Pensioners Health Insurance Fund
This Pensioners health insurance fund (KVdR) is a compulsory insurance scheme. It provides health insurance cover for pensioners and claimants of a pension who were registered members of a statutory health insurance fund for a certain length of time (known as the standard qualifying period - Vorversicherungszeit).
As a rule, you have satisfied the standard qualifying period, if you were a member of a statutory health insurance fund or were covered by family insurance for at least nine tenths of the second half of your working life. In this regard it is irrelevant whether you were a voluntarily or a compulsory member of the fund. In case of survivors pensions, the standard insurance period may also be satisfied by the deceased.
Start of KVdR
As a rule, KVdR begins at the date you submit your pension claim. You can submit the pension claim in writing or make it by appearing in person at your pension insurance institution or another government office, such as the public insurance department or local government office.
No liability to KVdR
If for some other reason, based on employment for example, you are liable to pay compulsory health insurance contributions, there is no liability to KVdR during this period. It will only take effect as soon as this other compulsory health insurance ends.
KVdR does not take effect if you are exempt from making contributions to health care insurance for some other reason such as having civil servant status (Beamter), being a beneficiary of a superannuation for civil servants or because of an employment with a salary that is above the annual earnings threshold fixed by the statutory health insurance. KVdR will only come into effect when your exemption from paying health care insurance contributions comes to an end
Contributions to KVdR
Contributions to KVdR must be deducted from the pension. This also applies if the liability to pay compulsory health insurance contributions is established by other regulations (by reason of employment for example). If you have other income such as a superannuation or earnings from a self-employment, this income will also be subject to compulsory health insurance contributions. If you are receiving more than one pension from the statutory pension insurance system, such as an old-age pension and a widows or widowers pension, all these pensions will be subject to compulsory health insurance contributions. In addition, pensions paid from abroad are subject to KVdR. If you are in receipt of a foreign pension, you must inform your health insurance fund to this regard.
The pension insurance institution pays a supplement towards the health care insurance contributions, which are deducted from the pension. Until to 28.02.2015 the nation wide standardised contribution amount will be 15.5% and with effect from 01.03.2015 14.6 % of the pension amount. In addition, a possible extra premium may be charged by the different health insurance funds. Until 28.02.2015 the pensioners will pay 8.2% of the contributions to the health insurance fund and with effect from 01.03.2015 7.3 % in addition to a possible extra premium charged by the health insurance fund. The remaining contribution amount of 7.3% is paid by the pension insurance institution.
Supplement to the voluntary or private health insurance
If you are a pensioner not covered by compulsory health insurance, but are insured voluntarily in the statutory system or under a private plan, you are entitled upon application to receive a supplement from your pension insurance institution in respect of your health insurance contributions.
Pensioners in Germany
Pensioners who are in receipt of a German pension and reside in Germany are subject to the German legal regulations regarding health care and long-term care insurance.
German pensioners health insurance (KVdR) is a compulsory insurance scheme, but only if a standard qualifying period in the statutory health care insurance system has been completed.
Pensioners who are not covered by this compulsory insurance, may, however, upon application be eligible for a supplement towards their voluntary or private health care insurance provided this is subject to the control of the German supervisory authorities or the supervisory authorities of a Member State.
Pensioners resident abroad
Compulsory health care insurance
Pensioners who receive a German pension and who reside abroad are not, as a rule, obligated to make contributions to German health and long-term care insurance.
Exceptions exist with regard to the relations to those foreign states with which Germany has certain statutory health care insurance agreements established under international regulations. These international regulations include the European Law and the agreements concluded with Bosnia-Herzegovina, Kosovo, Macedonia, Montenegro, Serbia, Turkey, and Tunisia.
Persons who are subject to insurance in the German health care insurance system because they are in receipt of a German pension, and who relocate their place of residence to another Member State or one of the aforementioned Contracting States, remain insured with the particular German health care insurance fund. When resident in another Member State, the particular person also remains insured under the long-term care insurance. The pensioner will not receive any additional insurance cover in the new State of residence.
In such cases the pensioner will receive benefits from the health care system of his or her new State of residence, which are paid by the relevant German health insurance fund.
A condition of this is, however, that a pension is received only from the German pension insurance system and that there is no entitlement to any benefits in the new state of residence by reason of illness (through an employment, for example).
The decision as to whether a pensioner is liable to pay contributions to the German health and long-term care insurance funds will be taken by the relevant health/long-term care insurance fund. More information on compulsory health care insurance for pensioners and long-term care insurance can be found in “Meine Krankenversicherung bei Wohnort im Ausland” published by the German liaison office for health care insurance overseas.
Supplement towards a voluntary or private health care insurance fund
Persons resident abroad normally do not receive any supplement towards a voluntary or private health care insurance plan. There are also exceptions to this rule for the States with which Germany has international agreements. When resident in
the Member States or
Australia, Bosnia-Herzegovina, Brasilia, Canada and Quebec, Chile, Israel, Japan, Macedonia, Kosovo, Montenegro, Morocco, the Republic of Korea, Serbia, Tunisia, Turkey, and the USA,
it is possible to make an application for Germans or citizens of that particular State to receive a supplement towards their voluntary or private health care insurance fund, provided the fund is subject to the control of the German supervisory authorities or the supervisory authorities of a Member State. Pensioners, whose pensions start after 30.4.2007 are not entitled to receive the supplement if they are liable to pay insurance contributions to a domestic or foreign statutory health care insurance fund.
Long-term care insurance for pensioners (PVdR – Pflegeversicherung der Rentner)
If the conditions for entitlement to KVdR are satisfied, there will also be an obligation to pay contributions to the long-term care insurance fund, even if KVdR is excluded on the grounds that you, as a pensioner, are a voluntary member of a statutory health care insurance fund. The deduction at source and payment of contributions to the long-term care insurance fund is regulated by the same principles as contributions made to health care insurance (KVdR). What differs is that, from 1.4.2004, contributions to the long-term care insurance must be paid in full from the pension by the pensioner. For long-term care insurance the contribution rate has been 2.05 % since 01.01.2013. For insured persons who have or had no children, a contribution surcharge of 0.25 % will be levied. The contribution rate then increases to 2.03 %. People under the age of 23 or who were born before 1 January 1940 are not subject to the payment of the surcharge. The 0.25 % contribution surcharge is not payable if you can prove parenthood to the pension insurance institution.