Direct insurance: Optimise and reduce health insurance contributions
5 Jun 2025
7
Minutes
Katrin Straub
Managing Director at nextsure
The payout of a direct insurance policy in retirement is often associated with unexpected health insurance contributions. Many insured individuals only learn about this additional financial burden when they retire. Find out here what regulations apply and how you may be able to reduce your contribution burden.
The topic in brief and concise terms
Benefits from direct insurance policies for individuals with statutory health insurance are subject to health and long-term care insurance contributions, which can reduce the payout by up to twenty percent.
A monthly allowance of €187.25 (as of 2025) for pensioners with mandatory insurance reduces the basis for health insurance contributions.
Private continuation of the contract as the policyholder or an early transfer can exempt parts of the service from the obligation to pay contributions.
Understanding Health Insurance Contributions on Direct Insurance Policies
Benefits from direct insurance policies are generally subject to contributions for those with statutory health insurance. This has been the case since a change in the law in 2004 and affects pensions as well as capital payments. In the case of a capital payment, the amount is distributed over ten years and is taxed monthly. This means that one one-hundred-and-twentieth of the capital benefit is considered the monthly payment amount. For those with private health insurance, this issue does not arise as their contributions are independent of income. The obligation to pay contributions can reduce the net payout by around twenty percent. This regulation has surprised many insured individuals who did not expect these deductions when signing their contracts. Therefore, it is important to examine the exact impact on your private pension.
Make use of allowances and reliefs
An important relief for occupational pensioners is the exemption for health insurance contributions. Since the first of January 2020, the GKV Occupational Pension Exemption Act has been in effect. For the year 2025, this exemption amounts to €187.25 per month. Only the part of the occupational pension that exceeds this exemption is subject to health insurance. For a monthly occupational pension of, for example, €300, only €112.75 would be subject to contributions. This exemption also applies to capital payouts spread over ten years. Important: Voluntary statutory insured persons do not benefit from this exemption. For them, the entire benefit is subject to contributions. A voluntary health insurance may have different rules here.
The following points should be noted regarding the exemption:
The exemption applies to retirees who are mandatorily insured in the statutory health insurance.
It amounts to €187.25 per month (as of 2025).
Only the excess amount of the pension benefits is used for health insurance contributions.
In the case of multiple occupational pensions, the exemption applies only once.
For long-term care insurance, there is an exemption threshold of the same amount; if exceeded, the full amount is subject to long-term care insurance.
The introduction of the exemption has brought noticeable financial relief for many pensioners. Nevertheless, a thorough review of the individual situation is essential.
Strategies for Reducing Contribution Burden
There are several approaches to minimise the burden of health insurance contributions on direct insurance policies. One option is to continue the policy privately if the employer is no longer the policyholder. If you become the policyholder yourself and pay the contributions, at least for this privately accumulated part, the obligation to contribute later ceases. Ideally, this should happen before the payout phase. An early transfer of the policyholder can be crucial here. For contracts under Section 40b of the Income Tax Act (EStG), where contributions have already been paid during the accumulation phase, the renewed burden is particularly annoying. Here, an examination of converting into a contract under Section 3, No. 63 EStG could be worthwhile. It is advisable to inform yourself about the possibilities of tax deductibility. Consulting with experts can help you find the best solution for your individual situation.
Lump sum payment versus pension: What should be considered regarding contributions?
The decision between a one-time capital payout and a monthly pension affects health insurance contributions. For a capital payout, the sum is hypothetically distributed over one hundred and twenty months. Health and nursing care contributions are then due on this monthly amount if it exceeds the exemption threshold. Similarly, a monthly pension is also subject to contributions if it exceeds the exemption threshold. For very small pensions that are below the exemption threshold of €187.25 (as of 2025), no health insurance contributions are due. Therefore, the choice of payout method should be carefully considered. An example calculation: A capital payout of €60,000 results in a hypothetical monthly amount of €500 (€60,000 / 120 months). After deducting the exemption threshold of €187.25 (as of 2025), €312.75 would be subject to contributions. This illustrates the substantial burden. Also consider what happens if a new employer does not take over the direct insurance.
Considerations regarding the payout method:
Capital payout: Distribution over 120 months for contribution calculation.
Monthly pension: Direct contribution on the part exceeding the exemption threshold.
Exemption threshold: Applies to both payout methods for compulsory insured persons.
Nursing care insurance: Observe the free limit, otherwise full contributions apply.
Privately insured: No health insurance contributions on the payout.
The long-term financial impacts of both options should be carefully compared.
Expert tips for optimising your direct insurance
To minimize the burden of health insurance contributions, there are several expert tips. Our expert tip: Check early on if it is possible to transfer the insurance policyholder status to you as an employee if you continue to pay contributions privately. This can exempt the privately funded portion from the contribution obligation. For old contracts (concluded before 2005), different regulations may apply, so a thorough review is essential here. Have the profitability of your direct insurance critically examined, especially if it is a contract according to paragraph 40b EStG. Professional advice can help save up to twenty percent of contributions. Also, clarify whether you may already be paying the maximum contribution to statutory health insurance; in this case, no additional contributions would be incurred on the direct insurance. Inform yourself about the possibility of taking company pension schemes with you. Forward-looking planning is the key to optimization.
Common mistakes and how to avoid them
A common mistake is engaging with the topic of health insurance contributions too late. Many insured individuals are confronted with the deductions only shortly before or at the onset of retirement, when there is little room for maneuver. Another mistake is assuming that one-time capital payouts are exempt from contributions; this has not been the case since 2004. Not checking the health insurance contribution notices can also lead to financial disadvantages. Do not underestimate the complexity of the regulations. It is also a misconception to believe that the allowance applies individually to each occupational pension; it is only granted once against the total of all pension benefits. Confusing the allowance (health insurance) with the exemption limit (long-term care insurance) can lead to false expectations. Also, clarify whether a Riester pension requires health insurance contributions.
Errors to avoid are:
Getting information on contribution obligations too late.
Assuming the exemption of capital payouts from contributions.
Not checking health insurance notices.
Misinterpretation of the allowance when having multiple occupational pensions.
Ignorance about the differences between an allowance and an exemption limit.
An active approach and well-informed decisions protect against unpleasant surprises.
Request your personal risk analysis now
The regulations regarding health insurance contributions for direct insurances are complex and depend on many individual factors. To optimise your personal situation and avoid unnecessary charges, expert advice is essential. We at nextsure help you gain clarity. Have your insurance situation checked for free and receive specific suggestions for optimisation. Request your individual risk analysis now and secure a financially worry-free future. With our expertise in the area of affordable health insurance, we will find the right solution.
More useful links
The Wikipedia offers a comprehensive overview of direct insurance in Germany.
The Federal Ministry of Health provides information about the GKV-Betriebsrentenfreibetragsgesetz and its regulations.
The Techniker Krankenkasse (TK) provides information on non-contributory pensions and exemption thresholds.
You can also receive details on allowances in occupational pension schemes from the Techniker Krankenkasse (TK).
The AOK offers explanations on health insurance contributions on pensions.
Destatis (Federal Statistical Office) provides a PDF document on contributions to retirement provision.
Another PDF from Destatis outlines the methods and fundamentals of health expenditure accounting.
FAQ
Wie kann ich die Krankenkassenbeiträge auf meine Direktversicherung reduzieren?
Möglichkeiten sind die Nutzung des Freibetrags (187,25 Euro in 2025 für Pflichtversicherte), die Prüfung der Versicherungsnehmereigenschaft bei privat fortgeführten Verträgen oder eine professionelle Beratung zur Optimierung Ihrer spezifischen Situation.
Gilt der Freibetrag für Krankenkassenbeiträge auch für freiwillig gesetzlich Versicherte?
Nein, der Freibetrag für Krankenkassenbeiträge auf Betriebsrenten gilt nur für pflichtversicherte Rentner in der gesetzlichen Krankenversicherung. Freiwillig Versicherte müssen auf die volle Leistung Beiträge zahlen.
Welche Rolle spielt das GMG bei den Krankenkassenbeiträgen auf Direktversicherungen?
Das Gesetz zur Modernisierung der gesetzlichen Krankenversicherung (GMG) von 2004 führte die Beitragspflicht zur Kranken- und Pflegeversicherung auf Leistungen der betrieblichen Altersvorsorge, einschließlich Direktversicherungen, für gesetzlich Versicherte ein.
Was ist der Unterschied zwischen dem Freibetrag und der Freigrenze bei Versorgungsbezügen?
Der Freibetrag (z.B. 187,25 Euro für Krankenversicherung in 2025) mindert die Bemessungsgrundlage; nur der übersteigende Teil ist beitragspflichtig. Eine Freigrenze (z.B. für Pflegeversicherung) bedeutet: Wird sie überschritten, ist der gesamte Betrag beitragspflichtig.
Muss ich auch auf den privat finanzierten Teil einer Direktversicherung Krankenkassenbeiträge zahlen?
Wenn Sie den Vertrag nach Ausscheiden aus dem Betrieb privat fortführen und selbst Versicherungsnehmer sind und die Beiträge zahlen, ist der auf diese privaten Beiträge entfallende Teil der Auszahlung in der Regel nicht krankenversicherungspflichtig.
Wie werden Kapitalauszahlungen aus Direktversicherungen bei den Krankenkassenbeiträgen behandelt?
Eine Kapitalauszahlung wird für die Beitragsberechnung auf zehn Jahre (120 Monate) verteilt. Ein Einhundertzwanzigstel der Summe gilt als monatlicher Versorgungsbezug, auf den dann Beiträge anfallen, sofern der Freibetrag überschritten wird.
