🩺 Health and long-term care insurance for pensioners (KVdR)

Pensioners are often compulsorily insured in the health insurance for pensioners (Krankenversicherung der Rentner, KVdR). The pension insurance pays half of the contribution.

KVdR health insurance for pensioners 9/10 rule additional contribution long-term care insurance occupational pension contribution allowance 197.75

In brief

If you receive a pension and were in statutory health insurance for long enough, you are compulsorily insured in the health insurance for pensioners (KVdR). The rule of thumb: in the second half of your working life you had to be in statutory health insurance for at least nine tenths of the time (9/10 rule).

The contribution is deducted from your pension. The pension insurance pays half of the general contribution.

Pensioners bear the long-term care insurance contribution alone; the pension insurance pays no share. People without children pay a surcharge of 0.6 percentage points in 2026 (4.2 percent of the gross pension in total).

Occupational pensions are also subject to contributions, but an allowance applies: in 2026 it is 197.75 euros per month.

Step by step

Clarify your insurance statusAsk your health insurance fund whether you are a compulsory KVdR member.
Check the contribution deduction in the pension noticeHealth and long-term care insurance are shown there as deductions.
Know your fund's additional contributionIt differs from fund to fund and can change.
Report your occupational pensionReport occupational pensions to the fund so that the allowance is taken into account correctly.

Deadlines

9/10

Prior insurance period: member or family-insured for at least nine tenths of the second half of the period from first gainful employment until the pension application§ 5 Abs. 1 Nr. 11 SGB V

€197.75/month

Allowance for pension-like benefits (occupational pension) in the KVdR 2026; 1/20 of the reference value of €3,955§ 226 Abs. 2 SGB V; secondary source

14.6 % + additional contribution

general contribution rate plus average additional contribution of 2.9 % (2026); the DRV pays half of eachHealth fund and association sources, not checked against the full text

Watch out – common mistakes

If you do not meet the 9/10 rule, you are not in the KVdR but possibly voluntarily insured and pay contributions on all income.
The allowance of 197.75 euros applies only to compulsorily insured KVdR members, not to voluntarily insured people, and not in long-term care insurance (where an exemption limit applies).
Contribution rates, additional contribution and long-term care insurance (3.6 % general) come from secondary sources. Check with the carrier.
Long-term care insurance: reductions (for example for parents of several children) were not checked.

In depth · legal basis, figures and practice – for advisers and professionals

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

Compulsorily insured are people who meet the requirements for receiving a pension and have applied for the pension, if from the first taking up of gainful employment until the application for the pension they were a member or family-insured under § 10 for at least nine tenths of the second half of this period.

Amount of contribution

According to association and health fund information: general contribution rate 14.6 percent, average additional contribution 2.9 percent (2026), the pension insurance bears half of both. The fund-specific additional contribution may differ. Long-term care insurance 3.6 percent of the gross pension, general rate (secondary source; § 249a SGB V and § 55 SGB XI not checked against the full text).

Pensioners bear the long-term care insurance contribution alone (no employer-type share from the DRV). People without children pay a surcharge of 0.6 percentage points in 2026, 4.2 percent of the gross pension in total.

Pension-like benefits

Occupational pensions are subject to contributions. According to secondary sources: allowance under § 226 Abs. 2 Satz 2 SGB V in 2026 of 1/20 of the monthly reference value (3,955 €), i.e. 197.75 €.

Not checked against the full text

Family insurance of spouses, contribution liability of other income (rent, capital), contribution assessment ceiling.

Who is responsible

Health insurance fund (Krankenkasse)
Long-term care insurance fund (Pflegekasse)
Deutsche Rentenversicherung (contribution deduction)

Quick questions

Worum geht es bei „Health and long-term care insurance for pensioners (KVdR)“?

Pensioners are often compulsorily insured in the health insurance for pensioners (Krankenversicherung der Rentner, KVdR). The pension insurance pays half of the contribution.

Which deadlines and figures matter?

9/10: Prior insurance period: member or family-insured for at least nine tenths of the second half of the period from first gainful employment until the pension application (§ 5 Abs. 1 Nr. 11 SGB V)
€197.75/month: Allowance for pension-like benefits (occupational pension) in the KVdR 2026; 1/20 of the reference value of €3,955 (§ 226 Abs. 2 SGB V; secondary source)
14.6 % + additional contribution: general contribution rate plus average additional contribution of 2.9 % (2026); the DRV pays half of each (Health fund and association sources, not checked against the full text)

What should I do first?

Clarify your insurance status: Ask your health insurance fund whether you are a compulsory KVdR member.
Check the contribution deduction in the pension notice: Health and long-term care insurance are shown there as deductions.
Know your fund's additional contribution: It differs from fund to fund and can change.

What do I need to watch out for?

If you do not meet the 9/10 rule, you are not in the KVdR but possibly voluntarily insured and pay contributions on all income.
The allowance of 197.75 euros applies only to compulsorily insured KVdR members, not to voluntarily insured people, and not in long-term care insurance (where an exemption limit applies).
Contribution rates, additional contribution and long-term care insurance (3.6 % general) come from secondary sources. Check with the carrier.

Evidence

§ 5 SGB V, gesetze-im-internet.de, retrieved 21 September 2026
Bundesregierung, Beitragsbemessungsgrenzen 2026 (search hit, full text not retrieved), retrieved 21 September 2026
Health fund and association sources on the allowance under § 226 SGB V (search-result summary), retrieved 21 September 2026

As of

September 2026 · Sources and method

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