Health Insurance for Self‐Employed

The 2009 health insurance reform made it compulsory for everyone who visits or lives in Germany to have adequate health insurance — including people who are self-employed. In Germany, freelancers and the self-employed can freely choose between private insurance and voluntary participation in the public health insurance scheme as long as they are a member oft the EU. If you are self-employed and you are not a member of the EU you do not have access to the german public health insurance. There are some important differences between public and private health insurance in Germany that you should consider as you make your decision.
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Private Health Insurance for the Self‐Employed

The amount you pay for private health insurance depends on your age, the level of coverage you want, and how healthy you are. This means that younger people, especially those with higher income, will likely find a much better balance of coverage/service and price in private insurance policies than they would in public health insurance.

Private health insurance companies also offer more flexible coverage — you can choose individual services according to your circumstances, only paying for what you need.

Freelancers and the self-employed generally opt for private health insurance coverage. This is, in part, because self-employed people tend to be young and healthy but also because of these benefits of private insurance:

  • check mark The cost of coverage isn’t dependent on your income.
  • check mark You’ll have shorter waiting times for appointments.
  • check mark You can adjust your contributions based on the services you’re interested in or by increasing your deductible.
  • check mark Some insurance companies offer premium refunds and bonus programs when you don’t make any claims.

Another significant benefit is that the cost of basic private coverage (equivalent to that of public health insurance) is fully tax deductible. Your contributions are considered special expenses, and you can add them to your tax return. The health insurance company will decide the exact amount that can be deducted (depending on the services) and issue you a tax certificate every year.

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Public Health Insurance for the Self‐Employed

Your contribution to public health insurance is calculated as a percentage of your gross income, specifically 14.6 %. Public health insurance companies are also allowed to charge an additional contribution wich is 1.6 % in 2023. An additional 3.3% is charged for compulsory nursing care insurance as well.

There are several disadvantages of public health insurance for freelancers and self-employed individuals:

  • check mark In a traditional employment relationship, your employer would cover half of your contribution. When you’re self-employed, you’re usually responsible for the entire contribution.
  • check mark You may face long waiting times for appointments and treatments with providers who accept statutory health insurance.
  • check mark Sick pay coverage doesn’t go into effect immediately, and it’s not built into your policy. It must be added on for an additional cost.
  • check mark Self-employed people with low income might have trouble affording the minimum health insurance contribution.

Because the contribution is based on income, high earners will have to pay much more, up to the maximum amount of 927,68 € per month.

A public health insurance policy might be more cost effective if you have a family, as it will cover all of your dependents. But the coverage and service may not meet the standards of a private plan.

Private Health Insurance For Germany

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