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🩹 Health insurance and long-term care insurance with a reduced earning capacity pension

Whether you are compulsorily insured in statutory health insurance for pensioners depends on your prior insurance.

KVdR health insurance for pensioners (Krankenversicherung der Rentner) 9/10 reference period voluntarily insured family insurance long-term care insurance

In brief

If you apply for a reduced earning capacity pension, the health insurance fund checks whether you are compulsorily insured in the health insurance for pensioners (KVdR).

The rule: in the second half of the time since your first working life, you must have been statutorily insured for at least nine tenths (§ 5 Abs. 1 Nr. 11 SGB V). If that is not met, there are other options, for example voluntary insurance or family insurance.

Report the pension application to your health insurance fund early. Have the contribution deduction in the notice checked.

Step by step

  1. Inform the health insurance fundTell the health insurance fund that you have applied for a pension.
  2. Ask about your insurance statusAsk whether you are compulsorily insured in the KVdR.
  3. Check contributions in the noticeCheck the contribution deductions in the pension notice.

Deadlines

nine tenths of the second half
Prior insurance period for compulsory insurance as a pensioner (pension application)§ 5 Abs. 1 Nr. 11 SGB V
Watch out – common mistakes
  • Anyone already compulsorily insured as an employee is not additionally covered by the pension rules (§ 5 Abs. 8 SGB V).
  • Anyone who does not meet the prior insurance period should clarify insurance cover immediately so that no gap arises.
  • Contribution rates and additional contribution were not checked in a primary source and are not given here.
In depth · legal basis, figures and practice – for advisers and professionals

Compulsory insurance under § 5 Abs. 1 Nr. 11 SGB V

Persons are subject to compulsory insurance if they meet the requirements for entitlement to a pension from the statutory pension insurance and have applied for it, if from the first taking up of gainful work until the pension application they were a member or family-insured for at least nine tenths of the second half of this period. Under paragraph 8, compulsory insurance under Nr. 11 to 12 does not apply if compulsory insurance under Nr. 1 to 8 already exists.

Not checked

Crediting of child-raising periods towards prior insurance, contribution calculation, assumption of contributions by the pension insurance, voluntary insurance, family insurance and long-term care insurance (SGB XI) were not checked in primary sources here. Ask your health insurance fund or an advice centre.

References

Health insurance during unemployment: group Arbeitslose. KVdR in retirement age: group Rentner.

Who is responsible
  • Health insurance fund (Krankenkasse)
  • Deutsche Rentenversicherung (German pension insurance)
Further reading
Application, medical report, assessment and pension noticeTax, housing benefit, co-payment exemption and further help

Quick questions

Worum geht es bei „Health insurance and long-term care insurance with a reduced earning capacity pension“?
Whether you are compulsorily insured in statutory health insurance for pensioners depends on your prior insurance.
Which deadlines and figures matter?
nine tenths of the second half: Prior insurance period for compulsory insurance as a pensioner (pension application) (§ 5 Abs. 1 Nr. 11 SGB V)
What should I do first?
  • Inform the health insurance fund: Tell the health insurance fund that you have applied for a pension.
  • Ask about your insurance status: Ask whether you are compulsorily insured in the KVdR.
  • Check contributions in the notice: Check the contribution deductions in the pension notice.
What do I need to watch out for?
  • Anyone already compulsorily insured as an employee is not additionally covered by the pension rules (§ 5 Abs. 8 SGB V).
  • Anyone who does not meet the prior insurance period should clarify insurance cover immediately so that no gap arises.
  • Contribution rates and additional contribution were not checked in a primary source and are not given here.
Evidence
  • § 5 SGB V, gesetze-im-internet.de, retrieved 21 September 2026
  • DRV, Erwerbsminderungsrenten, retrieved 21 September 2026
As of

September 2026 · Sources and method

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