Health Insurance for Retirees in Germany

Retiring in Germany means access to world-class healthcare, vibrant cities, and a high quality of life.
But one crucial step is securing the right health insurance.

Whether you plan to live in Germany full-time or split your time between countries, understanding your insurance options is essential. Costs and coverage depend on your work history, retirement status, and whether you choose public or private insurance.

Germany’s healthcare system is accessible and efficient, but the rules can be tricky for retirees.
This guide covers:

Public vs. private health insurance for retirees
How retirement and work history affect your options
Moving from the EU, UK, Switzerland, or abroad
Special rules for pensioners, parents, and voluntary members
How to estimate your health insurance costs

By the end, you’ll know exactly how to secure coverage for your retirement in Germany.

Health Insurance for retirees: The basics

Germany’s healthcare system provides excellent care, characterized by short wait times and low out-of-pocket expenses. Health insurance is mandatory, so you’ll need it once you settle here.

There are two main options:

Public health insurance (Gesetzliche Krankenversicherung, GKV)
Private health insurance (Private Krankenversicherung, PKV)

Public vs. Private Health Insurance

If you move to Germany and work before retiring, you may need to join GKV if you earn under €73,800 per year (2025 threshold).

Joining the public health insurance after moving can be complicated if you don’t meet this condition.

Rules vary based on your insurance history, and there are many edge cases. It’s best to consult an expert to determine the most suitable solution for your specific situation.

Once enrolled in the GKV for 12 months, you can switch to a different public insurance provider if you prefer. [link to how to change insurance company post]

If you earn more than €73,800, you have more flexibility.

You can either stay with public insurance or choose a private health insurance plan. This choice also applies to civil servants and self-employed individuals, though the thresholds differ:

Self-employed: €30,000 income threshold (or €45,000 if over age 50).
Civil servants: Can join private insurance regardless of income. Private insurance is often the preferred option for civil servants due to additional benefits.

There are several differences between private and public, including cost, coverage, and access to specialists.

Moving to Germany from the EU/EEA, UK, or Switzerland

If you move to Germany from another EU/EEA country, the UK, or Switzerland, and you were part of a statutory (public) health insurance scheme, you can usually keep your home country’s insurance.

However, if you plan to stay in Germany long-term, such as for retirement, you’ll need to submit Form S1 to a German statutory health insurance fund. The S1 form transfers your health insurance rights to Germany.

Once processed, the German fund covers your medical expenses and seeks reimbursement from your original insurance provider.

For short-term stays, you can use the European Health Insurance Card (EHIC); however, the S1 form is required for long-term stays.

If you have private health insurance from your country of origin, your situation is different.

You will likely need to pay for your medical treatments upfront in Germany and request reimbursement from your private insurer afterward.

However, not all private plans cover care abroad or meet German residency requirements.

International private insurance often does, but it’s essential to review your plan’s terms carefully before relocating (or ask your current insurer directly).

Learn more about how German health insurance works.

Basic Coverage Option: Basistarif

If you are declined from private plans and cannot join public health insurance, Germany offers a basic tariff plan (Basistarif) as a safety net. However, getting into the Basistarif isn’t simple:

You must already hold a valid German residence permit that is valid for over one year.
It is mainly available to those who are not mandatorily insured or who previously held private insurance.

Eligible groups include:

Voluntarily insured individuals (e.g., employees earning more than €73,400): Must apply for the Basistarif within six months of becoming voluntarily insured.
Private health insurance holders from before 2009: Can switch after turning 56, receiving a pension, or collecting social benefits.
Current private insurance holders (after 2009): Can switch at any time.

Note: The application process can take several months, and insurers often prioritize other applications. Feather cannot assist with Basistarif applications; you must apply directly through the insurance provider.

Pensioners’ health insurance in Germany

Once you retire, your health insurance options change.

You may become eligible for Krankenversicherung der Rentner (KVdR) status, also known as pensioners’ health insurance. KVdR isn’t a separate insurance plan; it’s a special status that affects how your contributions are calculated.

Health insurance costs under KVdR tend to be lower. This is because:

Your retirement income is usually lower than your working income.
Germany’s pension insurance fund automatically covers half of your health insurance contributions, similar to how employers share contributions for employees.

However, KVdR status is primarily available to those who worked in Germany before retirement.

If you move to Germany from a non-EU country as a retiree, you must usually enroll as a voluntary member in the public health system. In that case, you will be paying the full cost, and not be awarded the KVdR status.

Requirements for KVdR Status

To qualify for KVdR, you must meet both of these conditions:

You are receiving (or have applied to receive) a pension from Germany’s statutory pension scheme.
You had public health insurance coverage for at least 9/10 of the second half of your working life (commonly known as the 9/10 rule).

Here’s how the 9/10 rule works:

Calculate the total years you worked, from your career start to retirement.
Divide that number by two to find the “second half” of your working life.
You must have had public health insurance for at least 90% of this second half.

For example, let’s say you started working at 18 and retired at 60, giving you 42 years of work.

Half of 42 is 21.
To qualify, you need public health coverage for at least 18.9 years during the second half of your career.

Special Considerations for Parents

If you have children, you can add 3 bonus years per child to your public insurance period. This makes it easier to meet the 9/10 requirement.

For example, let’s say you worked for 22 years and have 2 children:

Half of 22 is 11 years.
You only had public insurance for 9 years.
With 6 bonus years for your children, your total rises to 15 years—enough to meet the rule.

This adjustment benefits retirees who took time off to care for their children.

What if you don’t qualify for KVdR?

If you don’t meet the KVdR requirements, you still have two options:

1. Voluntary membership in public health insurance

While it is technically possible to voluntarily enroll in the public system (GKV), retirees should be aware of important restrictions—especially if you are over 55 years old. Rejoining or joining the GKV after 55 is generally very difficult, unless you meet specific exceptions (such as having had prior coverage or being covered through a family member). In many cases, retirees over this age may not be eligible for voluntary membership at all.

If you are eligible, here are key details:

You pay the full contribution rate yourself, which is 14.6% of your income.
You may apply for a 50% subsidy from your pension insurance provider to offset costs.
Contributions are based on your total worldwide income, not just your pension. This includes:
- Rental income
- Investment income
- Income from businesses, farms, or shareholdings

Additionally, you must pay:

Long-term nursing care insurance: 4% of income if childless, 3.4% if you have children
Additional health contribution: Around 1.9% (varies by insurer)