Health insurance in retirement: the biggest deduction from your pension
For most pensioners in Germany, the biggest deduction is not income tax but health and long-term care insurance. On a gross pension of €1,800, a little over €222 a month goes to the insurers in 2026 — more than five times the income tax due in this case. How much you pay depends above all on whether you are compulsorily insured in the health insurance scheme for pensioners (KVdR) or voluntarily insured.
Who qualifies for the KVdR?
You are compulsorily insured as a pensioner if you meet the so-called prior insurance period: in the second half of the period between starting your first job and applying for your pension, you must have been in statutory health insurance for at least nine tenths of the time — as a member or through family cover. Since August 2017, three years are credited for each child. This mainly helps people who were privately insured for a while.
The check happens automatically: when you apply for your pension, the pension insurance registers you with your health fund, and the fund determines whether you meet the conditions. Anyone who misses them can usually continue in statutory insurance on a voluntary basis.
KVdR contributions in 2026
On the statutory pension, compulsorily insured pensioners pay half of the general contribution rate, i.e. 7.3%, plus half of their health fund's additional contribution. The pension insurance pays the other half. At the average additional contribution of 2.9%, that makes 8.75%. If your fund changes its additional contribution, the change applies to pensioners only two months later.
Pensioners pay long-term care insurance alone: 3.6% with children, 4.2% without. For a €1,800 pension this looks as follows:
- Health insurance (8.75%): €157.50
- Care insurance (3.6%): €64.80
- Total: €222.30 per month
In the KVdR, only the statutory pension and occupational benefits such as a company pension are subject to contributions. Rental income, interest, dividends or a private pension insurance remain contribution-free. Company pensions follow their own rules with an allowance, which we explain in the article on company pension deductions.
Voluntary statutory insurance: contributions on almost everything
Anyone who does not meet the prior insurance period usually stays in statutory health insurance on a voluntary basis. On the statutory pension, not much changes at first: you pay the full contribution but receive a subsidy of half from the pension insurance. In effect this matches the pensioner's share in the KVdR.
The difference lies in all other income. Voluntary members also pay contributions on rental income, investment income and private pensions — at the reduced rate of 14.0% plus the full additional contribution, and full care insurance on top. There is no subsidy from the pension insurance for this. With €500 of rental income per month, around €84.50 of health and €18 of care insurance are added. The upper limit is the contribution ceiling of €5,812.50 per month. At the lower end there is a minimum assessment base of €1,318.33 per month — even with lower income, you pay at least on that amount.
Privately insured in retirement
Privately insured pensioners pay their premium regardless of the pension amount. On application, the pension insurance pays a subsidy equal to what it would pay for a statutorily insured pensioner, but no more than half of the actual premium. Our calculator does not cover this case.
Contributions reduce your tax
Health and care insurance contributions are fully deductible as special expenses. For a €1,800 pension that is €2,667.60 a year, which reduces taxable income. The net pension calculator works out how this affects your net pension for both KVdR and voluntary insurance. The path from gross pension to net is explained in the main article on pension taxation 2026.
Note: as of 24 September 2026, not legal or tax advice.