No reduction due to subsidies from a bonus programme

No reduction of special expenses due to bonuses from bonus programmes

Many statutory health insurance companies offer bonus programmes under § 65a SGB V to promote health-conscious behaviour. Such bonus payments are not premium refunds and therefore do not reduce the deductible health insurance contributions. These promoted measures include:

• Preventive medical check-ups,
• Vaccinations,
• Healthy eating,
• Sporting activities.

The health insurance contributions deductible as special expenses therefore remain unchanged if the bonus payments are intended to promote such behaviour (BFH ruling of 1.6.2016, X R 17/15; BFH ruling of 6.5.2020, X R 16/18).

However, there are still benefits that are considered genuine premium refunds and reduce the deduction for special expenses.

Bonus payments vs. premium refunds

The Federal Ministry of Finance has clarified the distinction between bonus payments and premium refunds (BMF letter of 16.12.2021):

• Premiums under § 53 SGB V: Payments for programmes such as general practitioner-centred care are considered premium refunds and reduce the deductible special expenses.
• Bonus points: If the bonus is granted in the form of points, these must be converted into euros and reported as premium refunds.
• Family members: Bonus payments for family members are attributed to the main insured person.
• Basic health insurance: Bonuses for measures covered by the basic health insurance, such as preventive check-ups, are considered premium refunds.
• Costs for privately funded health measures: Bonus payments for privately funded health services such as osteopathy or a sports club membership do not constitute premium refunds and do not reduce the deduction for special expenses.

Simplification rule up to 150 Euro

Bonus payments under § 65a SGB V of up to 150 Euro per year and insured person are generally considered not to reduce the deduction for special expenses. If this amount is exceeded, the taxpayer must prove that it is not a premium refund. This regulation originally applied to payments until the end of 2023 and was extended to payments until 31 December 2024 (BMF letter of 28.12.2023).

Tips for checking

• Check your tax assessment: Health insurance companies are obliged to inform the tax authorities electronically whether a payment reduces the deduction for special expenses. Due to possible errors in the notifications, you should check your tax assessments to ensure that the correct values have been applied.
• Private insurance: Unlike statutory health insurance, bonus payments from private health insurance to promote cost-conscious behaviour are considered premium refunds and reduce special expenses if the bonuses are granted regardless of whether you have actually incurred costs (BFH ruling of 16.12.2020, X R 31/19).