How to correctly enter health insurance in your tax return and make use of savings opportunities
27.05.25
6
Minutes
Katrin Straub
Managing Director at nextsure
Many taxpayers ask themselves: where should I enter health insurance on my tax return? Correctly declaring your health insurance contributions can reduce your tax bill. Find out here how to do it and what to bear in mind.
The topic in brief and concise terms
Contributions to health and long-term care insurance for basic cover are generally deductible in full as special expenses in the Anlage Vorsorgeaufwand.
For other deductible personal insurance expenses (including optional benefits from health insurance), maximum amounts of €1,900 (employees) and €2,800 (self-employed) apply.
Insurers transmit data electronically, but you are still required to provide the correct information in your tax return.
Making health insurance contributions tax-deductible: understanding the basics
Contributions to health and long-term care insurance are deductible in the tax return as special expenses. This applies both to basic cover and, in some cases, to optional benefits beyond that. Since the Citizens' Relief Act in 2010, policyholders have been able to claim their contributions to statutory or private health insurance for tax purposes. The basic cover portion of health and long-term care insurance contributions can be claimed in full. The tax office deducts a flat rate of four per cent for statutory insured persons to account for any possible entitlement to sickness benefit. For privately insured persons, the deduction is limited to the contribution that would be incurred for basic cover. Correctly declaring your insurance contributions can reduce your tax burden by several hundred euros. These rules are anchored in section 10 of the Income Tax Act. Accurate entry is therefore the first step towards saving tax.
Schedule for provision expenses: The central place for your health insurance contributions
The main place to enter your health insurance in your tax return is the Vorsorgeaufwand schedule. Both statutory and private health and long-term care insurance contributions are recorded here. For those insured under the statutory scheme, lines 12 to 22 are relevant, depending on whether they are compulsorily insured or voluntarily insured. Policyholders with private insurance enter their contributions in lines 24 to 30. The insurance companies usually transmit the relevant data electronically to the tax office, but the correct declaration in your return is still necessary. Contributions for children are also declared in the Vorsorgeaufwand schedule or in the Kind schedule (line 31 for basic contributions). The exact line labels may vary slightly depending on the tax year; for 2023 these are the usual sections. A look at the current tax return instructions helps if anything is unclear. The Vorsorgeaufwand schedule is therefore the key to the tax treatment of your healthcare expenses.
Statutorily insured persons: How to enter your contributions correctly
As an employee with statutory insurance, you can find the relevant data for your tax return on your wage tax certificate. The amounts shown there under number 25 (employee contribution to statutory health insurance) and number 26 (employee contribution to social long-term care insurance) are the key figures. These sums are transferred to the corresponding lines of the Vorsorgeaufwand appendix. Your share of the supplementary contribution to your health insurance fund is already included here and is also taken into account for tax purposes. The average supplementary contribution was 1.7 per cent in 2024 and will rise to an average of 2.5 per cent for 2025. It is important to note the flat-rate deduction of four per cent for sickness benefit, which the tax office applies automatically if you are entitled to it. Pensioners can take the deductible contributions from their pension notice. Correct transfer of these figures secures you the maximum tax savings. For further details on deductibility, please read our article on the deductibility of insurance. Accurate documentation is crucial here for success.
Privately insured: Special considerations when entering your health insurance details
People with private insurance should note that only the portion of the contributions that corresponds to the level of statutory basic cover is tax-deductible. Your insurer will inform you annually of the amount of these deductible contributions; this certificate is important for your records. Enter these amounts in lines 24 onwards of the Vorsorgeaufwand schedule. Contributions for optional benefits, such as treatment by the chief physician or a single room, can only be deducted additionally if the maximum amount for other precautionary expenses has not yet been used up by basic health and long-term care insurance. The maximum amount is EUR 1,900 per year for employees and civil servants and EUR 2,800 for self-employed people. Contributions to private health insurance for pensioners follow similar principles. The exact breakdown provided by your insurer is worth its weight in gold here.
The following points are central for people with private insurance:
Only basic cover is fully deductible.
Insurer certifies deductible portions.
Enter in the Vorsorgeaufwand schedule (lines 24 onwards).
Optional benefits are deductible only if there is remaining maximum amount.
Observe the maximum amounts (EUR 1,900 / EUR 2,800).
Knowing these details helps avoid mistakes.
Maximum amounts and what happens if they are exceeded
There are maximum limits for other provision expenses, which also include contributions for optional health insurance benefits or other insurance such as liability or accident insurance. This is set at EUR 1,900 for employees, civil servants and pensioners who receive subsidies towards their health insurance. For the self-employed, who bear their contributions in full themselves, the maximum is EUR 2,800. The good news is: contributions to basic health insurance and statutory long-term care insurance are always recognised in full, even if they exceed these maximum limits. If the maximum limits have already been used up by basic cover, no further other provision expenses (e.g. for optional benefits or an accident insurance) can be claimed. A careful review of your own situation is therefore essential. This ensures that all deductible items are taken into account.
Children and health insurance: how parents can benefit for tax purposes
Parents can also claim the health and long-term care insurance contributions for their children for tax purposes. The prerequisite is that they are entitled to child benefit or the child allowance for the child. Enter the contributions for the child's basic cover in line 31 of the supplementary child form (Anlage Kind). Contributions for optional benefits or international health insurance for the child belong in line 37 of Anlage Kind and are taken into account as part of other pension expenses. Our expert tip: Even if your child is already over 25, but is still in education and you remain the policyholder and pay the contributions, these may in some circumstances be deductible if there is no longer any separate entitlement to child benefit. This must be checked on a case-by-case basis. The international health insurance can be considered separately here. The correct allocation of the contributions is crucial for tax recognition.
Contributions to a foreign health insurance policy can be claimed in a German tax return under certain conditions. It is important that the foreign policy provides benefits comparable to a domestic policy for basic cover. In addition, the insurance company must be established in an EU or EEA country or hold a business licence for Germany. The contributions are then also entered in the Anlage Vorsorgeaufwand. A ruling by the Federal Fiscal Court (BFH) of 14 December 2022 (X R 25/21) clarified that this also applies to insurance policies even if no tax-reducing allowance is granted in the respective country; however, pension expenses connected with income from certain third countries are excluded. Different rules apply to a direct insurance policy or contributions to retirement provision. International comparability is the key point here.
Please note the following for foreign insurance policies:
Comparability of basic cover.
Insurer established in the EU/EEA or business licence in Germany.
Entry in Anlage Vorsorgeaufwand.
Take note of current case law (BFH X R 25/21).
No tax relief abroad as a requirement.
These points help you to correctly declare cross-border contributions as well.
Expert depth: provisions, rulings and drafting tips
The central legal basis for the deduction of health insurance contributions is Section 10(1) No. 3 of the Income Tax Act (EStG). This provision governs the deductibility of retirement provision expenses. The Citizen Relief Act brought about the decisive expansion of deduction options in 2010, in particular for basic cover. Current rulings, such as the BFH judgment on foreign insurance policies already mentioned (X R 25/21), further clarify how it is applied. Our expert tip: Check whether a clever contract structure for private supplementary insurance, such as a unit-linked pension policy with health components, can bring tax advantages without jeopardising basic cover. Premium refunds reduce deductible special expenses in the year of payment. Careful planning and documentation of all contributions and refunds are essential to optimise your tax return. Knowledge of the legal foundations creates certainty when preparing your tax return.
Conclusion and your next step towards an optimised tax return
The correct declaration of your health insurance contributions in your tax return is an important lever for reducing your tax burden. The Vorsorgeaufwand annex is the central form here. For basic cover, you can usually claim your contributions in full. There are differences between those insured under the statutory system and those with private insurance, particularly in relation to optional benefits and the applicable maximum amounts of EUR 1,900 and EUR 2,800 respectively. Contributions for children and, in some cases, foreign insurance policies are also tax-deductible. A precise understanding of the rules and careful documentation are essential. Use the information and examples in this article to prepare your next tax return in the best possible way. Request an individual risk analysis now: Have your insurance situation checked free of charge and receive concrete recommendations for optimisation.
More useful links
The Federal Ministry of Finance (BMF) provides a circular on data exchange between private health and long-term care insurance, the tax administration and employers in the income tax withholding procedure.
The Federal Statistical Office (Destatis) offers comprehensive information on healthcare expenditure in Germany.
The NRW tax office provides information on the tax treatment of contributions to health and long-term care insurance that have been assumed.
The Association of Private Health Insurance (PKV) explains its position on the draft of a BMF circular concerning data exchange between PKV companies, the tax administration and employers.
FAQ
Which form do I need for health insurance on my tax return?
You need the Vorsorgeaufwand annex. All contributions to health and long-term care insurance, as well as other precautionary expenses, are entered here.
What is the difference between basic cover and optional benefits for tax deductions?
Contributions to basic cover (comparable to benefits under the statutory health insurance scheme) are fully deductible. Contributions for optional benefits (e.g. consultant physician) only if the maximum amount for other precautionary expenses has not yet been exhausted.
Do I need to submit proof of my health insurance contributions?
As a rule, your insurer transmits the data electronically to the tax office (eDaten). However, you should keep your insurer’s certificate for your records and enter the figures correctly in your tax return.
What happens if my contributions to basic health insurance exceed the maximum amount of €1,900?
Contributions to basic health and long-term care insurance are also recognised in full. The maximum amount of EUR 1,900 (or EUR 2,800 for self-employed persons) refers to other precautionary expenses, which only apply once this amount has not already been reached through basic cover.
I am retired, where do I enter my health insurance?
Even as a pensioner, you enter your health insurance contributions in the supplementary expenses annex. You can usually find the data in your pension notice or in the notification from your health insurance provider.
Can I also deduct contributions for overseas health insurance?
Yes, under certain conditions, contributions to overseas health insurance can also be deducted if it provides basic cover comparable to domestic insurance and the insurer meets certain criteria (e.g. being based in the EU/EEA).
