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Which private health insurance premiums are tax deductible in Germany?

In short

In Germany the share of your private health insurance premium that pays for basic cover is fully tax deductible, and so is compulsory long-term care insurance. Extras such as a private room, chief physician or sick pay fall under a cap of EUR 1,900 or 2,800 a year, which basic cover usually fills already. Deductibles you pay yourself are not premiums, and premium refunds reduce the deduction.

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Which private health insurance premiums are tax deductible in Germany?

What it costs

German tax limits for 2026 and typical effects, not premium prices.

Example	Typical range
Cap for other insurance, employees, civil servants, pensioners	EUR 1,900 a year
Cap for other insurance, self-employed	EUR 2,800 a year
Basic share of a typical full tariff	about 70 to 90 percent of the premium
Advance payment deductible in the same year	up to 3 times the annual premium

As of October 2026.

The basic share is a guide value from our quoting practice (Richtwert aus der Angebotspraxis) and differs by tariff; what counts is your insurer's certificate.

This is not tax advice, please ask your tax adviser about your case.

Worked example

Self-employed, 40, marginal tax rate 35 percent

How the deduction works for a private full tariff with sick pay.

Health insurance EUR 650 a month, basic share 85 percent	EUR 6,630 a year deductible
Long-term care insurance EUR 60 a month	EUR 720 a year deductible
Extras and sick pay	no effect, cap already exceeded
Total deduction for basic cover	EUR 7,350

At a marginal rate of 35 percent, income tax falls by about EUR 2,570 a year, plus solidarity surcharge and church tax where they apply.

What counts as basic cover

Deductible in full is the part of your premium that roughly matches what public health insurance would pay for. Your insurer calculates this share and reports it to the tax office (Finanzamt).

Every year you receive a certificate, by post or online. It shows how much of your premium went into basic cover and how much into extras. Keep it with your tax papers.

Part of the premium	Tax treatment
Basic cover share	fully deductible as special expenses (Sonderausgaben)
Compulsory long-term care insurance	fully deductible as special expenses
Chief physician, private room, alternative practitioner	only within the cap, usually no effect
Sick pay (Krankentagegeld)	only within the cap, usually no effect
Dental and other top-up policies	only within the cap, usually no effect
Deductible paid yourself	not a premium, possibly an extraordinary expense

Employees, civil servants and the self-employed

Employees can only deduct their own share. The tax-free employer contribution is subtracted. Since 2026 premiums are reported electronically to the tax office and your employer, so the wage tax withheld each month is correct from the start.

Civil servants (Beamte) and the self-employed pay the full premium and deduct the whole basic share. For the self-employed the premiums are not business expenses but special expenses in the private tax return.

Deductibles and premium refunds

Bills you pay yourself because of a deductible are not premiums. They can count as extraordinary expenses (außergewöhnliche Belastungen), but only above a reasonable burden that depends on your income. In practice that rarely works.

A premium refund (Beitragsrückerstattung) lowers your deductible premiums in the year it is paid out. If your tax rate is high, check the numbers before you hold back a bill just to get the refund.

Paying premiums in advance

Some insurers let you pay premiums for future years in advance. For tax purposes this counts in the year of payment, as long as the amount does not exceed three times the annual premium.

This mainly makes sense in a year with unusually high income. Ask your tax adviser (Steuerberater) whether it pays off for you.

If you came from abroad

German rules only apply if you are taxed in Germany. A policy with an insurer from another EU or EEA country can also count, but you usually have to show the basic share yourself, which is often difficult. Policies from insurers outside the EU are a case for your tax adviser.

If you are employed and your insurer reports the basic share correctly, you usually have nothing else to do. Entering extras separately in your return almost never saves a single euro, because the cap is already full.

Step by step

Find your insurer's annual certificate for the tax office.
Check basic share and long-term care insurance in the pension and insurance annex (Anlage Vorsorgeaufwand).
Enter any premium refunds received during the year.
As an employee, let the employer contribution be subtracted.
For children's policies, agree who pays and who deducts.
Pay premiums in advance only after talking to your tax adviser.

Checklist

Certificate showing the basic share is at hand
All premium refunds declared
Deductible not entered as a premium
Children's premiums assigned to the right parent
Self-employed: premiums not booked as business expenses

Common mistakes

Treating the whole premium as fully deductible, although extras usually have no effect
Entering doctor's bills you paid yourself as premiums
Leaving out premium refunds, which can lead to back payments later
Choosing a tariff for the tax effect rather than for the benefits

Questions and answers

Frequently asked

Is private health insurance fully tax deductible in Germany?

Only the basic share and compulsory long-term care insurance. The rest falls under caps that are usually already full.

Can I deduct my deductible?

Not as a premium. As an extraordinary expense only to the extent your medical costs exceed the reasonable burden for your income.

What about premium refunds?

They reduce your deductible premiums in the year you receive them.

Can I deduct my children's premiums?

Yes, if you pay them and are entitled to child benefit (Kindergeld) or the child allowance for that child. Your tax adviser can clarify the details.

Is sick pay insurance deductible?

It is not basic cover and falls under the cap, which is usually already used up.

Are premiums business expenses for the self-employed?

No, they are special expenses in your private income tax return.

Sources

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