German health insurance for pensioners (KVdR) in 2026
Two contributions come off every German statutory pension before it reaches your account. You share one with the pension insurer and pay the other alone.
Worked through by Radif Partners · Editorial policy · How we calculate
What health and care insurance take from the pension
Deduction a month
€197.60
| Health insurance (8.75 %) | €140.00 |
| Care insurance (3.6 %) | €57.60 |
| Left before tax | €1,402.40 |
Pensioners in German statutory health insurance pay two contributions from their pension in 2026. Health insurance consists of the general rate of 14.6 % plus your own fund’s extra rate (Zusatzbeitrag), on average 2.9 %; the pension insurer pays half, so you pay 7.3 % plus 1.45 %, 8.75 % of the gross pension in total. Long-term care insurance (Pflegeversicherung) of 3.6 % is paid by the pensioner alone, 4.2 % without children. On a €1,600 pension that is €197.60 a month, or €207.20 without children. If your fund raises its extra rate, pensioners feel it only from the second month after the change. Both contributions are deductible as special expenses and reduce the income tax on the pension. Parents with several children under 25 pay 0.25 percentage points less for care for each child from the second.
Who pays which part
Pensioners’ health insurance (Krankenversicherung der Rentner, KVdR) is compulsory statutory health insurance for pensioners who meet the conditions of section 5 SGB V; your health fund can tell you whether you qualify. If you are used to a tax-funded health service, the German model works differently: you pay a percentage of the pension, and the amount follows the pension. For everyone in statutory insurance, the contribution is split like this:
| Contribution | Total rate | Your share | Pension insurer’s share |
|---|---|---|---|
| Health insurance, general rate | 14.6 % | 7.3 % | 7.3 % |
| Extra rate (2026 average) | 2.9 % | 1.45 % | 1.45 % |
| Long-term care, with a child | 3.6 % | 3.6 % | 0 % |
| Long-term care, no child | 4.2 % | 4.2 % | 0 % |
The general rate is set in section 241 SGB V, its application to pensions in section 247, and the pension insurer’s half in section 249a. Care follows section 55 SGB XI with the surcharge for people without children; section 59 SGB XI makes pensioners pay it alone.
Deductions by pension amount
| Gross pension | Health | Care with a child | Total | Total, no child |
|---|---|---|---|---|
| €1,000 | €87.50 | €36.00 | €123.50 | €129.50 |
| €1,400 | €122.50 | €50.40 | €172.90 | €181.30 |
| €1,800 | €157.50 | €64.80 | €222.30 | €233.10 |
| €2,200 | €192.50 | €79.20 | €271.70 | €284.90 |
| €2,600 | €227.50 | €93.60 | €321.10 | €336.70 |
Across this table the contributions rise in step with the pension: about 12.35 % with a child and 12.95 % without. To include income tax, use the gross to net pension calculator, which also takes the start year.
Your fund’s extra rate
Everyone pays the same general rate, but each fund sets its own extra rate; the 2.9 % average is only a reference figure. Two examples on €1,600 with children: at an extra rate of 2.5% you pay €136.80 to the fund, at 3.5% €144.80. The gap of €8.00 a month comes to €96.00 a year, because you carry only half of the extra rate.
When the fund changes its rate, pensioners see it from the second calendar month afterwards. Until then the deduction stays as it was. It is worth knowing your fund’s current rate: each percentage point of extra rate costs you €8.00 a month on a €1,600 pension.
Pension increases: the contribution rises too
Because the contributions are a fixed percentage of the pension, every pension adjustment carries them along. On 1 July 2026 pensions rose by 4.24 %. €1,600 became €1,667.84 gross, €67.84 more. Of that, €8.38 went to health and care insurance, leaving €59.46 more a month before tax. The increase announced in the pension notice therefore never reaches your account in full. When you compare two years, look at the gross amount and the amount paid out separately.
Long-term care: paid alone
The pension insurer does not share the care contribution. With a child it is 3.6 %, without 4.2 %, for people without children aged 23 or over and born after 1939. Parents with several children under 25 pay less:
| Children under 25 | Care rate | Care contribution on €1,600 |
|---|---|---|
| 1 | 3.60 % | €57.60 |
| 2 | 3.35 % | €53.60 |
| 3 | 3.10 % | €49.60 |
| 4 | 2.85 % | €45.60 |
| 5 | 2.60 % | €41.60 |
The mini calculator above only knows “at least one child” or “none” and leaves the discount for several young children out. Someone retiring at 63 with two children under 25 pays €4.00 a month less under the table, as long as both are under 25.
Contributions and income tax
Health and care contributions reduce your taxable income (section 10 Income Tax Act). On €1,600 a month starting in 2026 they total €2,371 a year. Without this deduction taxable income would be €15,990; with it, €13,619, and the tax is €192. The pension at which tax starts is on tax-free pension limit.
What this page does not cover
All figures apply to the statutory pension of people in statutory health insurance. If you are privately insured, nothing is paid from the pension to a statutory fund; your premium follows your contract. Contributions on company pensions or other income are not covered either, and neither is health cover for pensioners who move abroad, which depends on where you live. Clarify how you will be insured in retirement with your health fund before you file the pension application.