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Foreign health and nursing care insurance



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?



Should contributions to foreign insurance policies also be declared in the tax return?

The consideration of insurance contributions in the German tax return extends beyond domestic insurances. Here is a summary of the relevant regulations:

  1. Health insurance and pensions: In addition to German insurances, contributions to foreign statutory pension insurance providers can be claimed as "pension contributions" (according to § 10 para. 2 no. 2c EStG). Contributions to "other insurances" from foreign companies may also be deductible, provided there is still room within the insurance maximum amount. However, the foreign company must be based in an EU or EEA country or have permission to operate in Germany (according to § 10 para. 2 no. 2a EStG).
  2. Economic connection and special expenses: In principle, social security contributions paid abroad are not deductible as special expenses if they are economically connected to tax-free income. This applies if income earned abroad is tax-free in Germany and is only considered under the progression clause (according to § 10 para. 2 no. 1 EStG).
  3. Special regulation since 2019: Since 2019, there has been a legal regulation allowing for an improved deduction of special expenses for contributions paid in the EU/EEA to statutory pension, health, nursing care, and unemployment insurance. This is applicable if:
    • the income from employment is earned in a member state of the European Union or a contracting state of the European Economic Area agreement,
    • this income is tax-free in Germany under a double taxation agreement, and
    • the employment state does not allow for the tax consideration of pension expenses in the taxation of this income.
    This regulation applies to various types of pension expenses (according to § 10 para. 1 EStG).
  4. Judgements and developments: The Federal Fiscal Court has ruled in favour of taxpayers in several cases (BFH rulings of 27.10.2021, X R 28/20 and X R 11/20; BFH rulings of 10.11.2021, X R 13/20 and X R 14-16/20) who wanted to deduct contributions to nursing care insurance in Luxembourg and basic health insurance in the Netherlands as special expenses in Germany. This was allowed because no tax-reducing consideration occurred in the respective countries. However, it is important to note that pension expenses related to income from third countries (e.g. China, Brazil, or India) are excluded from this regulation (BFH ruling of 14.12.2022, X R 25/21).

Overall, contributions to foreign insurances can be considered in the German tax return, provided certain conditions are met.

Note: It is advisable to inform yourself about the current regulations and rulings or to seek professional tax advice if necessary.

Should contributions to foreign insurance policies also be declared in the tax return?


Field help

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.
Contributions to foreign health insurance

Enter the insurance contributions which you paid in the year 2024 to a foreign health insurance company (minus tax-free benefits) which is comparable to domestic health insurance.

Do not enter any amounts here that are included in the employment tax statement in line 25 - "Employee contributions to statutory health insurance".

The entry is transferred to line 31 of Form "Pension expenses" (Vorsorgeaufwand).

... contributions contained therein which give entitlement to sickness benefit.

Enter the contribution part of the insurance contributions paid to a health insurance company in 2024, which does not entitle you to sickness benefit.

Do not enter any amounts here that are contained in the employment tax statement in line 25 - "Employee contributions to statutory health insurance".

The entry is transferred to line 32 of Form "Pension expenses" (Vorsorgeaufwand).

Contributions to foreign nursing care insurance

Enter here the insurance contributions paid in 2024 to a foreign nursing care insurance or a foreign compulsory nursing care insurance which is comparable to a domestic statutory nursing care insurance.

Do not enter any amounts here that are contained in the employment tax statement in line 26 - "Employee contributions to social nursing care insurance".

The entry is transferred to line 33 of Form "Pension expenses" (Vorsorgeaufwand).

Reimbursements from health and / or nursing care insurance

Enter the contribution reimbursements and contribution repayments received in 2024 from the foreign health or nursing care insurance.

The entry is transferred to line 34 of Form "Pension expenses" (Vorsorgeaufwand).

... the amounts included therein which give entitlement to sickness benefit.

Enter the contribution share from which no entitlement to sickness benefit can be derived in the year 2024.

The entry is transferred to line 35 of Form "Pension expenses" (Vorsorgeaufwand).

Contributions for optional, comfort and additional services

Enter here the contribution shares paid in the year 2024 minus reimbursed contributions for supplementary insurance and optional services. This includes all contributions for benefits that go beyond basic medical care / basic coverage.

This includes optional, comfort and additional services such as

  • Single room,
  • Treatment by a head physician,
  • Dental insurance,
  • Naturopath,
  • Daily sickness benefit or
  • Sickness benefit insurance.

The entry is transferred to line 36 of the "Form Vorsorgeaufwand (Pension expenses)".

Sum of the contributions

Sum of contributions to foreign statutory or private health and nursing care insurance


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