Bonus Programs

What Are Bonusprogramme?

Under §65a SGB V, German statutory health insurers (Krankenkassen) are authorized to offer bonus programs that financially reward members for engaging in healthy behavior. These are called Bonusprogramme, and they're one of the easiest ways to get real money back from your health insurance every year.

The idea is simple: Krankenkassen save money when their members stay healthy. So they incentivize preventive care, fitness activities, and health-conscious living with cash rewards, premium credits, or vouchers. Participation is completely voluntary — there's no downside to signing up, and most major Kassen offer some form of bonus program.

How Bonus Programs Work

While each Krankenkasse designs its own program, the general process is remarkably similar across all of them:

1. Register for your Kasse's bonus program — usually through their app, website, or by requesting a paper Bonusheft. Most Kassen now have fully digital programs.
2. Complete qualifying activities — these range from routine checkups you should be doing anyway, to fitness milestones and prevention courses.
3. Submit proof — depending on the activity, this could be a Stempel (stamp) from your doctor, a certificate from a course, automatic tracking via a fitness app, or a membership confirmation from your gym.
4. Receive your bonus — typically paid out once per year as a cash transfer to your bank account, a credit against your premiums, or sometimes as vouchers or product rewards.

Most programs run on a calendar-year basis. You collect activities throughout the year, submit them by a deadline (often Q1 of the following year), and receive your payout shortly after.

Qualifying Activities (Typical)

While the exact list varies by Kasse, here are the most common activities that earn bonus points or direct cash rewards:

Preventive Medical Checkups

• Gesundheits-Check-up (§25 SGB V): General health screening available every 3 years from age 18, annually from age 35. Covers blood pressure, cholesterol, blood sugar, kidney values, and more.
• Dental checkups (Zahnvorsorge): 2x per year — most Kassen give bonus points for each visit. This also builds your Bonusheft for better dental subsidies.
• Cancer screening (Krebsvorsorge): Skin cancer screening (from age 35, every 2 years), cervical cancer screening (annual for women), prostate screening (men from age 45), colonoscopy (from age 50/55).
• Flu vaccination (Grippeimpfung): Annual flu shot, especially rewarded for risk groups but often counted for everyone.
• Other STIKO-recommended vaccinations: COVID boosters, tetanus, diphtheria, pertussis, and any other vaccinations recommended by the Ständige Impfkommission.

Fitness & Lifestyle

• BMI in healthy range: Some programs award points for maintaining a BMI between 18.5 and 25. Documented at your Gesundheits-Check-up.
• Non-smoker status: Self-declaration or doctor confirmation. Some programs also reward successful smoking cessation.
• Sports club membership (Sportverein): Active membership in a registered sports club — one of the easiest points to earn if you're already a member.
• Gym membership (Fitnessstudio): Proof of active membership. Some Kassen require a minimum number of visits.
• Marathon/sports event participation: Completing a running event, Volkslauf, cycling event, or similar organized sporting activity.
• Step count goals: Digital programs often reward hitting daily step targets (e.g., 10,000 steps/day tracked via app).

Education & Community

• Gesundheitskurs (§20 prevention course): Certified courses in nutrition, exercise, stress management, or addiction prevention. These are a big bonus earner — see the dedicated section below.
• First aid course (Erste-Hilfe-Kurs): Completing a certified first aid course — many people take one for their driver's license anyway.
• Blood donation (Blutspende): Donating blood through DRK or another certified blood donation service.

How Much You Can Earn

The earning potential varies significantly between Kassen. Here's what the major insurers offer:

TK (Techniker Krankenkasse) — Bonusprogramm

TK's program is one of the most popular and well-structured. You earn points for each qualifying activity, and points convert to cash:

• Up to €180/year per adult member
• Partner and children can each participate separately
• Activities include checkups, vaccinations, fitness, and prevention courses
• Digital tracking via TK-Fit makes it easy to submit proof
• Cash payout directly to your bank account

BARMER — Bonusprogramm

• Up to €150/year per adult
• Points-based system with tiered rewards
• Strong focus on preventive checkups and vaccinations
• Digital bonus tracking through the BARMER app

AOK — Bonus Programs (Regional)

• Up to €200+/year depending on region
• Programs vary by regional AOK (AOK Bayern, AOK Nordost, etc.)
• Some AOKs offer choice between cash back and premium products/services
• AOK Bonus-App available in most regions

DAK-Gesundheit — Aktivbonus

• Up to €300/year — one of the highest in the market
• Two program variants: Aktivbonus (general) and Aktivbonus Junior (children)
• Higher rewards for completing more activities — scales with engagement
• Especially generous for sports and fitness activities

Other Notable Programs

• HEK (Hanseatische Krankenkasse): Competitive bonus amounts with a straightforward points system
• hkk: Known for low premiums AND solid bonus programs — double savings potential
• BKKs (Betriebskrankenkassen): Many company-based Kassen offer generous bonuses, sometimes exceeding the big national Kassen. Worth checking if you're eligible for a BKK through your employer.

Gesundheitskurse — Prevention Courses (§20 SGB V)

One of the most valuable and underused benefits in German health insurance coverage is the right to subsidized prevention courses under §20 SGB V. This goes beyond the bonus program — Krankenkassen are legally required to subsidize certified prevention courses.

What's Covered

• 2 courses per year — your Kasse must reimburse 80-100% of the cost, typically up to €75-150 per course
• Courses must be certified by the ZPP (Zentrale Prüfstelle Prävention) — the central certification body for prevention courses in Germany
• You can search for certified courses at www.zentrale-pruefstelle-praevention.de

Qualifying Course Categories

• Exercise (Bewegung): Yoga, Pilates, back strengthening (Rückenschule), aqua fitness, functional training
• Nutrition (Ernährung): Nutrition counseling, healthy cooking courses, weight management programs
• Stress management (Stressbewältigung): Progressive muscle relaxation, autogenic training, mindfulness courses, tai chi, qigong
• Addiction prevention (Suchtprävention): Smoking cessation programs, responsible alcohol consumption courses

How to Claim

1. Find a ZPP-certified course (online or in-person)
2. Pay the course fee upfront
3. Complete the course (minimum attendance required, usually 80%)
4. Receive a completion certificate (Teilnahmebescheinigung) from the instructor
5. Submit the certificate and invoice to your Kasse
6. Receive reimbursement within 2-4 weeks

Digital Bonus Tracking

Gone are the days of collecting paper stamps. Most major Kassen now offer digital bonus tracking that makes earning and claiming rewards significantly easier:

TK-Fit

• Part of the TK app — tracks steps, activities, and health goals
• Connects to Apple Health, Google Fit, and popular fitness trackers
• Daily step challenges with bonus rewards
• Automatic verification of some activities

AOK Bonus-App

• Digital bonus booklet replacing paper forms
• Scan QR codes at participating doctors and gyms
• Track progress toward annual bonus goals
• Available in most AOK regions

BARMER Bonusprogramm App

• Integrated into the main BARMER app
• Upload proof of activities digitally (photos of certificates, etc.)
• Real-time bonus balance tracking
• Push reminders for upcoming checkup deadlines

Wearable Integration

Many programs now integrate with wearables and fitness trackers. Some Kassen even offer subsidies toward purchasing a fitness tracker or smartwatch as part of their bonus program. Step counters, heart rate monitors, and activity trackers from Apple Watch, Fitbit, Garmin, and others can automatically log qualifying activities.

Wahltarife — Optional Tariffs Beyond Bonusprogramme

Beyond standard bonus programs, Krankenkassen offer Wahltarife(optional tariffs) under §53 SGB V that can save you additional money. These are separate from Bonusprogramme and involve different trade-offs:

Selbstbehalt (Deductible) Tariffs

You agree to pay a certain amount of medical costs yourself (e.g., the first €300-600/year). In return, the Kasse refunds part of your premium — often €300-900/year — if you don't file any claims. This works well for young, healthy people who rarely see a doctor.

Kostenerstattung Tariffs

You get billed like a private patient (according to GOÄ fee schedule) and submit claims for reimbursement. This can get you faster appointments and access to treatments not in the standard GKV catalog, but you may face co-pays for charges above what GKV reimburses.

Krankengeld Tariffs

For self-employed GKV members who opted out of Krankengeld, these tariffs let you buy back sick pay coverage — important if your income depends entirely on your ability to work.

Family Bonuses

Bonus programs become especially lucrative for families. Most Kassen offer separate bonus tracks for each family member — including children and spouses covered under Familienversicherung (family co-insurance):

Children's Bonus Activities

• U-Untersuchungen (U1-U9): The mandatory pediatric checkup series. Each completed U-exam earns bonus points — and you should be doing them anyway.
• J-Untersuchungen (J1, J2): Youth health checkups at ages 12-14 and 16-17
• Dental checkups: 2x/year for children, building their Bonusheft early
• STIKO vaccinations: All recommended childhood vaccinations earn points
• Sports club membership: Children's Sportverein membership counts
• Healthy BMI: Documented at pediatric checkups

Family Earnings Potential

A family of four — two adults and two children — can realistically earn:

• Adult 1: €150-300/year
• Adult 2: €150-300/year
• Child 1: €50-100/year
• Child 2: €50-100/year
• Family total: €400-800/year

At the high end (e.g., DAK Aktivbonus with diligent participation), families can exceed €500+ per year in combined bonus payouts. That's a meaningful amount — equivalent to a month of groceries or a family weekend trip.

Tax Implications of Bonus Payments

The tax treatment of bonus payments from Krankenkassen is a surprisingly nuanced topic that was clarified by a landmark BFH (Bundesfinanzhof) ruling in 2020. Here's what you need to know:

Tax-Free: Activity-Based Bonuses

Cash bonuses paid as rewards for completing specific prevention activities (checkups, vaccinations, fitness milestones, courses) are generally tax-free. They are not considered income and do not reduce your Sonderausgabenabzug (special expense deduction for health insurance premiums — see our tax deductions guide). The key criterion: the bonus must be tied to your active participation in health-promoting activities, not simply a refund of premiums.

Potentially Taxable: Premium Refund-Type Payments

Beitragsrückerstattung-type payments — where you receive money back simply for not using medical services (like with Selbstbehalt tariffs) — are treated differently. These may reduce your Sonderausgabenabzug, effectively increasing your taxable income. The Finanzamt considers these as a reduction in your actual insurance costs.

Is It Worth the Effort?

Let's do an honest ROI calculation:

Time Investment

• Initial setup: 15-30 minutes to register for the program
• Annual checkup: 30-60 minutes (you should do this anyway)
• Dental checkups: 30 minutes x 2 = 1 hour (you should do this anyway)
• Vaccination: 15-30 minutes (you should do this anyway)
• Submitting proof: 10-30 minutes/year (less with digital apps)
• Cancer screening: 30-60 minutes (you should do this anyway)

The Most Efficient Bonus Activities

Focus on activities you'd do anyway — these are essentially free money:

1. Annual Gesundheits-Check-up — ~€15-30 bonus for something that takes 30 minutes and is medically valuable
2. 2x dental checkups — ~€15-20 bonus each, plus you build your Bonusheft for higher Festzuschuss
3. Vaccinations — ~€5-10 per vaccine, takes minutes
4. Non-smoker confirmation — ~€10-20 for a simple declaration
5. Gym/sports club membership — ~€15-30 bonus if you're already a member
6. Gesundheitskurs — the biggest earner: get the course reimbursed AND earn bonus points

Comparison: Top Kassen Bonus Programs

Here's a side-by-side overview of bonus programs from the largest Krankenkassen:

Getting started is straightforward: log into your Krankenkasse's app or website, look for "Bonusprogramm" or "Bonus," and register. Then keep doing the healthy things you're (hopefully) already doing — and get paid for it.