Private disability insurance and health insurance: When contributions are due and how to optimise your finances
13 May 2025
5
Minutes
Katrin Straub
CEO at nextsure
Many people wonder: Does a private disability insurance pension count as income for health insurance? The answer is not always straightforward and depends on your individual situation. This article sheds light on the details and provides you with clear recommendations for action.
The topic in brief and concise terms
Whether a private occupational disability pension is considered as income by the health insurance depends on the insurance status (compulsorily or voluntarily insured in the statutory health insurance) and the receipt of a statutory reduced earning capacity pension.
Voluntarily insured individuals under the statutory health insurance typically pay the full health and nursing insurance contributions (both employee and employer share) on their private occupational disability pension.
Compulsory insured persons in the KVdR (often while simultaneously receiving a statutory disability pension) usually do not pay contributions on the private occupational disability pension.
Understanding Health Insurance Contributions on Private Disability Pensions: The Basics
The question of whether a private occupational disability pension (BU-Rente) counts as income for health insurance is a concern for many policyholders. In principle, recipients of an occupational disability pension must also pay contributions to health and long-term care insurance, as health insurance is mandatory in Germany. However, the amount of these contributions depends on several factors, particularly on whether you are privately or statutorily insured. For those in statutory health insurance, it is crucial whether they are classified as compulsory or voluntary members. This distinction has significant effects on the contribution liability of the private occupational disability pension.
For those with private health insurance (PKV), receiving an occupational disability pension generally does not change their regular contributions. These are calculated independently of income and must therefore continue to be paid in full even in case of occupational disability. Only the contribution for any available sickness daily allowance might be waived. It is advisable to calculate the occupational disability pension such that it can also cover the PKV contributions. The situation is considerably more complex for members of statutory health insurance (GKV).
Statutory Insured: Mandatory or Voluntary – A Critical Difference
For members of the statutory health insurance (GKV), the status – whether compulsorily insured or voluntarily insured – is crucial in determining whether and how the private occupational disability (BU) pension is subject to contributions. If you also receive a statutory disability pension in addition to your private BU pension and meet the conditions for the health insurance for pensioners (KVdR), particularly the so-called 9/10 rule, you remain compulsorily insured in the GKV. In this case, no health insurance contributions are due on the private BU pension. Contributions are then calculated solely based on the amount of the statutory disability pension. The 9/10 rule states that you must have been insured under the statutory scheme for at least nine-tenths of your working life in the second half of your working life.
The situation is different if you only receive a private BU pension and do not qualify for a statutory disability pension. In this scenario, you are generally classified as a voluntary member of the GKV. As a voluntary member, according to § 240 SGB V, all income used for living expenses is generally subject to contributions, including the private BU pension. You must then pay the full contribution rate (employee and employer share) on your BU pension. For the year 2025, the general contribution rate to the GKV amounts to 14.6 percent plus the additional fund-specific contribution. Contributions to long-term care insurance also apply. Careful planning of additional earnings is important here.
Contribution amount for voluntary insurance: Here's how it's calculated
Voluntary insured persons receiving occupational disability (BU) pensions under the statutory health insurance (GKV) must pay contributions on their private BU pensions for health and long-term care insurance. The assessment basis is the gross BU pension up to the contribution assessment ceiling, which in 2025 is 5,512.50 Euros per month. The general contribution rate for health insurance is 14.6 percent. Additionally, there is the average additional contribution of 2.5 percent in 2025 (the actual rate depends on your health insurance fund). As you, as a voluntarily insured person, bear both shares (employee and employer), this amounts to 17.1 percent (14.6 % + 2.5 %).
Contributions to the long-term care insurance are also due. The general rate in 2025 is 3.6 percent. Childless persons over the age of 23 pay a surcharge of 0.6 percent, bringing the total to 4.2 percent. There are reductions for those with multiple children. An example calculation: For a private BU pension of 2,000 Euros and an average additional contribution of 2.5 percent with childlessness, approximately 342 Euros for health insurance (2,000 Euros * 17.1 %) and 84 Euros for long-term care insurance (2,000 Euros * 4.2 %) are incurred. That amounts to a total of 426 Euros monthly. You should definitely take these deductions into account when determining your BU pension amount. It is also relevant whether you work despite receiving a BU pension.
Here is an overview of the typical contribution rates for voluntary insured persons (as of 2025):
General health insurance: 14.6 percent
Average additional GKV contribution: 2.5 percent
Long-term care insurance (with children/under 23 years): 3.6 percent
Long-term care insurance (childless, over 23 years): 4.2 percent (3.6 % + 0.6 % surcharge)
Reductions in long-term care insurance: 0.25 percentage points per child (from the second to the fifth child under 25 years) from the employee's share
These rates apply up to the monthly contribution assessment ceiling of 5,512.50 Euros (2025).
Special case of company disability pension and other types of income
If your occupational disability pension comes from an occupational pension scheme (bAV), for example, a direct insurance policy, it is generally fully liable for contributions to the statutory health insurance (GKV) and long-term care insurance (PV). This applies regardless of whether you are compulsorily or voluntarily insured, as such benefits are considered to be remuneration within the meaning of § 229 SGB V. An exception may exist if you have paid premium shares from taxed income yourself; there is a decision from the Federal Constitutional Court (1 BvR 1660/08) on this matter.
If you have, in addition to the private disability pension, other income, for example, from renting and leasing or from capital assets, this will also be taken into account for contribution assessment for voluntarily insured individuals. The total of all income liable for contributions is considered up to the contribution assessment ceiling. An interesting scenario may arise when a voluntarily insured disability pension recipient takes up employment subject to social security contributions, where the income exceeds the mini-job limit (556 euros from January 2025). This could lead to compulsory insurance, which would mean that the private disability pension is no longer liable for contributions. However, this is a complex individual case that requires careful examination. The combination with sickness benefits is also a special case.
Expert Depth: Legal Foundations and Relevant Judgments
The legal foundations for the obligation to contribute from disability insurance pensions are primarily found in the Fifth Book of the Social Code (SGB V). For pensioners with mandatory insurance (KVdR), § 237 SGB V is relevant, as it defines the income subject to contributions. Private disability insurance pensions are generally not included here if a statutory pension is received. For those with voluntary insurance, § 240 SGB V is decisive. This paragraph refers to the overall economic capacity. The GKV Spitzenverband has published a catalogue of incomes and their contribution-related evaluation to provide clarity.
An important ruling by the Federal Social Court (BSG, Ref. B 12 KR 16/16 R) on 10 October 2017 confirmed that private disability insurance pensions for voluntarily insured individuals are considered taxable income, as they determine economic capacity. The court denied that this is purely a depletion of capital. Our expert tip: When you receive a contribution notification, carefully examine the basis of calculation and seek expert advice if in doubt, especially regarding back payments. The taxation of disability insurance pensions is a separate topic that also deserves attention.
Key paragraphs at a glance:
§ 5 Para. 1 No. 11 SGB V: Conditions for health insurance of pensioners (KVdR), including the 9/10 rule.
§ 229 SGB V: Contribution obligation for pension benefits (e.g. occupational pension).
§ 237 SGB V: Income subject to contributions for mandatorily insured pensioners.
§ 240 SGB V: Income subject to contributions for voluntary members.
§ 18 SGB IV: Definition of reference value, important for income limits.
These regulations show how complex the matter is and why individual assessment is essential.
Recommendations for action: How to optimally secure your finances
To avoid financial surprises in the event of a claim, forward planning is crucial. When taking out your occupational disability insurance, factor in potential deductions for health and care insurance as well as taxes. The agreed disability pension should be high enough to maintain your standard of living even after these deductions. A general rule is that about seventy to eighty percent of your last net income should be covered. Regularly check the level of your cover, especially when your salary increases or your personal circumstances change.
Inform your health insurance fund immediately if you receive a private disability pension to clarify your correct insurance status and contribution amount. This is particularly important if you were previously compulsorily insured and may now be classified as a voluntary member. Our expert tip: Get advice from an independent source to analyze your individual situation and determine the optimal level of your occupational disability insurance. Early and comprehensive advice can save you a lot of trouble and financial losses later on. Also, consider the option of family insurance if the income limits permit this.
Request an individual risk analysis now: Have your insurance situation reviewed free of charge and receive specific optimization suggestions.
More useful links
Statista provides statistics on the distribution of reasons for occupational disability in Germany.
Statista illustrates the likelihood of occupational disability until the retirement age of 65.
The German Insurance Association (GDV) informs about 7 important facts regarding occupational disability insurance.
Under The Insurers, you will find information on the most common causes of occupational disability.
The German Pension Insurance explains the regulations regarding health and nursing care insurance for pensioners.
A brochure from the German Pension Insurance offers detailed information about health insurance for pensioners in PDF format.
The Stiftung Warentest provides tips on how pensioners can find affordable health insurance in old age.
FAQ
Does my private disability insurance pension count as income with the health insurance if I am voluntarily insured?
Yes, if you are voluntarily insured in the statutory health insurance (GKV), your private disability pension is generally considered contributory income. You have to pay contributions for health and long-term care insurance on it.
What happens if I receive a statutory disability pension and a private occupational disability pension?
If you receive a statutory reduced earning capacity pension and meet the requirements for health insurance for pensioners (KVdR) (especially the 9/10 rule), you are compulsorily insured. In this case, you do not pay health insurance contributions on your private occupational disability pension. The contributions are then only based on the statutory pension.
What is the contribution rate for health insurance on the disability pension for voluntary insured individuals in 2025?
For 2025, the general contribution rate is 14.6 percent. In addition, there is the individual additional contribution by the health insurance fund (on average 2.5 percent). As a voluntarily insured person, you bear both shares, which adds up to approximately 17.1 percent, plus contributions to the long-term care insurance.
Do I also have to pay health insurance contributions on a disability pension from an occupational pension scheme?
Yes, benefits from an occupational pension plan, including disability pensions, are generally subject to full contributions to health and nursing care insurance as pension benefits.
Can I be exempted from the contributions to the private disability insurance pension?
A direct exemption is not provided. The obligation to contribute depends on your insurance status. Under certain circumstances (e.g., mandatory insurance in the KVdR), no contributions are payable on the private occupational disability pension.
What should I consider about the amount of my private disability insurance pension regarding health insurance contributions?
You should take possible deductions for health and long-term care insurance (and taxes) into account when determining the pension amount, ensuring that your net disability pension is sufficient to cover your living expenses.
