KVdR (Krankenversicherung der Rentner): statutory health insurance for pensioners

What is the KVdR?

The KVdR (Krankenversicherung der Rentner) is the compulsory statutory health insurance status for pensioners, set out in § 5 Abs. 1 Nr. 11 SGB V. It is not a separate insurer or a separate scheme you join. It is a status inside the public system that changes two things: how much of your income is charged, and who pays part of the bill. Pensioners who do not qualify stay in the public system as voluntary members instead, on markedly different terms.

Who qualifies for the KVdR?

Two conditions have to be met together, and missing either one is enough to fall out. The first is an entitlement to a pension from the German statutory pension insurance. The wording matters: a pension from a professional scheme or a civil-service pension does not count. The second is the nine-tenths rule. You must have been publicly insured for at least nine tenths of the second half of the period between first taking up work and applying for your pension. Compulsory membership, voluntary membership and free family cover all count towards it.

The second half is the part people misjudge. It is not the second half of your career in a loose sense, it is a calculated period, and a stretch of private cover inside it counts against you. Raising children helps: each child is credited as a flat three years towards the nine tenths.

How much do you pay under the KVdR?

On your statutory pension the pension insurer carries half the health contribution directly, so your own share is around 8.75 percent in 2026. Long-term care insurance is not shared in the same way. You pay it in full from the pension, 3.6 percent if you raised children and 4.2 percent if you did not. Employment income in retirement is charged at half the rate. Company pensions are charged in full above an allowance of €197.75 a month in 2026.

What is not charged at all is the point of the whole status. Capital gains, rental income and payouts from Riester or Rürup contracts are contribution-free for KVdR members. For anyone whose retirement income is built on more than a pension, that exemption is usually worth more than the shared rate on the pension itself.

What changes without the KVdR?

You stay in the public system, but as a voluntary member, and voluntary members are assessed on their whole income. Capital gains, rental income and private pension payouts are all charged at the full rate. On the statutory pension itself you are no worse off, because the pension insurer pays a subsidy calculated the same way, around 8.75 percent of the gross pension, capped at half of what your health cover actually costs. The gap opens on everything else.

The practical ceiling matters here. A voluntary member with substantial income outside the pension reaches the maximum public contribution quickly, which in 2026 is around €1,226 a month with children and €1,261 without, and carries all of it themselves.

Why do doctors, lawyers and civil servants usually miss it?

Because of the first condition, not the second. Members of professional pension schemes, so doctors, dentists, vets, pharmacists, lawyers and notaries, auditors and tax advisers, architects and others, pay into their own scheme rather than into the statutory pension insurance. Many never accumulate the minimum contribution years needed for a statutory pension entitlement at all. They can have an unbroken record of public health insurance and still fail, because there is no statutory pension to attach the status to.

Civil servants are outside it for the same structural reason. A civil-service pension is not a statutory pension, so the KVdR does not open, and their cover in retirement runs through the state allowance and private insurance instead. Neither group is being penalised: the status is tied to the statutory pension system, and they were never in it.

What does this mean if you are privately insured now?

Moving to private cover interrupts public membership, and the nine-tenths rule counts exactly the years you would be interrupting. Someone switching in their early thirties who returns to public cover later may still clear it. Someone switching at 50 or later usually will not, because the second half of their working life is precisely the period being measured. It is not automatic either way, which is the reason to have the period worked out on your own record before you decide rather than after.

This is one input into the private-versus-public decision, not the whole of it. Private cover in retirement has its own mechanics that work in the opposite direction, and our guide to how private premiums develop in retirement sets those against each other properly.