This post will teach you all you need to know about health insurance for freelancers and self-employed in Germany.
We’ll break down everything, including:
- Your options
- Their cost
- What they cover
- How to choose the best plan
The tips and lessons below are tried and tested. Our experts help dozens of freelancers with this topic every month.
The feedback speaks for itself (4.9/5 on Trustpilot): what’s coming up is not only helpful but also super practical.
Let’s kick things off.
Do freelancers need health insurance in Germany?
The government demands that all residents get health insurance.
So, yes, freelancers in Germany need health insurance.
Unlike most expats, freelancers have greater flexibility in choosing the best option, as income eligibility thresholds differ greatly from those of employees.
If all this sounds like gibberish right now, our introduction to German health insurance might be useful.
Which insurance options do self-employed people have in Germany?
You have 6 options to get health insurance as a freelancer in Germany:
- Public health insurance
- Home country’s insurance (EU, EEA, Switzerland, UK)
- Private health insurance
- Public health insurance for Künstlersozialkasse (KSK) members
- Joining a cooperative for freelancers
- Expat health insurance
Each option comes with its own set of requirements and benefits. Here’s a rundown of each:
- Public health insurance
If you are moving your permanent residence to Germany and will register your freelancing activity here, you can access the public health system.
You must sign up for public insurance within 3 months of ending your home country’s insurance. If your home insurance ended over 3 months ago, you are not eligible for voluntary public insurance in Germany.
- Your home country’s insurance (if you are insured in the EU, EEA, Switzerland, or the UK.)
If your permanent residence and business activities are still in your home country, your stay in Germany is considered temporary. You can remain on your home insurance for a maximum of 2 years.
If you do this, you must request an A1 and S1 form from your home insurance company to access German healthcare.
This is not an option if you have registered your freelancing activity in Germany and are working for clients here.
- Private health insurance
Most freelancers will opt for this. It’s the easiest way to get insured without spending too much money.
There is technically no rule stopping freelancers from joining a private health insurance plan. However, these plans often have a minimum income requirement set by the insurance companies. Typically, self-employed individuals need to earn at least €30,000 annually to qualify for these plans.
- Public health insurance for Künstlersozialkasse (KSK) members.
If you are an artist or work in one of these professions, you can join the KSK.
It plays the role of an employer by covering half of your health insurance and pension contributions.
- Join a cooperative for freelancers
Joining a cooperative means you will be employed by them, either full or part-time, which allows you to access public health insurance.
- Expat health insurance
If none of the options suit you, expat health insurance is worth considering.
Although it is more affordable than public or private health insurance, it provides limited coverage.
Public vs private health insurance: What is best for the self-employed?
This is a question that demands a thoughtful answer.
Here’s why…
If you choose private health insurance (Private Krankenversicherung), you’ll find it quite difficult (or, in some cases, impossible) to switch to the public insurance system in the future.
Read our guide to switching from private to public insurance for more detailed explanations.
Here’s a quick overview for the self-employed considering their health insurance options:
Public health insurance (GKV)
It is best for start-ups and self-employed individuals with low revenue. The lower your income, the cheaper it will be. Statutory health insurance contributions are income-based, so you might save some money if you’re towards the lower end of the contribution bracket (more on that in a minute).
You may also consider it if you have multiple dependents, as your contribution also covers them.
Private health insurance (PKV)
Private health insurance is cheaper than public insurance for people with higher earnings.
If you want access to the best health services in Germany, you’ll also want private health insurance. Its coverage is much greater than statutory insurance, and you’ll have faster and greater access to the country’s best specialists.
Still, you should consider some of private insurance’s disadvantages before signing up:
- When you sign up, your private health insurance will calculate costs based on your risk profile (your age and health). This means higher costs for less healthy individuals.
- When business is slow, you must keep paying your premiums.
Ultimately, the decision between public and private insurance will vary from person to person. If you need more detailed explanations, you should read:
If your situation is more nuanced, just book a call with us. We’d be happy to discuss your options with you.
Statutory health insurance for newly self-employed individuals
If you were previously covered by public health insurance and are now self-employed but want to stay insured, you must apply within three months. Here’s what you need to do:
- Ensure you were insured for at least 24 months in the last five years or for 12 months continuously just before your mandatory insurance ended.
- Submit your application for voluntary insurance to a health insurance company within three months.
You can check Social Security Code V, Section 9, for more details.
How much do freelancers pay for German health insurance?
The answer depends on what type of health insurance you opt for. Here’s a detailed breakdown:
How much does public health insurance cost for freelancers?
Voluntary public health insurance costs are based on your (pre-tax) income and are generally calculated at around 19,5% of gross income (2024). This means the actual cost can vary from month to month.
The contributions are made up of:
- Health insurance (14%)
- Long-term care insurance (2.4-4%, depending on age and having children)
- Depending on the chosen company, a fee of around 1.2-2.7%.
- Long-term sickness coverage (0.6%)
Note that this is calculated on all types of income, including:
- Self-employment income
- Interests and dividends
- Rental income
- Capital gains
- Etc.
However, no matter how much you earn, your maximum contribution is €950 monthly. Similarly, the public system assumes you’ll earn at least €1,178.33 per month, so even if you earn less than that, you’ll still pay the minimum of €220 each month. (Figures updated for 2024)
Check out our public health insurance calculator to learn exactly how much you’ll contribute.
How much does private health insurance cost for freelancers?
When you sign up, you’ll receive a quote based on your risk profile (age, health, and desired coverage). This means the premiums for private health insurance vary significantly from person to person.
At Feather, a healthy, 30-year-old freelancer would pay around €450 for standard coverage or €680 for premium coverage.
Wondering what your tariff might be? Use our private health insurance calculator to find out.
What does health insurance for freelancers cover?
The specifics depend on your choice between public and private health insurance plans. Here’s the coverage you can expect from both:
- In-patient care
- Out-patient care
- Medication
- Check-ups
- Basic dental care
- Pregnancy care
On top of that, Feather’s private health insurance would also cover things like:
- Worldwide treatments
- Private hospital treatments
- Treatments by heads of departments
- Fertility treatment
- Vision aid & refractive eye surgery
- Natural health treatments
- Dental cleanings, inlays, and tooth replacements
How to sign up for health insurance as a freelancer
Thanks to Feather, it’s never been easier to get covered by health insurance; just follow these steps:
- Choose between public, private, and expat health insurance (or let our recommendation tool do the work for you)
- Complete our (short) questionnaire
- Wait a few days & get covered!
Freelancer Health Insurance FAQ
As a self-employed person in Germany, your health insurance contributions depend on your income.
Here’s how it works:
- Estimating Your Income:
Since self-employed individuals don’t have a fixed salary, health insurance companies guess your expected income. Since January 2018, this guess is based on your most recent income tax assessment. It is used to set your temporary payment amount for the year. - Adjusting Contributions:
Once your income tax report for the year is available, your health insurance payment is corrected. You’ll need to pay more if you earn more and get a refund if you earn less.
You must submit your income tax report within three years. If you don’t, the insurance company will charge you the maximum payment. - For Those Starting Out:
When you first become self-employed, you won’t have a tax report to submit. In this case, you can estimate your income. Once you receive your first income tax report, your health insurance fund will adjust your payments based on your income. - Estimating Your Income:
If your income drops by more than 25% in a year, you can request a recalculation of your contributions during the current year. To do this, you must provide proof of the lower income, such as an advance payment notice or documents from the tax authorities.
Travel insurance alone is not enough for freelancers.
Some travel insurance plans will meet visa requirements. But they’re not enough to register and work in Germany.
When registering in Germany (Anmeldung), you must have full insurance coverage. If you don’t get insurance quickly, you will have to pay for the time you were not covered.
Conclusion
So, now you’re the expert on self-employed health insurance in Germany.
It’s your turn now…
What did you think of our guide? Did we cover (pun intended) everything you wanted to know?
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