Apply for reimbursement of overpaid contributions for statutory health insurance and social long-term care insurance

Source: BUS Rheinland-Pfalz

The contribution you pay for your statutory health insurance and social long-term care insurance is determined by your financial capacity. The statutory income threshold sets the upper limit. An annual income above this limit does not increase your insurance contribution any further. The statutory income threshold is adjusted regularly.

In certain cases, you may have paid contributions above the income threshold. Your health insurance fund will then reimburse you for the excess contributions to health and long-term care insurance upon request.

This is usually the case if your health insurance fund was not aware of your actual income when it levied the contributions - for example, because

you had other income in addition to your regular salary
you are self-employed or
you have income from letting and leasing.

Reimbursement of contributions for employees subject to compulsory insurance
Your health insurance fund will automatically inform you if there are any indications that you may have paid too much in contributions. The health insurance fund will then also tell you how you can apply for a refund of contributions and what information and proof is required.
As a rule, your health insurance fund will contact you after you have received the annual report for the previous calendar year from your employer in February. Alternatively, you can contact your health insurance fund directly if, for example, you have not received a notification or suspect from your documents that you have paid too much in contributions.
If you are employed and subject to compulsory insurance and have other income in addition to your salary, this income is also subject to contributions - but only up to the contribution assessment ceiling. This is the case, for example, with

Pension payments such as company pensions,
Pensions from statutory pension insurance,
income from part-time self-employment.

In addition, one-off payments, such as bonuses, can lead to changes in the obligation to pay contributions for the previous months of the calendar year.

If you receive a pension from the statutory pension insurance scheme in addition to your salary, you may pay too much in contributions from your pension. This is because the contribution assessment ceiling cannot be taken into account for both incomes together in this case.

Reimbursement of contributions for voluntarily insured persons

If you are voluntarily insured, you must apply directly to your health insurance fund for a refund of overpaid contributions for health and long-term care insurance. This applies, among other things, to people who have paid contributions to health and long-term care insurance in excess of the contribution assessment ceiling for

self-employment
Income from letting and leasing

The prerequisite is that your actual income subject to contributions was below the contribution assessment ceiling.

The procedure differs for employees subject to compulsory insurance and those with voluntary insurance.
If you are employed and subject to compulsory insurance:

Your health insurance fund has a legal obligation to inform you if your other income in the previous calendar year has exceeded the income threshold. The health insurance fund is able to do this after you have received the annual report for the previous calendar year from your employer in February.
Your health insurance fund will tell you how you can apply for a refund of contributions and what information and proof is required. Alternatively, you can contact your health insurance fund yourself if, for example, you have not been notified or suspect from your documents that you have paid too much in contributions.
You apply for a refund of contributions.
The health insurance fund will check whether you are entitled to a refund of contributions and inform you of the result.
The health insurance fund will reimburse you for any overpaid contributions.

If you have voluntary statutory health insurance:

Contact your health insurance fund to find out how you can apply for a refund of contributions. As a rule, you can submit the application by post and - with many statutory health insurance funds - hand it in personally at the office or submit it online
Complete the application form from your statutory health insurance fund and submit it to the health insurance fund together with the required documents.
If necessary, you can also apply informally for reimbursement from certain health insurance companies. To do this, write an informal letter to your health insurance fund and state the account number (IBAN) of the bank account to which the contributions are to be refunded. The health insurance fund may ask you to provide further details and submit supporting documents.
The health insurance fund will check whether you are entitled to a refund of contributions and inform you of the result.
The health insurance fund will reimburse you for any overpaid contributions.

You can apply for reimbursement of contributions for statutory health insurance if

you are employed and subject to compulsory insurance and
your insurance contributions are also based on the part of your pension, your income from part-time self-employment or your pension that is above the contribution assessment ceiling.

Or:

You are voluntarily insured;
You are self-employed or work on a freelance basis;
You earn income from letting and leasing and
Your actual income was less than the income threshold used by your health insurance fund to calculate your contribution to voluntary health insurance.

If you are employed subject to compulsory insurance and have additional income:

Your employer's payslip for the previous calendar year

If you are voluntarily insured:

Tax assessment notice for the calendar year for which you are applying for a refund

Further documents may be required in individual cases. Please contact your statutory health insurance fund for more information.

For employees subject to compulsory insurance:

As a rule, your health insurance fund will inform you of the possibility of reimbursement at the end of the respective calendar year after it has received the annual notification from your employer in February. In addition, a limitation period of 4 years applies to the reimbursement of contributions. For example, you can apply for a refund of contributions that you have paid in excess since 01.01.2018 until 31.12.2022.

For voluntarily insured persons:
You can only apply for a refund after the end of the calendar year for which you paid the contributions. You must apply for the refund within the following 3 years.

Processing normally takes around 4 to 7 working days.
Your health insurance company must have the necessary information and any required documents in a complete and meaningful form in order to process and decide quickly.
The health insurance company decides on applications promptly, whereby the statutory processing period is adhered to in order to protect patients' rights.
Please note that the processing time stated is an average value for all health insurance companies. It may vary in individual cases.
The exact processing time also depends on the complexity of the individual case and may be longer. The same applies if documents or records are sent to you or your health insurance company by post.

Apply for reimbursement of overpaid contributions for statutory health insurance and social long-term care insurance

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