Private health insurance in retirement: contributions & tips

Many retirees with private health insurance are concerned about rising premiums in later life. However, there are numerous ways to reduce the cost of your private health insurance in retirement and to tailor your cover optimally. Find out here how you can make use of subsidies, optimise your plan and claim tax advantages.

Understanding contribution levels in private health insurance for retirees

Contributions to private health insurance (PKV) are generally independent of income in retirement. Unlike statutory health insurance (GKV), the level of your retirement income plays no direct role in the calculation of contributions. Many pensioners benefit from certain contribution components falling away: from the age of 60, the statutory surcharge of ten per cent no longer applies. On retirement, the need for sickness benefit insurance also usually ends, which further reduces the premium. The average PKV contribution for adults without entitlement to employer assistance was €535 per month in 2023. It is important to analyse your own contribution situation at an early stage. These factors have a significant impact on your future costs.

Secure a subsidy for private health insurance from the pension insurance provider

As a privately insured pensioner, you are entitled to a subsidy towards your health insurance contributions from the statutory pension insurance scheme. This subsidy must be applied for proactively, ideally together with your pension application. The amount of the subsidy is based on the general GKV contribution rate (currently 14.6 per cent) and the average additional contribution rate charged by health insurers. Privately insured individuals currently receive 8.75 per cent of their gross pension as a subsidy (half of 14.6 per cent general contribution rate plus half of the average additional contribution of 2.9 per cent; as of 2026). However, the subsidy is limited to half of your actual private health insurance contributions. For a pension of, for example, 1,000 euros gross, you could therefore receive a subsidy of up to 87.50 euros. Please note that no subsidy is paid towards contributions for private long-term care insurance. The health insurance for pensioners provides further details here.

Actively reduce premiums: check tariff changes and other options

There are several ways to optimise the premiums of your private health insurance in retirement. A very effective method is switching tariff within your insurance company in accordance with Section 204 of the Insurance Contract Act (VVG). This right guarantees you the switch to a cheaper tariff with comparable benefits, taking into account your accumulated age reserves. Savings on premiums of up to 43 per cent are often possible.

Further options for reducing premiums are:

• Reviewing and, if necessary, increasing the excess.
• Switching to an annual payment method for premiums, which is often associated with a discount of three to five per cent.
• Switching to the standard or basic tariff, provided the requirements are met and this is the appropriate solution. The standard tariff is open to policyholders who joined private health insurance before 2009, have been insured there for at least ten years, and meet certain age or income limits.
• Using premium relief tariffs, if these were taken out at an early stage.

Many policyholders are not aware of their right to an internal tariff switch under Section 204 VVG and therefore pay unnecessarily high premiums. Advice can reveal individual savings potential here. The costs of private health insurance can thus be actively managed.

Tax benefits: deduct private health insurance contributions

Contributions to private health and long-term care insurance can be claimed for tax purposes as retirement provision expenses. The deductible portion is the part that serves basic cover, i.e. benefits at the level of statutory health insurance. Your insurer informs you annually of the amount of deductible contributions, which you enter in the “Retirement provision expenses” schedule of your tax return. For employees and retirees, the maximum amount for retirement provision expenses is EUR 1,900 per year; for the self-employed it is EUR 2,800. These amounts double for married couples assessed jointly for tax purposes. Correctly declaring this in your tax return can significantly reduce your tax burden. Also find out more about the tax deductibility as a pensioner in detail. Any premium refunds received must also be declared in the tax return, as they reduce the deductible special expenses.

Switching to statutory health insurance: An option for a few retirees

A switch from private back to statutory health insurance (GKV) is only possible for pensioners under very strict conditions. In general, a switch from the age of 55 onwards is severely restricted. An important requirement for entry into the health insurance for pensioners (KVdR) is that, in the second half of your working life, you were insured under statutory health insurance for at least nine-tenths of the time. Since a legislative change in 2017, three years of insurance time in the GKV are credited per child as a flat rate, which can improve the chances of switching.

Another option may be family cover through a spouse, provided their income thresholds are not exceeded (maximum total monthly income of 565 euros or 603 euros for a mini-job, as of 2026). A switch should be carefully considered, as returning to the PKV later is often no longer possible and the GKV can also involve cost traps in old age, for example with voluntary insurance. The health insurance obligation for a private pension is a complex topic.

In-depth expert insight: legal foundations and design tips for your private health insurance in later life

For privately insured retirees, several paragraphs and regulations are of particular importance. The aforementioned § 204 VVG is the key instrument for optimising premiums through an internal tariff switch. It secures your right to switch to another tariff with the same insurer without a new health assessment and while taking all ageing provisions with you, provided the new tariff does not include any additional benefits. If additional benefits are included, a health assessment may be carried out for these. Another important aspect is the formation of ageing provisions during the term of the contract.

These are intended to cushion rising healthcare costs in old age. From the age of 60, the statutory surcharge of ten per cent, which served to build up these provisions, no longer applies, resulting in direct premium relief. Our expert tip: Have your contract situation reviewed by an independent specialist at least every three to five years. There are often newer tariffs with a better price-performance ratio, or your needs may have changed. A private health insurance policy should remain flexible. Also pay attention to the regulations on premium adjustments in your insurance conditions.

These must be transparent and comprehensible.

Forward-looking planning: securing long-term contribution stability

To keep the contributions for your private health insurance stable and affordable in retirement over the long term, forward-looking planning is essential. Even at a younger age, you can lay the foundations. Taking out a contribution relief tariff (BEA) is one option for receiving a fixed subsidy towards the premium from an agreed age, for example 67. These tariffs are state-subsidised. Another strategy is to deliberately choose a tariff with sufficiently high ageing reserves from the outset. The earlier you start making provision for stable contributions in later life, the lower the monthly cost will be. Also consider which benefits are really important to you in later life and whether a tariff with a higher excess is an option in order to reduce ongoing premiums. The combination of private pension insurance and optimised health insurance provides a strong foundation for retirement.