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Health insurance for retirees: How to insure yourself in retirement

Who can be exempted from compulsory health insurance?

Anyone who should actually have to take out health insurance for pensioners because they are drawing a statutory pension can, under certain conditions, be exempt from this obligation. This applies, for example, to those with private health insurance who are eligible. You can continue your private health insurance when you receive a pension. However, you must submit an application for exemption to a health insurance company within a period of 3 months.

An exemption should be carefully considered. The decision against statutory health insurance is usually of a permanent nature. That means that a return to the health insurance of the pensioners is hardly possible any more.

Which pension recipients can voluntarily take out insurance with a health fund?

Anyone who is legally insured but does not meet the minimum insurance period for the KVdR can in principle take out insurance as a voluntary member. In the past, certain previous insurance periods were required for this. A law from 2013 is interpreted in such a way that persons whose compulsory insurance (or family insurance) ends normally no longer have to have a previous insurance period for voluntary continued insurance.

For pensioners who do not get into the KVdR and only have low income, family insurance may be considered.

What is changing for the self-employed?

Anyone who works full-time as a self-employed person and applies for a statutory pension is not automatically subject to health insurance. The previous insurance remains in place, in this case it has priority. This does not apply to pensioners who only work part-time as self-employed.

How high are the health insurance contributions?

In principle, contributions are to be paid on the statutory pension (under certain conditions also on pensions from abroad), pension payments and on income from work (the profit from self-employment). The general contribution rate usually applies. Income up to a limit of 4,837.50 euros per month is taken into account. The pension insurance carriers pay half the health insurance contribution from the statutory pension. It is withheld directly from the pension and paid to the health insurers. Pensioners with pension payments or earned income have to pay the contributions on this alone.

In the case of voluntarily insured persons, interest, rents and other income subject to contributions are also taken into account. Under certain conditions, the income of the privately insured spouse can also influence the contributions of the voluntarily insured. More details are regulated in the contribution procedure principles of the National Association of Statutory Health Insurance Funds.

Voluntary members pay the full contributions and, upon request, receive a health insurance subsidy from the pension insurance agency, which is calculated as a percentage of the statutory pension.

The insurance companies have the option of charging individual, income-dependent additional contributions. Affected members have a special right of termination if funds raise or increase additional contributions. The pension insurance fund and pensioner each pay half of the additional contribution.

If the pension insurance agency or the paying agent pays the contributions to the health insurance company, the increase in the additional contribution only takes effect after a 2-month delay.

Background: For the system changeover, the pension insurance institutions and the paying agents for pension payments were given a transition period.

What is the situation like with privately insured persons?

Similar to those who are voluntarily insured, the pension insurance company pays private health insurers who are entitled to a statutory pension an allowance towards their contributions.

When cost pressure increases, pensioners can consider whether they should cut down individual benefits with their insurer, increase the deductible or, if available, choose an equivalent tariff with lower premiums. In certain cases, however, the right to change to the so-called standard tariff may be lost if the insurance cover is changed.

Although this has a very weaker scope of benefits, if there are no sensible tariff alternatives, its often low contribution can mean a certain alleviation of the financial situation.

Individuals whose benefit entitlement changes due to retirement can adjust their private insurance tariff within 6 months without a new health examination.

Are contributions to direct insurance rightly charged?

Lump-sum benefits and severance payments that serve to provide for old age and survivors are subject to contributions in statutory health and long-term care insurance. However, these must be related to professional life. Example: Private life and pension insurances are not affected for pensioners who are subject to health insurance. The paid-out capital is arithmetically distributed over ten years and then the monthly contribution is determined. There is an exemption for income from company pension schemes: Only the monthly limit of EUR 164.50 is taken into account for the calculation of contributions. According to the current legal situation, this regulation only applies to members of the fund who are subject to compulsory insurance, i.e. not voluntarily insured. In addition, the tax exemption is only applicable to health insurance, not to long-term care insurance (the previous tax exemption regulations remain in effect).

The Federal Constitutional Court (Az .: 1 BvR 1660/08) ruled in favor of (KVdR-) pensioners who initially invested further contributions in a company pension scheme after leaving the employment relationship: At least the privately financed portion of the payment from direct insurance may not be covered with health and long-term care insurance contributions in old age. However, in order to classify the benefit as "private" during the payment period after leaving the company, the company pensioners must be entered as policyholders in the insurance policy. Decisions on the health insurance contributions of pensioners who are subject to compulsory insurance and who continued to pay into pension fund contracts after the end of the operational phase are comparable (Ref .: 1 BvR 100/15 and 1 BvR 249/15). However, the situation is different for voluntarily insured pensioners: Since they also have to pay contributions on income of a private nature, they hardly benefit from the aforementioned decisions.