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How much does private health insurance cost in retirement?

In short

Privately insured people aged 65 and over usually pay EUR 500 to 650 a month for health cover, plus long-term care insurance. The German pension insurance adds 8.75 percent of your statutory pension, at most half the premium. With a small pension, private health insurance (PKV) can cost noticeably more in old age than public insurance.

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How much does private health insurance cost in retirement?

What it costs

Guide values for health insurance without long-term care, from published averages and maximum premiums 2026.

Example	Typical range
Average private health premium across all insured people 2026	around EUR 617 a month
Insured people aged 65 and over, average of recent years	about EUR 500 to 650 a month
Standard tariff after the 2026 adjustment, average	around EUR 480 a month, at most EUR 848.62
Basic tariff 2026	at most EUR 1,017.18 a month, half if you would otherwise need welfare
Subsidy on a EUR 2,500 German statutory pension	about EUR 219 a month

As of September 2026. The long-term care premium in retirement is a guide value from our quoting practice and depends on the tariff. Your insurer can give you a projection of your own premium in old age; we check which tariff switch is possible.

Worked example

Pensioner, 67, EUR 2,000 German statutory pension

This is how the numbers look if the tariff premium is in the usual range.

Health insurance according to tariff	EUR 650
Pension insurance subsidy (2,000 × 8.75 percent)	minus EUR 175
Statutory long-term care insurance, no subsidy	about EUR 60 to 100
For comparison: public insurance, own share on the pension	about EUR 250

In private insurance about EUR 535 to 575 a month remain, roughly twice the own share in public insurance with this pension.

Why the premium does not simply grow with your age

Private health insurance puts aside part of every premium from the start, the ageing reserve (Alterungsrückstellung). It is meant to absorb the fact that you need more treatment when you are older. So your premium does not rise because you age.

It rises because treatment gets more expensive and people live longer. Those increases also hit you as a pensioner. If you started at 35 with EUR 450, you often pay a lot more 30 years later, even though the reserve is working.

Element	Effect in retirement
Ageing reserve	softens increases, does not prevent them
10 percent surcharge (age 21 to 60)	ends at 60, the money is used from 65 to lower the premium
Sick pay (Krankentagegeld)	ends with retirement, its premium falls away
Premium relief tariff (Beitragsentlastungstarif)	lowers the premium from an agreed age if taken out early
Pension insurance subsidy	8.75 percent of the German statutory pension, capped at half the premium

The pension subsidy

If you draw a German statutory pension, the pension insurance (Deutsche Rentenversicherung) pays a subsidy of 8.75 percent of it in 2026. That is half the general contribution rate plus half the average additional contribution.

You only get it on application and never more than half your actual premium. There is nothing on company pensions, rent, private pensions or pensions from your home country, and nothing towards long-term care insurance.

Where private cover does worse in old age

In public insurance your contribution in retirement depends on your income. With a EUR 1,500 pension you pay little there, in private insurance the full tariff premium.

Couples are hit twice: each partner pays their own premium, there is no free cover for a spouse. Many expats only build up a small German pension because they started working here later. If that applies to you, do the maths before choosing private cover.

Where private cover does well in old age

If you joined early, have a premium relief tariff and draw a decent statutory pension, your premium after the subsidy is often manageable. According to the industry association, all age groups paid less than EUR 650 a month on average in 2024.

Retired civil servants (Beamte) keep their state aid (Beihilfe), usually 70 percent of costs. Their own private share therefore stays relatively small in old age.

If you retire outside Germany

Within the EU and EEA your policy usually continues. If you move further away, the contract normally ends unless the insurer agrees otherwise, and your ageing reserves are not paid out. Ask your insurer in writing before you move.

Also plan how you will be insured in your new country of residence. Returning to German public insurance later is usually closed from 55.

What you can do when the premium hurts

The most important lever is switching to another tariff with the same insurer. You have this right at any time, your reserves stay intact, and there is no new health check for equal or lower benefits.

If that is not enough, the standard and basic tariffs remain. They cover roughly what public insurance pays and their premium is capped.

Step by step

Ask your insurer for your current premium and how it developed over the last ten years.
Apply for the private health insurance subsidy together with your German pension application.
End sick pay when you retire if this does not happen automatically.
Have tariffs of the same insurer with equal or lower cover compared.
Check the deductible: in old age it only pays off if you rarely see a doctor.
As a last step, work out the standard or basic tariff.
If you plan to retire abroad, clarify in writing what happens to your contract.

Checklist

Pension insurance subsidy applied for
Sick pay ended after retirement
Tariff switch with your insurer checked
Premium relief tariff in place or consciously rejected
Long-term care insurance included in the calculation
Premium for your partner planned separately
Plans to retire abroad discussed with the insurer

Common mistakes

Not applying for the pension subsidy and giving away money
Looking only at the entry premium at 30 when choosing private cover
Switching insurer in anger over an increase and losing the reserves
Continuing to pay for sick pay after retirement although it no longer pays out

Questions and answers

Frequently asked

Does private health insurance become unaffordable in old age?

For most people not: the average from 65 is EUR 500 to 650. It gets critical with a small pension, no savings and an expensive tariff. A tariff switch or the standard tariff then helps.

Can I go back to public insurance as a pensioner?

As a rule no. If you are 55 or older and were not publicly insured in the last five years, you usually stay private.

Is there a subsidy for long-term care insurance too?

No. The pension insurance only contributes to health insurance, you pay the care part alone.

Does my pension from abroad count for the subsidy?

No. The subsidy is calculated only on the pension paid by the German statutory pension insurance.

Does the premium drop automatically at 60?

Yes, by the statutory 10 percent surcharge charged from 21. The other parts remain, and increases can eat up the effect.

Is private cover worth it if I expect only a small pension?

Often not. Public insurance is then usually cheaper in old age. Do this calculation before switching, not after.

Sources

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