Who pays my health insurance when I receive a disability pension in Germany?
In short
Who pays my health insurance when I receive a disability pension in Germany? It depends on your status. While you are employed, on sick pay or a compulsorily insured pensioner, the private pension is contribution free. If the private pension is all you have, you usually become a voluntary member and pay yourself, in 2026 at least EUR 222.80 a month for health insurance, plus long-term care.
Contribution figures for 2026 from the Federal Ministry of Health.
The value with care is a worked example at 21.1 percent; your additional contribution may differ.
Worked example
Engineer, 45, private pension EUR 2,000
Sick pay ends after 78 weeks. This is how his health insurance changes.
During sick pay
membership continues, no contribution on the private pension
Afterwards, no state pension
voluntary member
Contribution on EUR 2,000, no children, with care
about EUR 420 a month
If the state pension is approved
pensioners' insurance, private pension free
He applies for the state pension in parallel; approval would save him about EUR 400 a month.
Your status decides, not the pension itself
A private disability pension (BU-Rente) does not change how you are insured. What matters is whether you have a status that keeps you compulsorily insured in statutory health insurance (gesetzliche Krankenversicherung).
Your situation
Health insurance
Contribution on private pension
Still employed
compulsory
none, only on wages
Sick pay running
membership continues
none
Unemployment benefit I
compulsory
none
State disability pension with qualifying period
pensioners' insurance (KVdR)
none
Private pension only
voluntary
yes, full rate
Family insured via spouse
free
none while under the income limit
If you stay compulsorily insured
Employees pay on wages, state pension, occupational benefits and self-employed income (section 226 SGB V). A private disability pension is not on that list.
If you receive a state reduced earning capacity pension and meet the qualifying period, you join pensioners' insurance: nine tenths of the second half of your working life in statutory insurance (section 5 SGB V). Then only state pension, occupational benefits and work income are charged (section 237 SGB V).
If only the private pension remains
When employment and sick pay end without a state pension, you usually become a voluntary member. Then all income counts (section 240 SGB V), including the private pension. The minimum assessment is EUR 1,318.33 a month; the minimum health contribution in 2026 is EUR 222.80, plus long-term care.
With care insurance, health and care together cost roughly a fifth of income, about 21.1 percent for people without children. On EUR 1,500 that is a little over EUR 310 a month.
Family insurance and private cover
If your spouse is in statutory insurance, you can be insured free of charge if your total income does not exceed one seventh of the reference value, about EUR 565 a month in 2026 (section 10 SGB V). Total income means income for tax purposes (section 16 SGB IV); for a privately paid disability pension only the taxable portion counts. The health insurer decides in each case.
If you have private health insurance (PKV), your premium continues regardless of income, without the employer's subsidy once employment ends. Norman Nammert arranges cover as an insurance broker (Versicherungsmakler).
Step by step
Clarify your status: employed, sick pay, unemployment benefit or private pension only.
Check and file an application for the state pension.
Ask your health insurer about the qualifying period.
Have family insurance checked.
Build the contribution into the pension amount.
Checklist
Status after sick pay known
Qualifying period checked
Family insurance checked
Contribution calculated
Daily sickness benefit terms read if privately insured
Common mistakes
Forgetting health insurance when choosing the pension amount
Not applying for the state pension
Not checking family insurance
Questions and answers
Frequently asked
Do I pay health contributions on a private disability pension?
Only as a voluntary member.
Not while employed, on sick pay or as a compulsorily insured pensioner.
What is the minimum in 2026?
EUR 222.80 a month for health insurance for voluntary members, plus care.
Can I be family insured?
Yes, if total income stays under about EUR 565 a month in 2026.
What about an occupational disability pension?
It counts as an occupational benefit (section 229 SGB V) and is charged even in pensioners'
insurance.
I have private health insurance. What changes?
Your premium continues, the employer subsidy ends with employment.
