Is Private Health Insurance Tax Deductible in Germany? Basic Cover, Refunds and Deductibles (2026)
Basic-cover premiums for private health insurance are deductible as Sonderausgaben under § 10 EStG. What counts, refunds and deductibles explained.
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Yes. In Germany, premiums for private health insurance (PKV) that cover the same level as public insurance (Basisabsicherung), plus mandatory care insurance, are deductible as Sonderausgaben (special expenses) under § 10 EStG. Premiums for extras count only within an annual maximum. Not deductible as premiums: the deductible (Selbstbehalt) you pay out of pocket, any employer subsidy, and anything refunded to you. A deduction lowers your taxable income. It does not return the premium itself.
This guide explains what the tax office accepts, how refunds and deductibles change the picture and what to expect as an employee or freelancer. It is general information, not tax advice.
- Basic health and care insurance premiums: deductible as Sonderausgaben (§ 10 Abs. 1 Nr. 3 EStG).
- Annual maximum for premiums beyond the basic level: €2,800, or €1,900 if you receive a tax-free employer subsidy or have a claim to illness cost reimbursement without your own contributions, such as Beihilfe (§ 10 Abs. 4 EStG).
- Sickness allowance is not basic cover: in private insurance the Krankentagegeld share counts only within the annual maximum, and public contributions with a Krankengeld entitlement are reduced by 4% (§ 10 Abs. 1 Nr. 3 Buchst. a EStG).
- Statutory bonus programmes up to €150 per insured person and year do not count as premium refunds (§ 10 Abs. 2b EStG).
What part of my private health insurance premium is deductible?
The part of your premium that pays for cover comparable to public health insurance is deductible, together with your care insurance premium. The law calls this the basic level of cover (Basisabsicherung): contributions are deductible as far as they are needed to secure a level of care comparable to social assistance, and for private insurance the portion covering benefits comparable to those of public insurance (§ 10 Abs. 1 Nr. 3 Buchst. a EStG).
Your insurer calculates this split and reports it to the tax office electronically. You will usually also get a yearly tax certificate showing the amounts.
| Item | Deductible? | Basis |
|---|---|---|
| Premium share for basic cover (health) | Yes, in full | § 10 Abs. 1 Nr. 3 Buchst. a EStG |
| Mandatory care insurance premium | Yes | § 10 Abs. 1 Nr. 3 EStG |
| Premium share for extras (single room, chief physician, dental top-ups) | Only within the annual maximum | § 10 Abs. 1 Nr. 3a and Abs. 4 EStG |
| Sickness allowance (Krankentagegeld) share | Only within the annual maximum | § 10 Abs. 1 Nr. 3 Buchst. a Satz 3 and Nr. 3a EStG |
| Deductible (Selbstbehalt) paid out of pocket | No, not as a premium | Not a contribution |
| Employer subsidy | No, it is not your expense | You deduct only what you pay |
How do the deduction caps work?
Premiums for extras and some other insurances are deductible up to €2,800 a year, or €1,900 if you receive an employer subsidy or have a claim to reimbursement of illness costs. But if your basic cover premiums alone exceed that cap, they are deducted in full and the extras add nothing further (§ 10 Abs. 4 EStG).
For most adults with a full private policy, basic health and care premiums are higher than the cap. That means the cap is exceeded by the basic part alone, the whole basic part is deductible and the premium for extras brings no additional deduction. The cap matters mainly where basic premiums are low.
What does the deduction look like in a worked example?
For an employee, the deductible basic-cover amount is the basic health and care premium minus the tax-free employer subsidy. If that figure exceeds the €1,900 cap, as in the example below, extras add no further deduction. The example below uses invented round numbers and is simplified.
Hypothetical premiums per month: health insurance €700, of which €550 is the basic-cover share (your insurer's certificate shows the real split), plus care insurance €60. The employer subsidy is half of the actual premium, which is below the 2026 maxima (see our employer contribution guide): €350 for health and €30 for care, €380 in total.
Basic health €6,600 + care €720 = €7,320 a year. Minus the subsidy of €4,560 leaves €2,760 deductible as basic cover. That is above the €1,900 cap, so the remaining €1,800 a year for extras adds no further deduction. At a hypothetical 30% marginal rate the tax saving is about €828, which is an illustration, not a prediction. The example ignores sickness allowance, refunds and other insurances.
Basic-cover premiums are deducted in full even when they are higher than the €1,900 or €2,800 figure, because those figures are a cap for the other insurances, not for basic cover (§ 10 EStG).
How does a premium refund affect my tax deduction?
A premium refund (Beitragsrückerstattung) reduces the premiums you can deduct. Some tariffs repay several months of premium if you make no claims. As far as it relates to basic cover, the refund reduces the deductible amount in the year the money arrives (§ 10 Abs. 4b EStG, and the Federal Ministry of Finance guidance on provident expenses).
The deduction is reduced when a refund is paid out, so a refund in 2026 for a claim-free year 2025 lowers your 2026 deduction. If the refund is larger than the premiums you paid in that year, the surplus is set against other premiums of the same type, and a remaining surplus can increase your taxable income.
One exception is for public insurance bonus programmes. The law says bonuses up to €150 per insured person and year do not count as refunds (§ 10 Abs. 2b EStG).
Trade-off. A refund is cash in your pocket, a deduction is a tax saving at your marginal rate. If you are tempted to forgo claims to get a refund, compare both. Refund-versus-claim decisions are about money and health first, tax second.
Can I prepay private health insurance premiums to deduct more in one year?
Yes, within a limit. You can deduct up to three times the current year's basic-cover premiums in the year you pay them. Any excess counts in the year it relates to. Only basic-cover health and care premiums qualify, not extra benefits (§ 10 Abs. 1 Nr. 3 Satz 5 EStG).
The statute allows "das Dreifache der auf den Veranlagungszeitraum entfallenden Beiträge", the triple of the contributions attributable to the tax year. Check with your insurer and a tax adviser before paying early.
Is the Selbstbehalt (deductible) tax deductible?
No, not as an insurance premium. The Selbstbehalt is the amount of treatment costs you pay yourself before the insurer pays. It is not a contribution, so it does not count as a Sonderausgabe (Federal Ministry of Finance guidance). Medical costs you pay yourself can at most count as extraordinary burdens (§ 33 EStG), which only reduce tax once they exceed a personal threshold (zumutbare Belastung). The percentages are in the section on out-of-pocket medical costs below.
The lower premium you get from a high deductible is, in effect, less deductible premium too. A high deductible lowers your premium and your deduction together. The saving is real but smaller after tax than the headline number.
Can I claim out-of-pocket medical costs as extraordinary burdens?
Possibly. Medical costs you pay yourself can count as extraordinary burdens (außergewöhnliche Belastungen), but only the part above a reasonable personal burden (zumutbare Belastung) reduces your tax. That threshold is a percentage of your income, set by your income band, marital status and number of children (§ 33 Abs. 3 EStG).
| Your situation | Income up to €15,340 | €15,341 to €51,130 | Above €51,130 |
|---|---|---|---|
| No children, single | 5% | 6% | 7% |
| No children, joint assessment | 4% | 5% | 6% |
| 1 or 2 children | 2% | 3% | 4% |
| 3 or more children | 1% | 1% | 2% |
Children count if you receive Kindergeld or a child allowance (§ 32 Abs. 6 EStG). The Federal Fiscal Court applies the percentages in steps, so each rate applies only to the income within its band (BFH, judgment of 19 January 2017, VI R 75/14, as reported by tax publishers).
Hypothetical income of €60,000. Stepwise: 5% of €15,340 = €767.00, 6% of the next €35,790 = €2,147.40, 7% of the remaining €8,870 = €620.90. The reasonable burden is €3,535.30. Only medical costs above that amount reduce your taxable income.
What is different for employees and freelancers?
The deduction rules are the same, but the starting point differs. Employees deduct only what they pay after the employer subsidy, and the lower €1,900 cap applies to extras. Freelancers pay the whole premium, so their deductible amount is larger, and the €2,800 cap applies.
| Employee, private | Freelancer or self-employed | |
|---|---|---|
| Who pays the premium | You, with an employer subsidy | You, in full |
| What you deduct | Your own share, after the subsidy | The full basic premium |
| Cap for extras | €1,900 | €2,800 |
To see how the subsidy works, read employer contribution to private health insurance. For freelancer specifics, see private health insurance for freelancers.
How do I claim the deduction?
You claim it in your annual income tax return, in the section for provident expenses (Vorsorgeaufwendungen). Your private insurer sends the premium data to the tax authority, and you enter what is missing from your yearly tax certificate.
- Collect your insurer's yearly premium certificate, usually issued in the first quarter.
- Check the split between basic cover and extras, and any refund paid during the year.
- Enter the amounts in your tax return, or give them to your tax adviser.
For the wider process, see our tax return guide.
Frequently asked questions
Can I deduct my private health insurance premiums in Germany?
Is my Selbstbehalt (deductible) tax deductible?
What happens to my tax deduction if my insurer pays a premium refund?
Is the employer's subsidy deductible too?
Is the extra premium for a better tariff worth it for tax reasons?
Can I prepay my private health insurance premiums to deduct more?
Does the deduction mean I get the premium back?
Sources
- § 10 EStG: Sonderausgaben (Abs. 1 Nr. 3 and 3a, Abs. 2b, Abs. 4, Abs. 4b)
- Federal Ministry of Finance: tax treatment of provident expenses (premium refunds, deductibles)
- § 33 EStG: Außergewöhnliche Belastungen (extraordinary burdens, reasonable burden in Abs. 3)
- § 32 EStG: Kinder, Freibeträge für Kinder (Abs. 6, child allowance)
- BFH, judgment of 19 January 2017, VI R 75/14 (stepwise application of the reasonable-burden percentages; cited from secondary reports, original not consulted)
Figures last checked on 19 October 2026. This guide is general information, not individual tax advice.
