Insurance: how pensioners can get cheap health insurance

Some married civil servants or became self-employed, raised children, and then returned to work as employees. Others spent more time abroad, sometimes as private freelancers, sometimes without any health insurance, and now, in retirement, often just months away from making the jump to cheap health insurance for pensioners (KVdR).

There are plenty of people with gaps in their employment history, as Stefan Schemm, a health insurance expert at the Bavarian Consumer Center, reports. Those affected usually have to take out voluntary or private health insurance for a lot of money.

Some retirees with young people could perhaps still enter the KVdR. It can even work retrospectively. The more children, the greater the opportunity to save. Only the loophole is largely unknown. Records do not automatically generate any enhancements.

Seniors can benefit from having retiree health insurance.  For this, certain conditions must be met.

Seniors can benefit from having retiree health insurance. For this, certain conditions must be met. | Image: Stephan Scheuer, dpa

Why don’t all retirees join the KVdR?

When they retire, many working people often hear for the first time about the next hurdle to overcome: Only those who have had at least 90 percent of their working life with a statutory health insurance fund or have co-insurance can also take affordable compulsory insurance in retirement the KVdR. This is not a separate health insurance fund, but an insurance status that is offered by all statutory health insurance companies. The KVdR is a good thing for retirees.

Who enters saves a lot of money. The pre-insurance period is calculated on the exact day. It begins on the first business day and ends on the day the pension application is made. Intermediate calendar days are counted and then divided. The second half of working life is relevant, in which 90 percent of the time it was necessary to be legally insured. Sometimes it is only a few days, a few months, often a few years to enter the KVdR. If you don’t, your only option in old age is voluntary or private insurance.

how to enter

If you’ve been with a public health insurance company continuously in your professional life, you can easily overcome the barrier to entry, also known as the 9/10 rule. It does not matter if someone was insured compulsorily, jointly or voluntarily. As soon as larger gaps in working life open up, the necessary insurance periods do not come together. This applies, for example, to citizens who did not have any private health insurance or who had private health insurance for a while, for example as self-employed, self-employed or during a stay abroad.

Women on a mini-pension, with a civil servant as a spouse, as well as those with reduced earning capacity or early retirement, often miss out on the jump to the KVdR. That can be very expensive. Voluntary policyholders have the disadvantage of having to pay the full contribution burden on company pensions from the first euro, on maintenance payments for ex-partners or on rental income and capital goods, as highlighted by the pension consultant from Berlin Anke Voss.

Even the income of a spouse with private health insurance counts. Anyone who wants to have cheap health insurance with the KVdR in retirement should set the course for this at an early age, if possible before the age of 40.

Anyone who can and wants to switch to the KVdR must become active.

Anyone who can and wants to switch to the KVdR must become active. | Image: Maurizio Gambarini, dpa

How can children help?

Retirees with children who have been denied access to the KVdR can have their own case examined, explains pension adviser Voss. Because: Since August 1, 2017, since the reform of the Medicines and AIDS Law, a little-known opportunity for change has arisen. Since then, not only the days that are necessary for the KVdR status are counted.

The multitude of children also counts. A three-year flat fee is credited for each child, whether biological, stepchild, or adopted child. Any parent can request this. It doesn’t matter who raised the children. Important: This savings opportunity applies not only to new retirees, but also to long-retired seniors. For example, if a mother of three has voluntary health insurance when she is older because she had eight years of insurance left when she retires, she is more likely to enter the KVdR later.

That I have to do?

Health insurance companies only recalculate upon request. In the case of existing pensioners, they are not required to verify and accredit childcare periods themselves. Schemm explains that the easiest way to apply is to go to the health insurer you were last insured with. Anyone who writes an informal letter and immediately attaches copies of their children’s birth certificates is doing everything right. If the register has a branch, the request can also be made there. Previous insurance periods for the KVdR are checked again and, if possible, corrected. The insurance obligation can be modified retrospectively. If you pay too much, you get a refund.

In general, nothing changes automatically. If you want to save, you have to actively take care of it. Pension advisers or experts from the VdK social association offer assistance, among other things. An example from the VdK Bayern council: a pensioner with voluntary health insurance and a father of four children can now save 300 euros in contributions per month. The former self-employed worker had not overcome the KVdR hurdle before he retired. The crowd of children eventually turned out to be a gateway to cheaper insurance.

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Is it always worth the change?

Voss emphasizes that not all seniors can make the switch smoothly. In principle, pensioners with private health insurance can also consult the accreditation options for children. However, whether a change to the KVdR makes sense for them depends on many circumstances, not just the 9/10 rule.

A switch can be economically disadvantageous if people with private insurance receive a pension from the company, Voss warns. Because those who are compulsorily insured have to pay the full health insurance fee on this income – with the exception of an exempt amount – but not those who have private insurance, a change must be calculated well. “Most of the time it just isn’t worth making the switch to,” says Voss. Anyone who needs expert support can contact the VdK social association, a consumer advice center or a pension adviser at

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