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Health Insurance for Self-Employed and Freelancers in Germany [2025 English Guide]

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Health insurance for self-employed and freelancers in Germany

Health insurance is mandatory in Germany. Self-employed and freelancers can choose between

  • public health insurance
  • private health insurance
  • artist’s social insurance

Artist’s Social Insurance

Freelancers pursuing artistic or journalistic activity can get public health insurance via artists’ social insurance (Künstlersozialversicherung in German) (KSVG).

You can also opt for private health insurance. You must apply for the exemption from compulsory public health insurance within 3 months of starting your career as a freelancer.

The exemption from compulsory public health insurance automatically ends after 6 years (per Social Insurance Act § 6 KSVG). You must switch from private to public health insurance once the exemption ends.

The only way to stay in private health insurance is if you earn more than the compulsory insurance limit (i.e., 73,800€ (as of 2025) (2026: 77,400€)) in the previous three years.

NOTE: If you exempt yourself from the statutory health insurance via KSK, you can never return to public health insurance.

Private health insurance

You can get private health insurance without any restrictions. Moreover, there is no minimum income threshold for self-employed people (§ 6 SGB V) to join private insurance.

On the other hand, employees must earn more than the income threshold (Jahresarbeitsentgeltgrenze, JAEG) (i.e., 73,800€ (as of 2025) (2026: 77,400€)) to be eligible to apply for private health insurance. 

Public health insurance

If you are self-employed, you can become a voluntary member of a statutory health insurance fund. The rules for voluntary membership are set out in § 9 SGB V.

Whether you are eligible for public health insurance depends on your

  • previous insurance history (you were previously insured in the public or private system),
  • your nationality (EU or non-EU), and 
  • type of visa (long-term or short-term visa)

Suppose you were compulsorily insured in the public system before becoming self-employed. In this case, you must meet the following criteria to continue in the public system. 

You must have been compulsorily insured for 

  • at least 12 uninterrupted months before becoming self-employed, or 
  • 24 months within the last five years.

If you meet the eligibility criteria, you must apply for voluntary statutory insurance within three months after the end of compulsory public insurance.

What are the consequences of not taking health insurance in Germany?

Here are the consequences for not getting health insurance on time.

Employers ensure that their employees have valid health insurance in Germany. However, freelancers and self-employed people must take care of their health insurance themselves.

What health insurance is better for the self-employed in Germany – public or private?

Let’s understand the differences between private and public health insurance to see which is right for the self-employed in Germany.

Statutory health insurance for self-employedPrivate health insurance for self-employed
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.

– Basic amount: 14% of your gross monthly income (no sick pay). 14.6% of your gross monthly income (with sick pay)(§ 241 SGB V).
– Additional contribution (Zusatzbeitrag): 2.5% (as of 2025) of your gross monthly income

Public insurance providers decide the Zusatzbeitrag. Zusatzbeitrag of some insurers like TK is 2.45% (lower than 2.5% (as of 2025)). And some insurers’ Zusatzbeitrag is higher than 2.5% (as of 2025).		Based on our research, good private health insurance plans cost between
– 466 € and 683 € per month to self-employed
– 301 € and 355 € per month to employees (The cost is after deducting the employer’s contributions are already deducted)
– 288 € and 400 € per month to civil servants
Nursing care insurance cost
3.6% of your gross monthly salary (as of 2026) for self-employed people with one child and 4.2% of your gross monthly salary (as of 2025) with no children (§ 55 SGB XI)Included in the above private insurance costs.
Minimum monthly premium
If you haven’t started earning from your business yet, you must still pay a minimum health insurance premium. As of 2024, the minimum monthly premium is between 258 € and 265 €.

How is the minimum premium calculated?
Public insurers consider the minimum income for calculating the insurance premium: 1,248.33€ (as of 2025)

Case 1: No child
– Basic amount: 182.25 € (14.6% of 1248.33)
– Additional contribution: 31.20 € (2.5% of 1248.33)
– Nursing care: 52.42 € (4.2% of 1248.33)
– Minimum monthly premium: 265.87 € (182.25 + 31.20 + 52.42)

Case 2: One child
– Basic amount: 182.25 € (14.6% of 1248.33)
– Additional contribution: 31.20 € (2.5% of 1248.33)
– Nursing care: 44.93 € (3.6% of 1248.33)
– Minimum monthly premium: 258.38 € (182.25 + 31.20 + 44.93)		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 when calculating the premium. It is 5,512.5 € per month (as of 2025) (2026: 5812.5€ per month).

Thus, the maximum monthly premium in public health insurance is 1174€ per month (as of 2025).		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 (§ 10 SGB V).You must take a separate health insurance policy for your spouse and each child.
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.

If you don’t get “Unemployment Benefit I,” you can voluntarily insure under statutory health insurance. In this case, you must pay the minimum insurance premium.		– If you receive “Unemployment Benefits I,” you’ll automatically be covered by statutory health insurance, even if you previously had private insurance.
– You cannot switch to statutory health insurance if you are 55 and over. It doesn’t matter if you receive “Unemployment Benefit I.” 
– You can stay with your private health insurer after being unemployed if you have private insurance for five years before becoming unemployed. The job center pays a subsidy for your health insurance contributions.
– Privately insured people who receive “Unemployment benefit II” remain in private health insurance. You get a subsidy from the job center.
Sickness benefits
Your basic amount increases from 14% to 14.6% if you opt for sickness benefits. Sickness benefits are paid by the public health insurance company 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 (§ 47 SGB V).

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 better 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. You can use our public health insurance cost calculator to check how much you save by switching the insurer.Changing private health insurance providers in Germany is expensive. 
– You lose a large part of your saved retirement provisions.
– A new health insurer will demand a complete health check. Hence, it might lead to higher insurance costs.
– You usually pay a higher premium to the new insurer as you age.
Switching between private and public health insurance in Germany
You can switch from public to private health insurance anytime.Returning to the public health insurance system is tough. It’s almost impossible for people 55 and older to make the switch.

If you cannot return to the public system, you can switch to a “Basistarif” of your private insurer. Every private health insurance company must offer “Basistarif”. Its benefits are comparable to those of public insurance. The Basistarif is regulated under § 12 VAG and § 193 VVG.

Conclusion: The right health insurance for the self-employed in Germany

Artist’s health insurance

If you qualify for an artist’s health insurance, get it. The reason is that KSK contributes half of the health insurance premium, and you pay the other half (§ 10 KSVG). 

You can pick any public health insurance company of your choice.

Artist’s health insurance ->

Public health insurance

Public health insurance is the safest choice. If you are unsure about which health insurance to pick, just go with public insurance.

Here is why.

  • Premium depends on your income.
  • You can insure your non-earning family members for free.

In general, if you have just started your business and don’t have a stable income, public health insurance is the right choice.

Best public health insurance ->

Private health insurance

Private health insurance (PKV) is usually a good choice for high-income and healthy self‑employed people. If you earn more than the income threshold, you save between 290€ and 500€ per month. But it’s the gross savings. You must also deduct income tax on this amount.

Assuming you earn more than 73,800€ (as of 2025) (2026: 77,400€), your personal income tax rate will be 42%. Thus, your net savings will be between 168€ and 290€ per month.

Good private health insurance plans also offer better coverage than public insurance. 

You can use our “Health Insurance Finder” tool to help you choose between private and public insurance based on your life situation.

If you are unsure, get personalised advice from an independent insurance broker or a Verbraucherzentrale (consumer advice centre).

Best private health insurance plans ->

How do you get health insurance as a self-employed or freelancer in Germany?

Artist’s social insurance (KSK) for self-employed in Germany

You can apply for the artists’ social insurance online on KSK’s website. KSK will verify if you meet the requirements.

You are free to choose any public health insurer.

Public health insurance for self-employed persons and freelancers in Germany

You have two ways to get a statutory health insurance policy in Germany:

  • Via an insurance broker or agent
  • Directly from the public health insurance company.

If you don’t speak German, you can use our service to register with TK online in English.

You can also apply directly on the public insurer’s website. Many health insurance providers in Germany have websites in German and English.

Private health insurance for freelancers in Germany

Like public health insurance, you can get a private insurance policy via

However, we recommend consulting an insurance broker or a fee-based adviser for personalized advice before taking private health insurance in Germany.

Book a free call with a health insurance expert

  • German health insurance is a complicated product. There are several factors that must be considered before deciding which health insurance is best for you. An expert can guide you and help you pick the best option for you.
  • An Insurance broker is liable for their advice. This means if the policy they recommended doesn’t offer the coverage you requested, they are liable to pay the damages incurred in the future.
Book a call

Statutory health insurance coverage in Germany

Public health insurance is regulated by the Fifth Book of the Social Code (SGB V). Insured persons are entitled to necessary medical treatment as set out in the law (§ 27 SGB V).

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 (§ 12 SGB V). 

Every public health insurance provider must offer services regulated by law. Thus, there is little difference in the services that different public health insurance providers offer. 

NOTE: The German public healthcare system is under a lot of pressure due to demographic change and increased medical costs. Thus, the public health insurance premium will rise drastically in the near future.

Private health insurance coverage in Germany

Private health insurance companies offer many plans, from basic to comprehensive coverage. Thus, it is critical to check and compare the services before signing the health insurance contract.

NOTE: Private health insurance companies are better prepared for the future. This is because they save at least 10% of your monthly premium as a retirement provision (§ 149 VAG). How private health insurance companies can use the reserves is also defined in law (§ 150 VAG).

Here are some essential services a good private health insurance should cover.

  • Doctors’ fees
  • Freedom to select the doctor
  • 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 does your private insurance cover?
  • Dental benefits
  • Ensure that the psychotherapy coverage in your private health insurance matches that of your public insurance.
  • What type of therapies does your health insurance plan cover?

Minimum services your private health insurance must cover ->

You can download our checklist to ensure your policy covers the minimum recommended services.

Private health insurance services checklist

private health insurance benefits checklist
  • A comprehensive list of services good private insurance should cover.
  • Use it during your consultation with an insurance broker or a fee-based advisor.
  • Use it while searching for a private health insurance policy.
Free Download

FAQs

1. Can you 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,
– You get a job and your salary goes below the income threshold.
– You shut down your business and receive “unemployment benefit I.”
– You shut down your business (unemployed) and want to be insured under your spouse’s public health insurance.

How to return from private to statutory health insurance? ->

2. Can freelancers and self-employed deduct health insurance premiums from taxes?

Contributions for health insurance that cover the basic, statutory-equivalent insurance (Basisabsicherung) are fully deductible (§ 10 EStG). 

Additional benefits (e.g., high daily sickness allowance, private room, etc.) are deductible up to the maximum limit set by the tax office. The maximum limit is €2,800 per year (as of 2025) for self-employed and €1,900 per year (as of 2025) for employees, civil servants, and pensioners.

How to deduct health insurance premiums from taxes? ->

3. I am self-employed part-time. How does it affect my health insurance?

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. In this case, your employer will stop contributing to your health insurance premiums. 

Similarly, if you are unemployed and self-employed part-time, you can continue to be covered under your spouse’s public health insurance. But free family insurance ends in the following cases.
– Your earnings exceed the family-insurance threshold.
– Your public health insurer considers your self-employment not marginal.

4. What happens if you cannot afford health insurance premiums as a self-employed?

Publicly insured individuals have the following options.
– Insure yourself in family insurance via your spouse.
– Apply for state support.

Privately insured self-employed and freelancers who cannot pay insurance premiums anymore fall into the emergency tariff. In an 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.

Health insurance when you are unemployed ->

5. What is the Künstlersozialkasse? Why should I take it?

The Artists’ Social Fund (Künstlersozialkasse (KSK)) is an organization that checks your eligibility to join 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 euros per year (more than 325 euros per month) from your artistic work.

The benefit of getting health insurance via the artist’s fund is that you only pay half of the health insurance premiums. 

Read our guide on the artists’ social insurance fund to learn more.

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