Explore the health insurance options available to you as a self-employed and freelancer in Germany. This guide explains how to choose between private and public health insurance as a freelancer. We simplified the German healthcare system to enable you to make the right decision.
Key takeaways
Self-employed and freelancers must get health insurance in Germany.
You can choose between private and public health insurance.
In certain scenarios, private health insurance is the right choice, and in others, public.
You can deduct up to 2,800 € of health insurance contributions from taxes.
Freelancers pursuing artistic or journalistic activity must get public health insurance via the Artist's social insurance fund.
This is how you do it
Understand the differences between public and private health insurance in Germany.
Consult a fee-based advisor to get personalized advice.
Get public health insurance in the following cases.
You have a low income.
You have an average or high income, want to settle in Germany, raise a family, and your spouse doesn't earn.
Get private health insurance in the following cases.
You have an average or high income but don't want to settle in Germany.
You have a high income, plan to settle in Germany, have a family, and your spouse is employed and publicly insured.
You can get public health insurance via Feather*. Feather offers services in English. Hence, it's easier for expats who don't speak German.
Compare private health insurance providers and plans on Check24*.
Table of contents
Health insurance for freelancers and self-employed in Germany
Self-employed and freelancers can choose between public and private health insurance in Germany.
Employees must earn more than 69,300 € (as of 2024) to be eligible to apply for private health insurance. But for self-employed people, there is no minimum income threshold.
But the freelancers pursuing artistic or journalistic activity aren't free to choose between private and public insurance. They are subject to artists' social insurance (Künstlersozialversicherung in German).
Which insurance fits best depends on your marital status, number of children, age, health, and income.
For example, the statutory health insurance policy is the right fit if you just started freelancing and have a low income. It's because public health insurance (GKV) premium depends on your income.
On the other hand, you can get more services via a private health insurance scheme than in the statutory system. But the private health insurance premium depends on your age and health. It means you must continue paying the full premium, even if your business is not doing well.
Moreover, unlike employees, the self-employed must pay the whole premium themselves.
Do I need health insurance as a freelancer in Germany?
Yes, everyone living in Germany is legally obliged to get health insurance. In other words, taking health insurance is mandatory in Germany.
If you don't take health insurance in Germany, you'll be liable to pay fines.
The employer ensures that their employees have valid health insurance in Germany. However, freelancers and self-employed must take care of health insurance themselves.
NOTE: Suppose you had compulsory public health insurance before becoming self-employed. Now you want to continue in the public healthcare system. Then, you must apply for the voluntary public health insurance within 3 months after the end of compulsory public insurance.
Should I take public or private health insurance in Germany?
Let's understand the differences between private and public health insurance to see which is right for self-employed in Germany.
Statutory health insurance for self-employed | Private health insurance for self-employed |
|---|---|
Health insurance cost | |
Factors on which health insurance cost depends. | |
Public health insurance costs depend on your income, number of children, and whether you'll opt for sick pay. Your insurance premium decreases and increases with the decrease and increase of your income. | Private health insurance costs depend on your age, health, occupation, and services you opt for. It doesn't depend on your income. Thus, your insurance premium will remain the same even if your income decreases. |
How much is the insurance premium? | |
Public health insurance costs comprise two things.
Public insurance providers decide the Zusatzbeitrag. Zusatzbeitrag of some insurers like TK* is 1.2% (lower than 1.7%). And some insurers' Zusatzbeitrag is higher than 1.7%. | To find the private health insurance costs, we compared different insurance plans on Check24*. Based on our research, good private health insurance plans cost between
|
Nursing care insurance cost | |
| Included in the above private insurance costs. |
Minimum monthly premium | |
Public insurers consider 1,132 per month (as of 2023) as the minimum income to calculate the insurance premium. 165 Thus, considering 14.6% basic amount, 1.7% additional contribution, and 3.4% nursing care, the minimum monthly premium is 223 €. On the other hand, considering 14% basic amount, 1.2% additional contribution, and 3.05% nursing care, the minimum monthly premium is 206.5 €. | It depends on age, health, occupation, and the services you opt for. |
Maximum monthly premium | |
There is a maximum limit on how much gross income public insurers can consider for calculating the premium. It is 4987.50 € as of 2024. Thus, considering 14.6% basic amount, 1.7% additional contribution, and 3.4% nursing care, the minimum monthly premium is 977.5 €. On the other hand, considering 14% basic amount, 1.2% additional contribution, and 3.05% nursing care, the minimum monthly premium is 910 €. | It depends on age, health, occupation, and the services you opt for. |
Family health insurance | |
Your spouse (if they don't have any income) and children are covered for free under your public health insurance. | You must take a separate health insurance policy for your spouse and each child. Thus, private health insurance will get expensive for self-employed with several kids. |
What happens if I am unemployed or have no income? | |
If you receive "Unemployment benefit I" from the job center, you remain insured with your public health insurance provider. Your insurer will get the monthly contribution directly from the job center. You can voluntarily insure under statutory health insurance if you don't get "Unemployment benefit I." In this case, you must pay the minimum insurance premium, i.e., 206.5 € or 223 € per month. | You receive "Unemployment benefit I"
You receive "Unemployment benefit II"
|
Sickness benefits | |
Your basic amount increases from 14% to 14.6% if you opt for sickness benefits. In sickness benefits, the public health insurance company pays you when you are sick for the long term. You get sick pay from the 43rd day of your illness. You can take an optional tariff if you want to start getting paid earlier. You can also get supplementary private daily sickness benefit insurance to cover your finances during long-term illnesses. You can compare different daily sickness benefits insurance on the comparison portal Check24*. | While choosing private health insurance, you can decide on the daily sickness allowance and when to start getting it. |
Changing health insurance plan with the same provider | |
Statutory health insurance providers have standard coverage and don't offer multiple plans. Of course, you can take supplementary private health insurance on top. | You can switch to a new health insurance plan offered by your insurer. However, the insurer may demand a complete health check. Depending on the health check results and services in the new tariff, your health insurance premium might be higher than the older tariff. |
Changing health insurance provider | |
You can change your public health insurance provider anytime. | Changing private health insurance providers in Germany is expensive.
|
Switching between private and public health insurance in Germany | |
You can switch from public to private health insurance anytime. But if you want to make the switch, you should do it before you turn 45. It's because the earlier you enroll in private health insurance, the more you save in retirement provision. The retirement provision keeps the private insurance premium in old age stable. | Returning to the public health insurance system is tough. It's almost impossible to make the switch for people who are 55 and above. But there are a few ways to return to statutory insurance. You can learn about them in our guide on switching from public to private health insurance in Germany. |
Conclusion: The right health insurance as a freelancer and self-employed in Germany
We created the below flow diagram to make choosing between private and public insurance easier.
You can find the explanations as to why the flow diagram looks the way it is below.
In the following scenarios, private health insurance makes sense for the self-employed
Scenario 1
You are not planning to settle in Germany.
You have an average or high income.
You can save a lot of money by opting for private health insurance in Germany. Moreover, you are in Germany temporarily. So, you don't have to worry about increased insurance premiums in old age.
To give you an idea of the savings. You pay around 977 € per month in public insurance if you earn more than the income limit.
On the other hand, you can find a good private health insurance policy in a price range of 466 € and 683 €.
So you save between 294 € and 511 € per month. But it's the gross savings. You must also deduct income tax on this amount.
Assuming you earn more than 62,000 €, your personal income tax will be 42%. Thus, your net savings will be between 170.52 € and 296.38 € per month.
Scenario 2
You plan to settle in Germany.
You have a family and children. But your spouse is employed and insured with public health insurance.
You earn more than the maximum income limit of public insurance (4987.50 € gross per month as of 2024).
Again, you can save a lot by taking out a private health insurance scheme.
But as your spouse is employed and publicly insured, the employer pays half of their health insurance contribution. And your children can be included for free under your spouse's public insurance.
Get a private health insurance policy in Germany
Compare offers and prices.
Comparison calculator to find suitable private health insurance policies.
Compare the insurance providers and their ratings.
In the following scenarios, statutory health insurance makes sense for the self-employed
Scenario 1
You have a low income
Public health insurance premium depends on your income. Thus, it makes sense to get it if you have a low income.
Scenario 2
You have an average or high income.
You want to settle in Germany.
You have a family and children. But your spouse doesn't earn.
Private health insurance doesn't cover your spouse and children for free. Thus, you must take a separate insurance policy for them.
So, you must add the cost of your family's health insurance policies to get the total cost. Usually, taking private health insurance in this scenario is expensive.
Moreover, you must consider long-term. The private insurance premium will increase as you grow old. And if your business performs poorly, you'll be unable to afford high private insurance premiums for the whole family.
Hence, staying in the public healthcare system in this scenario is better.
Get Public Health Insurance in Germany via Feather
Get public health insurance in Germany.
Complete the application process in English.
Public insurance is the best choice for low-income freelancers.
How do you get health insurance as a freelancer in Germany?
Public health insurance for self-employed
You have two ways to get a statutory health insurance policy in Germany:
via broker
directly from the public health insurance company.
You can get public health insurance via Feather* if you don't speak German. Feather offers services in English and free health insurance consultation.
You can also go directly to the public insurer's website and apply. Many health insurance providers in Germany have websites in both German and English.
TK even provides customer center service in English. But you must expect a longer waiting time to get service in English.
Get Public Health Insurance in Germany via Feather
Get public health insurance in Germany.
Complete the application process in English.
Public insurance is the best choice for low-income freelancers.
Private health insurance for self-employed
There are many private health insurance providers in Germany. Thus, comparing the offers on the comparison portal Check24* is best.
We recommend getting advice from a fee-based advisor before choosing private health insurance. Getting private insurance is a lifelong decision.
It's because returning to the public healthcare system later is tough. And switching your private insurance provider later is expensive.
Get a private health insurance policy in Germany
Compare offers and prices.
Comparison calculator to find suitable private health insurance policies.
Compare the insurance providers and their ratings.
What should my health insurance cover?
Statutory health insurance coverage in Germany
The German government regulates public health insurance coverage per the Fifth Social Law.
The law states that the publicly insured person is entitled to adequate, needs-based medical treatment corresponding to the generally recognized state of medical science. This includes
medical treatment,
dental treatment,
psychotherapeutic treatment,
the supply of medicines, bandages, remedies, aids,
home nursing care,
hospital treatment,
medical rehabilitation services, and other services.
The law specifies that medical services must be sufficient, appropriate, and economical. Services must not exceed what is necessary.
So, every public health insurance provider must offer services regulated by law. Thus, there is not much difference in the services different public health insurance providers offer.
Private health insurance coverage in Germany
Private health insurance companies offer many plans, from basic to comprehensive coverage. Thus, checking and comparing the services before signing the health insurance contract is critical.
Here are some essential services a good private health insurance should cover.
Private health insurance plans should cover the doctors' fees
You should have the freedom to select the doctor
Take a low deductible
Check if there are any reimbursement limits.
Your private health insurance provider should cover the cost of both generic and non-generic medicines.
What life support and physical aids do your private insurance cover?
Dental benefits
Ensure psychotherapy coverage in your private health insurance matches that in public insurance.
What type of therapies does your health insurance plan cover?
There are other services and things you should keep in mind while looking for a private health insurance policy. You can learn more about it in our guide on benefits a good private health insurance should offer in Germany.
FAQs
Can I switch from Private to Public Health Insurance in Germany?
Switching from private to public health insurance is difficult. And it gets tougher as you grow old.
There are a few ways to return to the public healthcare system. For example,
Your salary goes below the amount required for private health insurance. It's 69,300 € (as of 2024).
You get unemployed and receive "unemployment benefit I."
You are unemployed and want to insure under the public health insurance of your spouse.
In our guide, you can learn more about the tips and tricks of returning to statutory health insurance.
Can freelancers and self-employed deduct health insurance premiums from taxes?
Yes, the contributions to the health insurance are tax deductible. You can deduct up to 2,800 € of health insurance contributions from taxes.
Self-employed Part-time Regulations
If you are employed full-time and self-employed part-time, your health insurance via employment will continue. However, you must inform the health insurance company about your part-time self-employment.
The health insurer will determine whether your self-employed work is part-time. If the health insurer determines it's not part-time, your compulsory public health insurance via employment will end.
You must take out voluntary public health insurance or private insurance. And your employer will stop contributing to your health insurance premiums in this case.
Similarly, if you are unemployed and self-employed part-time, you can continue to be covered under your spouse's public health insurance. But as soon as you earn above the minimum amount, you must voluntarily insure under statutory health insurance or get a private insurance policy.
Emergency Tariff For Self-employed and Freelancers
Privately insured self-employed and freelancers who cannot pay insurance premiums anymore fall into the emergency tariff. In emergency tariff, you get the minimum health services.
But as soon as you can afford the health insurance premiums, you must return to your original tariff.
You should consider reducing your private health insurance premium if you cannot afford it. The easiest way to do so is by switching to a cheaper tariff offered by your insurance provider.
Learn about other ways to reduce private health insurance costs in our guide.
What is the Künstlersozialkasse?
The Artists' Social Fund (Künstlersozialkasse (KSK)) is an organization that checks your eligibility to be part of the fund. It also collects health insurance premiums and forwards them to the relevant public health insurance providers.
You can get health insurance via the artists' social insurance fund if you
do artistic or journalistic activity commercially,
you do not employ more than one employee (except for trainees and mini-jobbers),
you earn at least 3,901 € per annum (more than 325 € per month) from your artistic work.
The benefit of getting health insurance via the artist's fund is you only pay half of the health insurance premiums. Besides, you are legally obliged to insure via the KSK if you are self-employed and doing artistic or journalistic activity.