Private disability pension and health insurance: When contributions are due and how you can optimise your finances
13.05.25
10
Minutes
Katrin Straub
Managing Director at nextsure
Many people ask themselves: Does a private occupational disability pension count as income for health insurance purposes? The answer is not always straightforward and depends on your individual situation. This article explores the details and gives you clear recommendations for action.
The topic in brief and concise terms
Whether a private occupational disability pension counts as income for health insurance purposes depends on your insurance status (compulsorily insured or voluntarily insured in statutory health insurance) and on whether you receive a statutory reduced earnings capacity pension.
Voluntarily insured statutory health insurance members generally pay the full health and long-term care insurance contribution on their private occupational disability pension (employee and employer shares).
Compulsorily insured members of the KVdR (often when also receiving a statutory disability pension) usually do not pay contributions on their private occupational disability pension.
Understanding health insurance contributions on private disability pensions: The basics
The question of whether a private BU pension counts as income for health insurance concerns many policyholders. As a general rule, recipients of a BU pension must also pay contributions to health and long-term care insurance, as health insurance is compulsory in Germany. However, the amount of these contributions depends on several factors, in particular whether you are covered by statutory or private health insurance. For those with statutory insurance, it is decisive whether they are classified as mandatory members or voluntary members. This distinction has a significant impact on the obligation to pay contributions on a private BU pension.
For those with private health insurance (PKV), receiving a BU pension usually does not change their regular contributions. These are calculated independently of income and therefore continue to be payable in full even in the event of occupational disability. Only the premium for any existing daily sickness allowance may cease to apply. It is advisable to calculate the amount of the BU pension accordingly so that the PKV contributions can also be covered by it. The situation is considerably more complex for members of statutory health insurance (GKV).
Statutory health insurance members: compulsory or voluntary – an important difference
For members of the statutory health insurance scheme (GKV), status – compulsory insured or voluntarily insured – is decisive as to whether, and how, the private BU pension is subject to contributions. If, in addition to your private BU pension, you receive a statutory reduced earning capacity pension and meet the requirements for the health insurance for pensioners (KVdR), in particular the so-called 9/10 rule, you remain compulsorily insured in the GKV. In this case, no health insurance contributions are payable on the private BU pension. Contributions are then calculated solely on the basis of the amount of the statutory reduced earning capacity pension. The 9/10 rule states that in the second half of your working life you must have been insured under the statutory scheme for at least nine-tenths of the time.
The situation is different if you receive only a private BU pension and no statutory reduced earning capacity pension. In this scenario, you are generally classified as a voluntary member of the GKV. As a voluntary member, under § 240 SGB V, all income used to cover living expenses is generally subject to contributions – this also includes the private BU pension. You must then pay the full contribution rate (employee and employer share) on your BU pension. For 2025, the general contribution rate for the GKV is 14.6 per cent plus the insurer-specific additional contribution. Contributions to long-term care insurance are also added. Careful planning of additional earnings is important here.
Contribution amount for voluntarily insured persons: How it is calculated
Recipients of a BU pension who are voluntarily insured under statutory health insurance must pay contributions to health and long-term care insurance on their private BU pension. The assessment basis is the gross BU pension up to the contribution assessment ceiling, which in 2025 is EUR 5,512.50 per month. The general health insurance contribution rate is 14.6 percent. In addition, there is the average supplementary contribution of 2.5 percent in 2025 (the actual rate depends on your health insurance fund). As you are liable for both shares as a voluntarily insured person (employee and employer), this adds up to 17.1 percent (14.6% + 2.5%).
Contributions to long-term care insurance are also due. The general rate is 3.6 percent in 2025. Childless people over the age of 23 pay an additional 0.6 percent, bringing the total to 4.2 percent. There are reductions for several children. An example calculation: for a private BU pension of EUR 2,000 and an average supplementary contribution of 2.5 percent, with no children, around EUR 342 is due for health insurance (EUR 2,000 * 17.1%) and EUR 84 for long-term care insurance (EUR 2,000 * 4.2%). That is a total of EUR 426 per month. You should definitely take these deductions into account when determining the amount of your BU pension. It is also relevant whether you work despite receiving a BU pension.
Here is an overview of the typical contribution rates for voluntarily insured persons (as at 2025):
Health insurance general rate: 14.6 percent
Average GKV supplementary contribution: 2.5 percent
Long-term care insurance (with children/under 23): 3.6 percent
Long-term care insurance (childless, over 23): 4.2 percent (3.6% + 0.6% surcharge)
Long-term care insurance reductions: 0.25 percentage points per child (from the second to the fifth child under 25 years of age) from the employee share
These rates apply up to the monthly contribution assessment ceiling of EUR 5,512.50 (2025).
Special case: occupational 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 subject to full contributions in statutory health insurance (GKV) and long-term care insurance (PV). This applies regardless of whether you are compulsorily insured or voluntarily insured, as such benefits are regarded as pension benefits within the meaning of Section 229 of the German Social Code Book V (SGB V). An exception may apply if you have yourself paid in premium portions from taxed income; there is a ruling by the Federal Constitutional Court on this (1 BvR 1660/08).
If, in addition to your private occupational disability pension, you have other income, for example from letting and leasing or capital assets, this is also taken into account for the assessment of contributions for voluntarily insured persons. The total of all contributory income is taken into account up to the contribution assessment ceiling. An interesting scenario may arise if a voluntarily insured person receiving an occupational disability pension takes up employment subject to social insurance contributions, the remuneration for which is above the mini-job threshold (EUR 556 from January 2025). This can result in compulsory insurance, which means that the private occupational disability pension is no longer subject to contributions. However, this is a complex individual case that needs to be examined more closely. The combination with sickness benefit is also a special case.
Expert depth: legal foundations and relevant rulings
The legal basis for the contribution obligation of occupational disability pensions can be found primarily in Book Five of the Social Code (SGB V). For pensioners covered by compulsory insurance (KVdR), Section 237 SGB V is relevant, as it defines the contributionable income. Private occupational disability pensions generally do not fall under this if a statutory pension is being received. For voluntarily insured persons, Section 240 SGB V is decisive. This provision is based on the person's entire economic capacity. The GKV-Spitzenverband has published a catalogue of income and its assessment for contribution purposes, which provides clarity.
An important ruling by the Federal Social Court (BSG, case no. B 12 KR 16/16 R) of 10 October 2017 confirmed that private occupational disability pensions are treated as income subject to contributions for voluntarily insured persons, as they determine economic capacity. The court rejected the argument that this is merely a case of consuming capital. Our expert tip: If you receive a contribution notice, check the calculation basis carefully and, if in doubt, seek expert advice, especially where retrospective payments for the past are concerned. Taxation of the occupational disability pension is a separate issue that also deserves attention.
Important sections at a glance:
Section 5(1)(11) SGB V: conditions for pensioners' health insurance (KVdR), including the 9/10 rule.
Section 229 SGB V: contribution obligation of pension benefits (e.g. occupational pension schemes).
Section 237 SGB V: contributionable income of pensioners subject to compulsory insurance.
Section 240 SGB V: contributionable income of voluntarily insured members.
Section 18 SGB IV: definition of the reference value, important for income thresholds.
These provisions show how complex the matter is and why an individual assessment is essential.
Recommendations for action: How to secure your finances optimally
To avoid financial surprises in the event of a claim, forward planning is crucial. When taking out your disability insurance, factor in the possible deductions for health and long-term care insurance as well as taxes. The agreed disability pension should be high enough to secure your standard of living even after these deductions. A rule of thumb is that around seventy to eighty per cent of your last net income should be covered. Review the level of your cover regularly, especially after salary increases or changes in personal circumstances.
Inform your health insurer immediately if you receive a private disability pension so that your correct insurance status and contribution level can be clarified. This applies in particular if you have previously been compulsorily insured and may now be classified as a voluntary member. Our expert tip: Get independent advice to analyse your individual situation and determine the optimum level of your disability insurance. Early, comprehensive advice can save you a great deal of hassle and financial loss later on. Also consider the possibility of a family insurance arrangement if the income limits allow it.
Request an individual risk analysis now: Have your insurance situation checked free of charge and receive concrete recommendations for optimisation.
More useful links
Statista provides a statistic on the distribution of the causes of occupational disability in Germany.
Statista shows the likelihood of occupational disability up to the retirement age of 65.
The German Insurance Association (GDV) provides information on 7 important facts about disability insurance.
At Die Versicherer you will find information on the most common causes of occupational disability.
The German Pension Insurance explains the rules on health and long-term care insurance for retirees.
A brochure from the German Pension Insurance provides detailed information on retirees' health insurance in PDF format.
The Stiftung Warentest offers tips on how retirees can be covered by affordable health insurance in later life.
FAQ
Does my private occupational disability pension count as income for health insurance if I am voluntarily insured?
Yes, if you are voluntarily insured under the statutory health insurance scheme (GKV), your private disability pension is generally treated as contributory income. You must pay contributions towards 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) (in particular the 9/10 rule), you are compulsorily insured. In this case, you do not pay any health insurance contributions on your private occupational disability pension. The contributions are then calculated solely on the basis of the statutory pension.
What is the health insurance contribution rate on the occupational disability pension for voluntarily insured persons in 2025?
For 2025, the general contribution rate is 14.6 per cent. In addition, there is the individual supplementary contribution set by the health insurance fund (on average 2.5 per cent). As a voluntary member, you bear both portions, so the total is around 17.1 per cent, plus long-term care insurance contributions.
Do I also have to pay health insurance contributions on a disability pension from an occupational pension scheme?
Yes, benefits from an occupational pension scheme, including disability pensions, are generally fully subject to contributions in health and long-term care insurance as pension benefits.
Can I be exempted from paying contributions towards the private disability pension?
A direct exemption is not предусмотрed. The obligation to pay contributions depends on your insurance status. Under certain circumstances (e.g. compulsory insurance in the KVdR), no contributions are payable on the private occupational disability pension.
What should I bear in mind regarding the amount of my private disability pension in relation to health insurance contributions?
You should already take the possible deductions for health and long-term care insurance (and taxes) into account when determining the pension amount, so that your net BU pension is sufficient to cover your living expenses.
