already exists within the statutory health insurance system or an exemption according to § 8 SGB V applies. Since legal clerks in a civil servant relationship on revocation typically receive aid from the employer, there is regularly the option to choose between statutory and private health insurance. Arranging health insurance is the individual’s own responsibility; the employer does not serve as an insurer. Automatic transfer to statutory health insurance only takes place if status changes, such as leaving civil service or in special cases. It is advisable to independently clarify the insurance relationship before starting the clerkship and, if necessary, formally provide proof of adequate insurance coverage.
What options do I have when choosing health insurance as a legal clerk?
Legally, legal clerks generally have the option to voluntarily insure themselves in the statutory health insurance (§ 9 SGB V) or with a private health insurer, provided they are entitled to aid. The choice between statutory and private health insurance can be made once according to § 8 Section 1 SGB V; upon entering the civil servant status on revocation, exemption from the statutory insurance obligation is possible. In the case of private insurance, the state or federal aid office usually covers a portion of the incurred medical expenses (generally 50%, possibly more depending on family situation), while the remaining costs must be covered via private supplementary insurance. Switching back to GKV after this choice is only possible under certain legal conditions, such as returning to an employee status. It is important to apply for exemption from statutory health insurance in writing and in a timely manner if you opt for PKV.
Do I need to consider a standby insurance (Anwartschaftsversicherung) during the clerkship?
A standby insurance (Anwartschaftsversicherung) is especially recommended if a change from private to statutory health insurance or vice versa is foreseeable, for example if you may not be retained as a civil servant on probation or expect a period without your own insurance coverage. Legally, however, there is no obligation to take out a standby insurance; it is a voluntary precaution to allow rejoining the previous insurance status (especially PKV) without a new health check and at the original entry age. This option should be considered carefully, for instance if family changes, incapacity for service, or a switch to statutory health insurance after finishing the clerkship are likely.
What happens to my health insurance if the legal clerkship is terminated early?
If the legal clerkship ends before the regular period (for example, through dismissal, withdrawal, or failure), the civil servant status on revocation ends at the same time. As a result, the entitlement to aid generally ceases as well. According to § 2 SGB V, compulsory statutory health insurance is then triggered, provided there was no alternative coverage before. Former private health insurance must be converted to a standby insurance or, if applicable, voluntary continued coverage, while registration in the statutory health insurance system is mandatory within two weeks of the change in status. It is therefore advisable to notify both the previous and future insurer of the status change without delay to avoid gaps in coverage and back payment obligations.
How high are the health insurance premiums during the clerkship, and does the employer subsidize them?
In the civil servant relationship on revocation during the clerkship, there is no employer’s contribution to statutory health insurance as with employees. With private health insurance, legal clerks receive aid from the employer, the amount of which depends on marital status and the aid regulations of the respective federal state, usually around 50% of medical costs. The remaining share must be privately insured and is subject to individual premiums, depending on age, health condition, and chosen level of coverage. In statutory health insurance, the premium is paid voluntarily in accordance with § 240 SGB V and is based on current minimum income, less any relevant earnings. There is no direct subsidy for health insurance premiums from the employer; only aid reduces the actual out-of-pocket costs if you choose PKV.
What should I consider regarding health insurance in the case of prolonged illness or maternity leave?
During legal clerkship, the civil servant relationship generally continues in case of prolonged illness or maternity leave, unless dismissal or voluntary resignation occurs. The insurance arrangement is not affected from a legal perspective: Entitlement to aid and the chosen health insurance coverage continue. During maternity leave, special provisions of the federal or state civil service laws may apply, affecting aid benefits. Otherwise, in the case of prolonged illness, there are no statutory contributions from the employer; therefore, privately insured legal clerks should provide for daily sickness allowance insurance. In statutory health insurance, contributions are generally still owed during illness, regardless of current income received.
Can I, as a married legal clerk, be covered under my spouse’s family insurance?
A non-contributory family insurance according to § 10 SGB V is possible for spouses in statutory health insurance, provided the legal clerk is not himself or herself compulsorily insured or entitled to aid as a civil servant on revocation. Since civil servants are generally required to take out their own health insurance, free family insurance during the clerkship is excluded by law in practice, regardless of whether the spouse is statutorily insured. In private health insurance, insurance must also be arranged according to aid entitlement and individual circumstances. Only under certain conditions, following a subsequent change in status (e.g. leaving the civil service), could family insurance become an option, but this must be legally examined in each individual case.