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Which health and nursing insurance contributions can I claim?
Since 2010, you can enter your full health and nursing insurance contributions for basic cover as special expenses in your tax return. The tax office deducts only four per cent for sickness benefit from the contributions paid to statutory health insurance.
For those privately insured: Costs for health and nursing insurance are only recognised up to the basic contribution of the private health insurance. Optional benefits, such as treatment by the head physician or a two-bed room in hospital, are considered under "other insurance contributions" if there is still room within the deductible maximum amount.
If you have a more comprehensive contract, the private health insurance will determine the exact share of basic cover. If you do not exceed the maximum amount of 1.900 Euro (self-employed 2.800 Euro) with your health insurance contributions, you can still claim contributions for other insurances. Favourable contributions include those for unemployment insurance, additional health or nursing insurance, private disability insurance, accident or liability insurance, or term life insurance. Endowment and pension insurance policies can be considered as special expenses if the policies were taken out before 2005.
Beispiel
A married couple pays a total of 4.600 Euro in contributions for health and nursing insurance in a year, without sickness benefit. This means the contributions exceed the joint maximum amount of 3.800 Euro (twice 1.900 Euro). Nevertheless, they are deductible as special expenses to this extent, but further insurance contributions, such as accident or motor liability insurance, can no longer be deducted.
As the general contribution rate for those with statutory insurance covers sickness benefit, the contributions are reduced by 4% as a lump sum. The reduction only applies if there is an entitlement to sickness benefit in the event of illness. The reduction is made by the tax office. Until 2014, the reduction did not apply to the income-independent additional contribution. Since 2015, the following legal situation applies: The newly designed fund-specific income-dependent additional contribution is now considered an integral part of the health insurance contribution and is therefore included in the assessment basis for determining the four per cent reduction amount. The contribution is no longer differentiated into a basic contribution and the additional contribution.
(2021): Which health and nursing insurance contributions can I claim?
Should contributions to foreign health insurance also be declared in the tax return?
It is not necessary for the subsidised health insurance to be German.
Subsidised "pension contributions" also include contributions to foreign statutory pension insurance providers (§ 10 para. 2 no. 2c EStG).
Contributions to "other insurance" from foreign companies can also be deducted (provided there is still room within the maximum insurance amount). However, the company must have its registered office or management in an EU or EEA country or have permission to operate in Germany (§ 10 para. 2 no. 2a EStG).
In principle: If the social security contributions paid abroad are economically related to tax-free income, they cannot be deducted as special expenses in Germany. This is the case if the wages earned abroad are tax-free in Germany and are only included in the progression clause (§ 10 para. 2 no. 1 EStG).
However: Since 2019, a legal regulation has been introduced for improved deduction of special expenses for contributions paid in EU/EEA countries to statutory pension, health, nursing care and unemployment insurance (§ 10 para. 2 no. 1 EStG, amended by the "Act to Avoid VAT Losses in the Trade of Goods on the Internet and to Amend Other Tax Regulations").
The new regulation applies to all open tax cases (§ 52 para. 18 sentence 4 EStG).
According to this: Pension expenses are now deductible as special expenses in the German tax return, provided that
- they are directly economically related to income from employment in a member state of the European Union or a contracting state of the European Economic Area,
- this income is tax-free in Germany under a double taxation agreement, and
- the country of employment does not allow any tax consideration of pension expenses in the taxation of this income.
This regulation applies to basic pension expenses (§ 10 para. 1 no. 2 EStG), contributions to basic health insurance and statutory nursing care insurance (§ 10 para. 1 no. 3 EStG) as well as to other pension expenses (§ 10 para. 1 no. 3a EStG).
(2021): Should contributions to foreign health insurance also be declared in the tax return?
