Correctly enter health insurance in the tax return and make use of savings potential.
27 May 2025
6
Minutes
Katrin Straub
CEO at nextsure
Many taxpayers wonder: Where to enter health insurance in the tax return? Correctly declaring your health insurance contributions can reduce your tax burden. Find out how it works and what to consider here.
The topic in brief and concise terms
Health and nursing care insurance contributions for basic coverage are generally deductible as special expenses without limit in the supplementary sheet Vorsorgeaufwand.
For other provisions (including elective benefits from health insurance), maximum amounts of €1,900 (employees) or €2,800 (self-employed) apply.
Insurers transmit data electronically, but it is still necessary for you to provide the correct information in the tax return.
Understanding the Basics of Claiming Health Insurance Premiums for Tax Purposes
The contributions to health and long-term care insurance can be deducted as special expenses in the tax return. This applies to both basic coverage and, under certain circumstances, additional elective services. Since the Citizens' Relief Act in 2010, insured persons can deduct their contributions to statutory or private health insurance for tax purposes. The basic coverage of health and long-term care insurance contributions can be claimed in full. The tax office generally deducts four percent from those with statutory insurance for a potential entitlement to sick pay. For those privately insured, the deduction is limited to the contribution that would apply for basic coverage. Correctly stating your insurance contributions can reduce your tax burden by several hundred euros. These regulations are anchored in § 10 EStG. Correct entry is thus the first step towards your tax savings.
Anlage Vorsorgeaufwand: The central place for your health insurance contributions
The main place to enter your health insurance in the tax return is the Anlage Vorsorgeaufwand. Here, contributions to both statutory and private health and nursing insurance are recorded. For those with statutory insurance, lines 12 to 22 are relevant, depending on whether they are mandatorily insured or voluntarily insured. Privately insured individuals enter their contributions in lines 24 to 30. Insurance companies usually transmit the relevant data electronically to the tax office; nevertheless, it is necessary to provide the correct information in your declaration. Contributions for children are also declared in the Anlage Vorsorgeaufwand or the Anlage Kind (line 31 for basic contributions). The exact designations of the lines may change slightly depending on the tax year; for the year 2023, these are the common areas. A look at the current Anleitung zur Steuererklärung helps in case of uncertainties. The Anlage Vorsorgeaufwand is thus the key to the tax consideration of your health expenses.
Statutory insured individuals: How to correctly input your contributions
As an employee with statutory insurance, you will find the relevant data for your tax return on your income tax certificate. The amounts listed there under number 25 (employee's share of statutory health insurance) and number 26 (employee's share of social care insurance) are significant. These sums are transferred to the corresponding lines of the 'Vorsorgeaufwand' attachment. Your share of your health insurance's additional contribution is also included and considered for tax purposes. The average additional contribution was 1.7 percent in 2024 and increases to an average of 2.5 percent for 2025. Important is the flat deduction of four percent for sickness benefit, which the tax office automatically applies if you are entitled to it. Retirees take the deductible contributions from their pension notice. Correctly transferring these values ensures you get the maximum tax savings. For more details on deductibility, read our article on the deductibility of insurance premiums. Accurate documentation is crucial for success here.
Private Insurance: Special features when specifying your health insurance
Privately insured individuals must note that only the portion of contributions equivalent to the statutory basic coverage level is tax-deductible. Your insurer will notify you annually of the amount of these deductible contributions; this certification is important for your records. You should enter these amounts in lines 24 and following of the 'Vorsorgeaufwand' annex. Contributions for optional benefits, such as private doctor treatment or single rooms, can only be additionally deducted if the maximum amount for other insurance expenses has not yet been exhausted by the basic health and care insurance. The maximum amount is €1,900 per year for employees and civil servants, and €2,800 for self-employed individuals. Contributions to the private health insurance for retirees follow similar principles. A detailed breakdown by your insurer is invaluable here.
The following points are central for the privately insured:
Only basic coverage is fully deductible.
Insurer certifies deductible portions.
Entry in 'Vorsorgeaufwand' annex (lines 24 ff.).
Optional benefits deductible only with free maximum amount.
Observe maximum amounts (€1,900 / €2,800).
Knowing these details helps avoid errors.
Maximum amounts and what happens if they are exceeded
For other pension expenses, which also include premiums for elective health insurance services or other insurances such as liability or accident insurance, there are maximum limits. This is 1,900 euros for employees, civil servants, and pensioners who receive subsidies for their health insurance. For self-employed individuals who fully pay their contributions themselves, a maximum limit of 2,800 euros applies. The good news is: Contributions to basic health and statutory nursing care insurance are always fully recognised, even if they exceed these maximum limits. If the maximum limits are already exhausted by the basic cover, no further other pension expenses (e.g. for elective services or an accident insurance) can be claimed. A thorough examination of one's own situation is therefore essential. This ensures that all deductible items are taken into account.
Child and Health Insurance: How Parents Benefit Tax-wise
Parents can also claim their children's health and nursing care insurance contributions for tax purposes. The prerequisite is that they are entitled to child benefit or the child allowance for the child. You enter the contributions to the child's basic coverage in line 31 of the Anlage Kind form. Contributions for optional services or an international health insurance for the child belong in line 37 of the Anlage Kind form and are considered as part of other precautionary expenses. Our expert tip: Even if your child is already over 25 years old but still in education, and you continue to be the policyholder and pay contributions, these may still be deductible under certain circumstances if there is no longer an independent entitlement to child benefit. This needs to be checked on a case-by-case basis. The international health insurance can be considered separately in this regard. The correct allocation of contributions is crucial for tax recognition.
Foreign health insurance and special cases: What is important to consider?
Contributions to a foreign health insurance can be claimed in the German tax return under certain conditions. It is important that the foreign insurance provides comparable benefits to a domestic one for basic coverage. Additionally, the insurance company must be based in an EU or EEA state or have a business license for Germany. The contributions are then also entered in the 'Vorsorgeaufwand' annex. A judgment by the Federal Finance Court (BFH) from 14 December 2022 (X R 25/21) clarified that this also applies to insurances when no tax-reducing consideration occurs in the respective country, except for precautionary measures that relate to income from certain third countries. Different regulations apply to direct insurance or contributions to retirement provision. International comparability is the crucial point here.
Consider the following for foreign insurances:
Comparability of basic coverage.
Insurance company's headquarters in EU/EEA or business license in DE.
Entry in 'Vorsorgeaufwand' annex.
Observe current case law (BFH X R 25/21).
No tax consideration abroad as a prerequisite.
These points will help you correctly state cross-border contributions.
Expert Depth: Paragraphs, Judgments and Design Tips
Conclusion and your next step towards an optimized tax return
More useful links
The Federal Ministry of Finance (BMF) provides a document regarding the exchange of data between private health and long-term care insurance, tax authorities, and employers in the payroll tax deduction process.
The Federal Statistical Office (Destatis) offers comprehensive information on health expenditures in Germany.
The Tax Office NRW provides information on the tax treatment of contributions to health and long-term care insurance that are taken over.
The Association of Private Health Insurance (PKV) explains its position on the draft BMF document regarding data exchange between PKV companies, tax authorities, and employers.
FAQ
Which form do I need for health insurance in the tax return?
You need the annex for pension expenses. This is where all contributions to health and long-term care insurance, as well as other pension expenses, are recorded.
What is the difference between basic coverage and optional services for tax deduction?
Contributions towards basic cover (comparable to GKV services) are fully deductible. Contributions for optional services (e.g. senior consultant) are only deductible if the maximum amount for other precautionary expenses has not yet been exhausted.
Do I need to provide proof of my health insurance contributions?
Typically, your insurer will electronically transmit the data to the tax office (eData). However, you should keep the certificate from your insurer for your records and accurately state the values in your tax return.
What happens if my contributions to the basic health insurance exceed the maximum amount of 1,900 euros?
Contributions to basic health and nursing care insurance are fully recognised, even in full. The maximum amount of 1,900 euros (or 2,800 euros for self-employed persons) applies to other precautionary expenses, which only come into effect if this amount has not already been reached through basic cover.
I am a pensioner, where do I enter my health insurance?
Even as a pensioner, you enter your health insurance contributions in the Appendix Vorsorgeaufwand. You typically obtain the data from your pension statement or notification from your health insurance.
Can I also deduct contributions for an overseas health insurance?
Yes, under certain conditions, contributions to a foreign health insurance can also be deducted if it offers a basic coverage comparable to domestic insurance and the insurer meets certain criteria (e.g., based in the EU/EEA).
