Health insurance for pensioners (KVdR): All the important information

Even in well-deserved retirement, people with statutory health insurance must continue to pay for statutory health insurance. Whether this is cheaper or more expensive fun depends on the individual circumstances.

Once they reach retirement age, many retirees get a shock. The reason: The pension is often smaller than expected due to taxation and health insurance contributions.

Especially retirees who do not make it into the so-called health insurance for retirees often have to accept losses. Contrary to what the name suggests, health insurance for pensioners is not an insurance of its own, but only the insurance status. Pensioners with this status stay with their health insurance company, but pay a lower contribution than the voluntarily insured pensioners.

Who is eligible for pensioners’ health insurance?

Pensioners’ health insurance (KVdR) only includes pensioners who were insured in statutory health insurance (GKV) for at least 90 percent of the time during the second half of their working life.

It does not matter whether you were insured as a compulsory member or a voluntary member. Periods of family insurance and insurance in the former GDR can also be taken into account.

Periods spent in statutory health insurance abroad can also be taken into account – in the case of countries in the European Economic Area (EEA) or countries with which there is a social security agreement.

It is therefore especially important above all in the second half of working life To be in the statutory health insurance for most of the time, as only this period is really counted for classification in the insured status.

New retirees who have been privately insured in the meantime still have a chance to get into the KVdR. For each child of the pension applicant, three years are credited – also for foster children.

An example: Suppose a mother of two applies for a pension in 2020 after having been employed between 1970 and 2020. Most of the time she was insured by the state, only for the last five years of her working life has she taken out private insurance.

To get health insurance for pensioners, they would have to have been legally insured for at least 90 percent of the second half of their working life, i.e. the last 22.5 years. But because she ended up with private health insurance for five years, there is actually not enough time in statutory health insurance. But since she has two children, she gets three years for each child, so a total of six years. So she still makes it into the cheaper health insurance for pensioners.

How can I get voluntary health insurance?

If seniors do not meet the criteria for inclusion in the pensioners’ health insurance, they can take out voluntary statutory insurance if they were with a statutory health insurance company before retirement.

The problem: unlike pensioners in the health insurance of pensioners, voluntarily insured persons have to pay contributions to health and long-term care insurance on all their income. In addition to the pension, this income also includes pension payments, earned income, income from renting and leasing and from capital assets.

It is therefore advisable to work towards membership in the KVdR at an early stage and to stay in the statutory health insurance from the age of 40 – or alternatively to opt for private health insurance.

How high are my health insurance contributions as a pensioner?

The amount of the contributions varies depending on whether you are included in the pensioners’ health insurance or in the voluntary insurance. In addition, the level of the percentage rates differs according to. As with all other health insured persons, the current normal contribution rate of 14.6 percent also applies to pensioners, of which the pension insurance pays half.

Regardless of whether you are voluntarily insured or under the KVdR, you therefore pay 7.3 percent on your creditable income, i.e. the income from the statutory pension.

Differences only occur with other types of income. Those who are pensioners in health insurance pay the full 14.6 percent on pension payments like a voluntarily insured person. Unlike pensioners in voluntary insurance, however, you do not have to pay contributions to income from renting, investment income or private pension insurance in the pensioner’s health insurance.

Don’t forget: the normal contribution rates are often not enough – many health insurance companies charge an additional contribution. In 2020 the Additional contribution an average of 1.1 percent, with some health insurers significantly higher. Pensioners pay half this rate, which is calculated as a percentage of their statutory pension.

Important: All contributions are only charged up to the income threshold, which is 56,250 euros in 2020 and 58,050 euros from 2021.

How do retirees pay health insurance?

Pensioners who come to the pensioners’ health insurance, i.e. who are compulsorily insured, do not have to worry about the payment to the health insurance company. With them, the contributions are automatically transferred from the pension insurance to the health insurance – the pension amount is reduced accordingly.

The situation is different with those who are voluntarily insured. They have to pay their health insurance contributions themselves. Important: Voluntarily insured pensioners must therefore apply to the pension insurance company for half of the health insurance contributions. This subsidy is then paid out together with the pension.

When do I have to have health insurance when I retire?

All those who have applied for a pension and were 90 percent of the statutory health insurance in the second half of their working life are compulsorily insured in the health insurance of pensioners. If this is not the case, three years will still be credited per child – so that the insurance obligation can still occur.

Who can be exempted from compulsory health insurance?

It can happen that privately insured persons also fulfill the previous insurance period for statutory health insurance – for example due to the number of children or due to the previous insurance periods of a deceased spouse. In such a case, the pension applicant receives the information that he or she fulfills the previous insurance periods for the statutory health insurance and thus comes into the statutory health insurance of the pensioners. If you do not want this, you have three months to free yourself from the compulsory insurance and remain in private health insurance.

You can also be exempted from compulsory insurance if you are, for example, a former civil servant and entitled to allowance. But be careful: Such a step should always be carefully considered, as it is difficult for retirees to re-enter health insurance later.

As a pensioner, can I still switch back to GKV?

Basically, it is difficult to switch to statutory health insurance only when you reach retirement age. In order for a change to be possible, some requirements must be met. In the second half of your working life, you must have been in the statutory health insurance for at least 90 percent of the time.

If you have children, the chances are a little better, because three years of previous insurance are credited to you for each child. It is also helpful if you were legally insured for at least two and a half years in the five years prior to your planned return.

If none of this applies, it may be possible to switch via the spouse. If you have a low income, for example for a mini job, you could get family insurance through your statutory partner.

– .