Which health and nursing insurance contributions can I claim?

You can enter your full health and nursing insurance contributions for basic cover as special expenses in your tax return. The tax office deducts a flat rate of four per cent for sickness benefit from the contributions paid to statutory health insurance.

For those privately insured: Costs for health and nursing insurance are only recognised up to the basic contribution of the private health insurance. Optional benefits, such as treatment by the head physician or a two-bed room in hospital, are considered under "other insurance contributions" if there is still room within the deductible maximum amount.

If you have a more comprehensive contract, the private health insurance will determine the exact proportion of basic cover. If your health insurance contributions do not exceed the maximum amount of 1.900 Euro (2.800 Euro for self-employed), you can claim contributions for other insurances. Favourable contributions include those for unemployment insurance, additional health or nursing insurance, private disability insurance, accident or liability insurance, or term life insurance. Endowment and pension insurance policies can be considered as special expenses if the policies were taken out before 2005.

A married couple pays a total of 4.600 Euro in contributions for health and nursing insurance in a year without sickness benefit. This means the contributions exceed the joint maximum amount of 3.800 Euro (twice 1.900 Euro). Nevertheless, they are deductible as special expenses to this extent, but further insurance contributions, such as accident or motor vehicle liability insurance, can no longer be deducted.

Since the general contribution rate for those with statutory insurance covers sickness benefit, contributions are reduced by 4% on a flat-rate basis. The reduction only applies if there is an entitlement to sickness benefit in the event of illness. The reduction is made by the tax office. Until 2014, the reduction did not apply to the income-independent additional contribution. Since 2015, the following legal situation applies: The newly designed fund-specific income-dependent additional contribution is now considered an integral part of the health insurance contribution and is therefore included in the assessment basis for calculating the four per cent reduction amount. The contribution is no longer differentiated into a basic contribution and the additional contribution.

(2023): Which health and nursing insurance contributions can I claim?

Contributions to health and nursing care insurance

If you, as the policyholder, have paid contributions to health and nursing care insurance for your child's coverage, these can be deducted as special expenses. This only applies to contributions for basic coverage.

If you have paid contributions to health and nursing care insurance as part of your maintenance obligation, which your child (for whom you are entitled to child benefit or child allowances) owes as the policyholder, these contributions can be deducted as insurance expenses. However, this applies only to contributions for basic coverage. If you claim these amounts, they cannot be deducted as special expenses for your child.

If you are not jointly assessed for income tax with the other parent of your child, only enter the contributions you have paid yourself. Please do not forget to enter your child's identification number.

(2023): Contributions to health and nursing care insurance

Must the child's tax ID be provided?

Parents can deduct their child's health insurance contributions as special expenses if they are entitled to child benefit or the child allowance. This also applies to children in vocational training.

From 1 January 2023, parents must provide their child's tax identification number in their tax return to claim the contributions as special expenses.

(2023): Must the child's tax ID be provided?

How do I correctly deduct my child's health and nursing care insurance contributions?

Since 2010, contributions to statutory and private basic health insurance as well as statutory nursing care insurance can be deducted as special expenses in their actual amount and without limit. Not only contributions for your own coverage are deductible, but also contributions for the coverage of dependent children.

However, correctly claiming contributions for children in the tax return has become very complicated. It depends on whether you are still receiving child benefit for the child and whether you or the child is the policyholder.

(1) You are entitled to child benefit, and you are the policyholder
Contributions to the child's health and nursing care insurance can be deducted as special expenses by you. Enter the contributions for basic coverage in the "Form Child". Contributions for optional benefits, foreign health insurance, etc. can be deducted by you as "other insurance" and must also be entered in the "Form Child".

(2) You are entitled to child benefit, and the child is the policyholder
A special legal regulation applies here: If you pay the health insurance contributions for a dependent child for whom you are entitled to child benefit, you can deduct the contributions as special expenses (§ 10 para. 1 no. 3 sentence 2 EStG). Enter the contributions paid in the "Form Child". Contributions for optional benefits, foreign health insurance, etc. can only be deducted as special expenses by the policyholder - i.e. the child - as "other insurance" and must therefore be entered in their tax return in the "Form Pensions and insurance". A deduction of these contribution shares by the parents is not possible.

Note: According to a recent ruling by the Federal Fiscal Court, the tax deduction requires that the parents have actually paid or reimbursed the contributions to the child (BFH ruling of 13.3.2018, X R 25/15). However, this ruling is not recognised by the tax authorities and a legal amendment has since provided clarification. The contributions to the child's (basic) health and nursing care insurance are deductible as special expenses, regardless of whether the parents bear the child's contributions as part of their maintenance obligation through cash or in-kind support. It is also irrelevant whether the child has their own income. However, the child must be entitled to maintenance. (§ 10 para. 1 no. 3 sentence 2 and 3 EStG, amended by the "Act on Further Tax Promotion of Electric Mobility and Amendment of Other Tax Regulations" of 12.12.2019).

(3) You are not entitled to child benefit, and you are the policyholder

If the child is insured with you, you can deduct the contributions you have paid as your special expenses (§ 10 para. 1 no. 3 EStG). Claim the expenses in the "Form pensions and insurance".

(4) You are not entitled to child benefit, and the child is the policyholder
If the child is the policyholder and you pay the insurance contributions, you cannot deduct the expenses as special expenses. The above-mentioned special regulation does not apply here. However, you can claim the contributions paid for basic coverage as extraordinary expenses according to § 33a para. 1 EStG and enter them in the "Anlage Maintenance". In general, maintenance payments are deductible up to a maximum amount of 10,347 Euro (2022). In this case, however, the maximum amount is increased by the health and nursing care insurance contributions paid. A reasonable burden is not taken into account.

(2023): How do I correctly deduct my child's health and nursing care insurance contributions?