Health insurance for pensioners

Of course, pensioners also have to have health insurance. But how high are the contributions? Can one remain in the usual insurance or is there a special health insurance for pensioners? Does family insurance still work? And what else is there to consider? We answer these and other questions about health insurance for pensioners.

This depends mainly on how you were insured in the past years and decades. If you have been in a statutory health insurance, it makes little sense to change to a private insurance now. The premiums would simply be too high for such a late entry.

Conversely, if you have been privately insured up to now, it will probably stay that way. There are legal restrictions that make it difficult to return to statutory health insurance. Especially after the age of 55, it is much more difficult to switch. The reason for this is to prevent too many people from taking advantage of the benefits and often lower premiums of private health insurance when they are young and then wanting to return to statutory insurance when they are older. After all, an insurance company's premiums depend on the average costs of its insured. In most cases, the higher the age, the higher the costs for the health insurance companies. If many pensioners who have not paid into the statutory health insurance system in recent decades were to return, this calculation would no longer add up and contributions would have to rise for everyone. Therefore, if you have been privately insured up to now, you will usually stay that way.

If you have been compulsorily insured in a statutory health insurance fund up to now, you automatically switch to the health insurance fund for pensioners (KVdR) when you retire. However, little changes for you: you remain with your usual health insurance fund or can change it if you wish. The KVdR is billed internally.

The KVdR saves you a lot in contributions. However, there are some conditions for switching to the KVdR:

• You must receive a statutory pension. Whether this is an old-age pension, a survivor's pension or a pension for reduced earning capacity is irrelevant.
• And you must have been insured by the state for at least 90 percent of the time in the second half of your working life. It is irrelevant whether this was family insurance, compulsory insurance or voluntary insurance. However, if you were privately insured for a longer period of time, for example during self-employment, you are no longer automatically eligible for KVdR.

If you do not meet these requirements, you can apply for voluntary KVdR insurance. However, the conditions are then no longer as optimal. A prerequisite for voluntary insurance in the KVdR is that you were already voluntarily insured in a statutory health insurance fund before you retired. It is not normally possible to switch from private insurance.

How high the contributions are can vary greatly. It is particularly favourable if you are compulsorily insured in the KVdR of your health insurance fund. In this case, the German pension insurance pays half of the contribution, just as the employer did in the past. In addition, in this case the health insurance contribution is only due on the statutory pension, on a possible company pension and on income from self-employment. All other income (for example private pensions, interest income or rental income) is not taken into account. As a result, the contributions are particularly low for this type of insurance.

In the case of voluntary KVdR insurance, contributions are usually significantly higher. This is because they also include other income such as interest, rental income or private pensions in the calculation. In addition, the insurance assumes a minimum monthly income of 1015 euros. Even if your actual income is significantly lower, the health insurance contribution is calculated at least on this basis.

In both cases, the general contribution rate for pensioners is currently 14.6 percent. Half of this is paid by the pension insurance. The contribution you still have to pay is therefore 7.3 per cent of your pension and possibly your other income. However, this rate can be increased. This depends, among other things, on the additional contribution of the health insurance fund, your year of birth and whether you have children.

Anyone who is insured in the KVdR automatically also has compulsory insurance in the pensioners' long-term care insurance. The contribution is currently 3.3 per cent for childless pensioners and 3.05 per cent for pensioners with children.

Yes, free family insurance is still available for pensioners. However, some preconditions apply:

• The income limit for persons in family insurance is 455 euros. This includes all income of the family-insured person, i.e. both the pension and possible other emoluments or additional earnings.
• Family insurance is possible for spouses and partners, for children up to the age of 25 or for stepchildren and grandchildren who live in your household or for whose living expenses you are primarily responsible.
• Family insurance is not possible for persons who are self-employed on a full-time basis, who are subject to compulsory insurance themselves as employees or who are insured in a private health insurance scheme.

If these requirements are met, then free family insurance is possible. Otherwise, each person in the household must insure themselves individually. By the way: Family insurance via the spouse is the only way in which a change from private health insurance to statutory health insurance is possible in individual cases.