Key takeaways
- Public health insurance for pensioners (Krankenversicherung der Rentener (KVdR) is only a status, not a new type of health insurance fund.
- You must be insured in statutory health insurance for 90 percent of the time in the second half of your working life to be eligible for KVdR.
- You pay lower health insurance premiums if you are insured with health insurance for retirees (KVdR).
This is how you do it
- To be insured in KVdR after retirement, you must switch to public health insurance before age 40.
- You must apply for a health insurance subsidy from statutory pension insurance if you are not eligible for KVdR.
Table of Contents
Health insurance after retirement in Germany
The German health insurance system offers special status to people who reach retirement age. The status is called health insurance for retirees or Krankenversicherung der Rentner (KVdR).
To get KVdR status, you must fulfill certain criteria. People who get this status pay lower public health insurance premiums than those who don’t.
After retirement, you’ll be insured in one of the three groups.
- Compulsorily insured in the pensioners’ health insurance scheme (KDvR)
- Voluntarily insured under statutory health insurance
- Have private health insurance
Compulsorily insured in the pensioners’ public health insurance scheme (KVdR)
Pensioner’s health insurance scheme is just a status and not a new type of health insurance fund. You must fulfill certain requirements to get this status.
The biggest benefit of having KVdR status is that you pay a low health insurance premium after retirement. This is because the public health insurance company calculates the premiums based on income from the statutory pension, work, and pension benefits. Income from other sources, such as rent, interests, etc., is not considered.
Voluntarily insured under statutory health insurance after retirement
If you don’t meet the KVdR requirements, you can be voluntarily insured in public health insurance. In this case, the public health insurance provider calculates insurance premiums based on income from all sources. This increases the monthly premium you pay.
If you recieve a statutory pension, you are eligible for a pensioner’s subsidy on health insurance contributions. However, you must apply for it.
Have private health insurance after retirement in Germany
If you have private health insurance, KVdR status is irrelevant. However, private health insurance premiums also decrease after retirement, depending on the following factors.
- Retirement provisions saved
- Private health insurance plan
- How long you were insured in private insurance
Retired individuals with private insurance are also eligible for a pensioner’s subsidy on health insurance contributions if they recieve a statutory pension.
What is pensioners’ health insurance in Germany (Krankenversicherung der Rentner (KVdR)?
The pensioners’ health insurance (Krankenversicherung der Rentner (KVdR)) is a status given to those who
- receive statutory pension AND
- have been insured in public health insurance for a certain period
If you qualify for KVdR status, you only pay health insurance contributions on your
- statutory pension
- income from work (employment or self-employment)
- pension benefits (company pension, pension schemes, etc.)
Income from other sources, such as interest, rent, etc., is exempt from contributions.
If you have health insurance for retirees (KVdR), you can choose any public health insurance provider and change it if necessary. Read our guide to learn about the best public health insurance in Germany.
What are the eligibility criteria for joining the pensioners’ health insurance scheme (KVdR)?
You must fulfill the following requirements to become eligible for the pensioners’ health insurance scheme (KVdR).
- You receive or have applied for a pension from the statutory pension insurance scheme.
- You were insured in public health insurance for 90 percent of the time in the second half of your working life (9/10 rule, Section 5 Paragraph 1.11 SGB V ). It doesn’t matter if you were compulsorily, voluntarily, or insured for free in family insurance.
NOTE: You are not eligible for health insurance for pensioners (KVdR) if you continue to work fulltime as a self-employed while getting pension.
How is the 90% time calculated?
Start of working life: The working period starts when you get your first job, including vocational training and self-employment. If you were not working, the date of your marriage or your 18th birthday applies.
End of working life: Your working life ends when you apply for a statutory pension.
Calculation:
- The public health insurer calculates the total number of working years based on start and end of your working life.
- Divide the total working years by 2 to find out the second half of the working life.
- Check how many years you were insured with public insurance during the second half of your working life. If you were insured for at least 90% of the time, you are eligible for health insurance for retirees (KVdR).
NOTE: If you have children, the public health insurance company will add three years per child when calculating the 90% time.
Example: Suppose you were insured in public insurance for 15 years out of 20. In this case, you are not satisfying the 90% rule. However, if you have one child, the insurer will add three years to your 15-year period. This brings the number to 18 years; you now satisfy the 90% rule.
Example for determining the eligibility for public health insurance for pensioners (KVdR)
Work-life timeline
- Suppose Kathi started working as an employee at the age of 25 and had statutory health insurance.
- When she was 32, she started working as self-employed and switched to private health insurance.
- At the age of 47, Kathi took a job as an employee and returned to statutory health insurance.
- Kathi finally retires at the age of 65.
Calculation
- Total working life of Kathi: 40 years (started at 25 and retired at 65).
- The first half of Kathi’s working life: 25 to 45 (20 years (40/2))
- The second half of Kathi’s working life: 45 to 65 (20 years (40/2))
- Number of years insured in public health insurance after Kathi turned 45: 18 years (Kathi moved back to public insurance when she was 47)
- What percentage of time Kathi was insured in statutory health insurance during the second half of her working life: 90% (18/20)
As Kathi was insured 90% of the time in statutory health insurance during the second half of her working life, she is eligible for KVdR.
Health insurance cost after retirement in Germany
Pensioners pay the same public health insurance contribution rate as others. The only difference is the income considered when calculating the insurance premiums.
Here is how much you pay in public health insurance
- Health insurance contribution: 14.6% of your income
- Additional contribution: 1.7% of your income (depends on your public health insurer. 1.7% is the average as of 2024)
- Long-term nursing care: 3.4% (if you have children) or 4% (No children)
- Maximum income considered for calculating the premium: 5,175€ (as of 2024), 5,512.5€ (in 2025)
Pensioners insured voluntarily in public health insurance pay the premium on all their income. Pensioners compulsorily insured in public health insurance (KVdR) pay the premium on the following incomes only.
- Statutory pension
- Pension benefits (eg: company pension)
- Income from employment or self-employment
Both voluntarily and compulsorily insured individuals get a subsidy from the statutory pension. The subsidy equals half of the “health insurance” and “additional” contribution you pay on your pension income.
No subsidy on long-term nursing care contribution.
The table below clarifies which incomes are considered for calculating health insurance premiums in old age.
| Income sources | Compulsory public health insurance for pensioners (KVdR) | Voluntarily insured in public health insurance after retirement | ||
| Health insurance contribution | Additional contribution | Health insurance contribution | Additional contribution | |
| Is income considered for calculating premiums? If yes, how much do you pay? | ||||
| Statutory pension | Yes – 7.3% of the statutory pension you recieve | Yes – 0.85% | Yes – 7.3% of the statutory pension you recieve | Yes – 0.85% |
| Pension benefits (eg: company pension) | Yes – 14.6% of the income | Yes – 1.7% | Yes – 14.6% of the income | Yes – 1.7% |
| Income from employment or self-employment | ||||
| Rental income | No | Yes – 14% of the income | ||
| Interests, dividends | ||||
| Private pension schemes | ||||
Example: How much retirees pay in public health insurance premiums in old age
Suppose Julius and Teresa both earn the same income in old age and have no children. Julius is insured under KDvR status, and Teresa is voluntarily insured by public insurance.
Here is how much they’ll pay in health insurance contributions after retirement.
| Income sources | Income | Compulsory public health insurance for pensioners (KVdR) | Voluntarily insured in public health insurance after retirement |
| Julius | Teresa | ||
| Statutory pension | 1000 | 81.5 ((7.3% + 0.85%) of 1000) | 81.5 |
| Pension benefits (eg: company pension) | 500 | 81.5 ((14.6% + 1.7%) of 500) | 81.5 |
| Income from employment or self-employment | 0 | 0 (as no income from work) | 0 |
| Rental income | 500 | 0 | 78.5 ((14% + 1.7%) of 500) |
| Interests, dividends | 250 | 0 | 39.25 ((14% + 1.7%) of 250) |
| Private pension schemes | 500 | 0 | 78.5 ((14% + 1.7%) of 500) |
| Health insurance premium | 163€ per month | 359.25€ per month | |
| Long-term care insurance | 60€ (4% of 1500) | 110€ (4% of 2750) | |
| Total (Health insurance + Long-term care insurance) | 223€ per month | 469.25€ per month |
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