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Health and nursing care insurance

 



Which pension expenses can I deduct in the tax return?

Pension expenses are expenditures with which you provide for your future. Pension expenses are divided into health and nursing care insurance, retirement provision, and other insurance.

Retirement pension expenses mainly include contributions to the statutory pension insurance, a Riester pension, or a private Rürup pension (funded pension). Contributions to occupational pension schemes are also included if they provide benefits comparable to statutory pension insurance. This mainly applies to employees and self-employed members of professional chambers, e.g. doctors, dentists, veterinarians, pharmacists, tax consultants, lawyers, auditors, notaries, architects, engineers.

There is a separate maximum amount for payments into a Riester contract. Therefore, you can claim contributions to the specially subsidised Riester pension separately. For this, there is the "Anlage AV", in which the Riester contributions must be entered. This must then be submitted to the tax office together with the provider's certificate.

Contributions to statutory and private basic health insurance as well as statutory nursing care insurance (i.e. social nursing care insurance and private compulsory nursing care insurance) are deductible as special expenses in their actual amount and unlimited.

Other pension expenses mainly include contributions to unemployment insurance, occupational disability, accident, and liability insurance, term life insurance, private health insurance (beyond basic cover), and private nursing care insurance. Capital life insurance and pension insurance with a capital option (considered at 88%) as well as pension insurance without a capital option concluded before 2005 are also included here.

Insurance that does not serve to provide for the future is not deductible as pension expenses. This includes, for example, property insurance, such as household or legal protection insurance or comprehensive car insurance.

Also not deductible as pension expenses are contributions to direct insurance, a pension fund, or a pension scheme if they are tax-advantaged. Insurance amounts and other pension expenses do not fall under the "special expenses allowance" because they are not unlimited deductible special expenses.

The maximum pension amount is usually already exhausted by health and nursing care insurance and retirement pension expenses. Therefore, other pension expenses (see above) often have no tax effect.

For this reason, it is advisable to claim occupational insurance not covered by the employer as income-related expenses. In practice, a deduction in Anlage N (section "Employees > Income-related expenses") is mainly possible for professional liability insurance and professional legal protection insurance.

Since accident insurance usually covers both private and occupational risks, the contributions are partly deductible as income-related expenses and partly as special expenses. Claim 50% of the contributions as income-related expenses and 50% as special expenses ("other insurance"). However, if you have a hazardous occupation and the occupational risk share is greater than 50%, you should have this certified by the insurance company. Claim the certified share as income-related expenses and attach the certificate to your tax return.

Which pension expenses can I deduct in the tax return?



Which health and nursing insurance contributions can I claim?

Sie können Ihre kompletten Kranken- und Pflegeversicherungsbeiträge für die sogenannte Basisabsicherung als Sonderausgaben in der Steuererklärung eintragen. Das Finanzamt zieht von den gezahlten Beiträgen zur gesetzlichen Krankenversicherung lediglich vier Prozent pauschal für Krankengeld ab.

Für Privatversicherte gilt: Kosten für Kranken- und Pflegeversicherung werden nur in Höhe des Basisbeitrags der privaten Krankenversicherung anerkannt. Wahlleistungen, wie Chefarztbehandlung oder Zwei-Bett-Zimmer im Krankenhaus, werden im Rahmen der "anderen Versicherungsbeiträge" berücksichtigt, sofern dafür noch Spielraum beim abzugsfähigen Höchstbetrag besteht.

Wenn Sie einen weitergehenden Vertrag haben, ermittelt die PKV den genauen Anteil der Basisabsicherung. Falls Sie nicht über den Höchstbetrag von 1.900 Euro (Selbständige 2.800 Euro) mit Ihren Beiträgen zur Krankenversicherung kommen, können Sie noch Beiträge für weitere Versicherungen geltend machen. Begünstigt sind beispielsweise Beiträge zur Arbeitslosenversicherung, zu einer zusätzlichen Kranken- oder Pflegeversicherung, zur privaten Erwerbs- oder Berufsunfähigkeitsversicherung, zu Unfall- oder Haftpflichtversicherungen oder zu Risikolebensversicherungen. Kapitallebens- und Rentenversicherungen können als Sonderausgaben berücksichtigt werden, wenn die Policen vor 2005 abgeschlossen wurden.

Ein Ehepaar zahlt im Jahr ohne Krankengeld insgesamt 4.600 Euro an Beiträgen für die Kranken- und Pflegeversicherung. Damit übersteigen die Beiträge die gemeinsame Höchstsumme von 3.800 Euro (zweimal 1.900 Euro). Dennoch sind sie in dieser Höhe als Sonderausgaben absetzbar, doch weitere Versicherungsbeiträge, wie Unfall- oder Kfz-Haftpflichtversicherung, können nun nicht mehr abgesetzt werden.

Da der allgemeine Beitragssatz bei gesetzlich Versicherten das Krankengeld mit absichert, werden die Beiträge pauschal um 4 % gekürzt. Die Kürzung erfolgt nur dann, wenn im Krankheitsfall ein Anspruch auf Krankengeld besteht. Die Kürzung wird vom Finanzamt vorgenommen. Bis 2014 erfolgte die Kürzung nicht vom einkommensunabhängigen Zusatzbeitrag. Seit 2015 gilt folgende Rechtslage: Der neu ausgestaltete kassenindividuelle einkommensabhängige Zusatzbeitrag wird nunmehr als originärer Bestandteil des Krankenversicherungsbeitrags gewertet und ist daher in die Bemessungsgrundlage für die Ermittlung des vierprozentigen Kürzungsbetrags einzubeziehen. Eine Differenzierung des Beitrags in einen Grundbeitrag und den Zusatzbeitrag erfolgt jetzt nicht mehr.

Which health and nursing insurance contributions can I claim?



Increased deduction for insurance premiums from 2010

Since 2010, you can enter the full health and nursing insurance contributions for basic cover as special expenses in your tax return. The tax office deducts only four per cent from the contributions paid to statutory health insurance.

However, for privately insured individuals: You can only fully deduct the health and nursing insurance contribution if you pay the basic tariff of private health insurance. Policyholders with a different private health insurance tariff can deduct contributions up to the "basic cover" amount for tax purposes. In this case, the private health insurance company determines the exact share. However, these contributions are only recognised for tax reduction if the deductible maximum amount for "other insurance" has not yet been exhausted.

For employees, civil servants, pensioners and their partners, this is 1.900 Euro, for self-employed persons 2.800 Euro.

An employee earns 1.500 Euro gross per month. He pays around 132 Euro per month, 1.584 Euro per year, for his statutory health and nursing insurance. The tax office deducts four per cent from this amount. Thus, it recognises 1.521 Euro as special expenses. The taxpayer has therefore not yet reached his maximum amount of 1.900 Euro.

He can now also claim expenses for unemployment, liability and other insurance up to the maximum amount of 1.900 Euro. To do this, he deducts the 1.531 Euro. For the employee, this means: He can enter a further 379 Euro in insurance contributions in the income tax return.

Increased deduction for insurance premiums from 2010



How are children's health insurance contributions taken into account?

Claim contributions to your child's health and nursing care insurance on your tax return as follows:

(1) You are entitled to child benefit, and you are the policyholder
The contributions to your child's health and nursing care insurance are deductible as special expenses for you. Enter the contributions for basic cover in the "Anlage Kind" (line 31). Contributions for optional benefits, foreign health insurance, etc. are deductible for you under "other insurance" and should be entered in the "Anlage Kind" (line 37).

(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 "Anlage Kind" (line 31). Contributions for optional benefits, foreign health insurance, etc. are only deductible as special expenses for the policyholder - i.e. the child - under "other insurance" and must therefore be entered in their tax return in the "Anlage Vorsorgeaufwand" (line 36). These contribution shares cannot be deducted by the parents.

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 financially cover 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 sentences 2 and 3 EStG, amended by the "Act on Further Tax Promotion of Electromobility 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 "Anlage Vorsorgeaufwand" (line 40 ff.).

(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 cover as extraordinary expenses under § 33a para. 1 EStG and enter them in the "Anlage Unterhalt". In general, maintenance payments are deductible up to a maximum amount of 11,784 Euro (2024). 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.

How are children's health insurance contributions taken into account?



Can contributions to mutual support societies be deducted?

Many citizens have either statutory or private health insurance. An alternative form of coverage is membership in mutual benefit societies or solidarity communities, which have existed for almost 100 years. However, there are frequent disputes with the tax authorities over whether contributions to such societies can be deducted as special expenses. This is often rejected on the grounds that no legal entitlement to benefits is acquired, as confirmed by many tax courts.

However, in 2023, the Federal Fiscal Court (BFH) made an important decision. It overturned a ruling by the Hessian Finance Court and referred the case back for reconsideration. The BFH found that there might indeed be a legal entitlement that would allow the contributions to be deducted as special expenses (BFH ruling of 23.08.2023, X R 15/22). A similar case from the Münster Finance Court was also referred back for a new hearing (BFH court order of 23.08.2023, X R 21/22).

The decision of the Münster Finance Court has now been made (ruling of 01.03.2024, 11 K 820/19 E). It decided that contributions to health care at mutual benefit societies can be deducted as special expenses, as they provide a level of coverage equivalent to that of statutory and private health insurance. In addition, members have a legally binding entitlement to benefits in the event of illness. However, contributions to long-term care insurance remain non-deductible, as only statutory long-term care insurance is eligible.

Conclusion: Contributions to mutual benefit societies for health care can be deductible as special expenses under certain conditions, provided there is a legal entitlement to benefits. This does not apply to long-term care insurance.

Can contributions to mutual support societies be deducted?



How is my contribution to statutory health insurance calculated?

Calculation of contributions to statutory health insurance

The contribution to statutory health insurance (GKV) is based on the gross monthly salary. Employers and employees share the contribution, while non-working family members (spouse, children) are co-insured free of charge.

Contribution rates:
  • General contribution rate: Applies to those insured with entitlement to sickness benefit, e.g. employees. Pensioners also pay this rate, even though they are not entitled to sickness benefit.
  • Reduced contribution rate: Applies if there is no entitlement to sickness benefit, e.g. for students and self-employed persons.

Voluntarily insured persons can acquire entitlement to sickness benefit from the seventh week of illness onwards through the general contribution rate. Until the seventh week, loss of earnings must be covered privately or through an optional tariff.

Contribution rate and additional contribution:

Since 2015, the general contribution rate has been 14.6%, shared between employer and employee. In addition, the employee pays a fund-dependent additional contribution, which averages 1.7% in 2024.

Contribution assessment ceiling:

The insurance contribution is only calculated up to the contribution assessment ceiling, which is 62.100 Euro annually or 5.175 Euro monthly in 2024. Income above this limit is not subject to contributions.

Reduction of contributions:

As the general contribution rate covers sickness benefit, contributions are reduced by a flat rate of 4% if there is an entitlement to sickness benefit. The additional contribution is also included in the calculation of the reduction.

How is my contribution to statutory health insurance calculated?



Which health insurance subsidies do I need to declare?

If medical expenses or health insurance contributions are not paid from your own funds but are partially or fully covered by third parties, this must be indicated in the tax return. This includes, for example, tax-free employer contributions to health insurance for employees subject to social insurance (employer's share of health insurance). Also relevant are employer contributions for voluntarily insured persons, health insurance contributions for pensioners through the statutory pension insurance, benefit claims for civil servants and pensioners, and contributions from the artists' social insurance fund.

Up to what amount are health insurance contributions deductible?

Contributions to statutory and private basic health insurance as well as statutory nursing care insurance (i.e. social nursing care insurance and private compulsory nursing care insurance) are deductible as special expenses in the actual amount and without limit. Contributions and contribution shares to private health and nursing care insurance that go beyond basic cover can generally be deducted under "other insurance", but they usually have no effect there because the possible deduction limit has already been exhausted.

Which health insurance subsidies do I need to declare?


Field help

Other contributions to basic coverage

Other contributions paid to the statutory health and nursing care insurance in Germany include contributions that you made in 2024 for the basic coverage (health and nursing care insurance):

  • (Voluntary) contributions for basic coverage
  • Additional contributions for basic coverage
  • Reimbursements and supplements for basic coverage

Important: All contributions already recorded in sections "employment tax statement" or "pensions" should not be entered here again. They are automatically taken over by Lohnsteuer kompakt and considered when calculating your tax refund.

Statutory health and long-term care insurance

The page "Statutory health and nursing care insurance" shows all social insurance contributions already entered in the section "Employment tax statement".

Important: You do not have to enter all social insurance contributions already entered in the "employment tax statement" section again here. These are automatically transferred by Lohnsteuer kompakt and taken into account when calculating your tax refund.

In addition, you can enter

  • Reimbursement of premiums and contributions from the insurance contract,
  • Additional contributions to the statutory health insurance.
Which health insurance did Partner B have in 2024?

Select how the wife is covered by health insurance.

This information is necessary for determining the different maximum amounts. Depending on the selection, other pension expenses up to a maximum amount of 2.800 Euro or 1.900 Euro can be taken into account.

(1) If the wife is fully or partially insured in the health insurance of the spouse, select option (1). In this case, the maximum amount for other pension expenses is 1.900 Euro.

(2) If the wife does not fully pay the health insurance contributions himself / herself, select option (2). This is the case if

  • the wife receives a health insurance benefit / subsidy, for example, from the employer, the pension insurance company or a public fund.
  • for example, the employer or the pension insurance pays part of the contributions of the wife.
  • the wife is insured with the artists' social insurance (Künstlersozialkasse (KSK)).

The maximum amount for other pension expenses is 1.900 Euro in this case.

(3) If the wife pays the health insurance completely by her/himself, select the option (3). In this case, the maximum amount for other pension expenses is 2.800 Euro.

(4) If the wife is not health insured, select option (4). In this case, the maximum amount for other pension expenses is 2.800 Euro.

Sum of the contributions

Sum of contributions to health and nursing care insurance

Which health insurance did Partner A have in 2024?

Please select how the taxpayer is covered by health insurance.

This information is necessary for determining the different maximum amounts. Depending on the selection, other pension expenses up to a maximum amount of 2.800 Euro or 1.900 Euro can be taken into account.

(1) If the taxpayer is fully or partially insured in the health insurance of the spouse, select option (1). In this case, the maximum amount for other pension expenses is 1.900 Euro.

(2) If the taxpayer does not fully pay the health insurance contributions himself / herself, select option (2). This is the case if

  • the taxpayer receives a health insurance benefit / subsidy, for example, from the employer, the pension insurance company or a public fund.
  • for example, the employer or the pension insurance pays part of the contributions for the taxpayer.
  • the taxpayer is insured with the artists' social insurance (Künstlersozialkasse (KSK)).

The maximum amount for other pension expenses is 1.900 Euro in this case.

(3) If the taxpayer pays all his health insurance contributions himself / herself, select option (3). In this case, the maximum amount for other pension expenses is 2.800 Euro.

(4) If the taxpayer is not health insured, select option (4). In this case, the maximum amount for other pension expenses is 2.800 Euro.

Which health insurance did Partner A have in 2024?

Select how you are covered by health insurance.

This information is necessary for determining the different maximum amounts. Depending on the selection, other pension expenses up to a maximum amount of 2.800 Euro or 1.900 Euro can be taken into account.

(1) If you are partially or wholly covered by the health insurance of a relative, select option (1). In this case, the maximum amount for other pension expenses is 1.900 Euro.

(2) If you do not pay all health insurance contributions yourself, select option (2). This is the case if

  • you receive a health insurance benefit / subsidy, for example, from the employer, the pension insurance company or a public fund.
  • for example, the employer or the pension insurance pays part of your contributions.
  • you are insured with the artists' social insurance (Künstlersozialkasse (KSK)).

In this case, the maximum amount for other pension expenses is 1.900 Euro.

(3) If you pay all your health insurance contributions yourself, select option (3). In this case, the maximum amount for other pension expenses is 2.800 Euro.

(4) If you do not have any health insurance, select option (4). In this case, the maximum amount for other pension expenses is 2.800 Euro.

Do you have private health and nursing care insurance?

Select Yes if you have paid contributions to private health and / or nursing care insurance.

Have you paid contributions to the health/nursing care insurance of other people?

Select Yes if you have made contributions to health and / or nursing care insurance for other people.

"Other people" are, for example:

  • Children, for whom you are not entitled to child benefit / child tax allowance
  • Registered spouse / partner

Important: If you have made contributions for children, for whom you are entitled to child benefit / child tax allowance, the information should be entered in the section "Children" (in the form "Child").

Have you made contributions to foreign health and nursing care insurance?

Select Yes if you have made social security contributions abroad.

These include:

  • Contributions to a foreign health insurance comparable to a domestic statutory or private health insurance.
  • Contributions to a foreign social nursing care insurance or compulsory nursing care insurance that is comparable to a domestic nursing care insurance.
  • Contributions to health insurance and/or social nursing care insurance or compulsory nursing care insurance reimbursed abroad.

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