Health Insurance
for Self-Employed Individuals and Freelancers

If you are self-employed and new to the German Health Insurance System — without pre-existing coverage under a EU public health insurance scheme — you are required to take out private health insurance (PKV). Enrollment in statutory health insurance (GKV) is generally not possible.

If you were previously covered by statutory health insurance (GKV), you have the option to remain in the public system or switch to private health insurance.

Please note that switching from statutory to private health insurance is generally irreversible for the duration of your self-employment. The decision should therefore be made carefully — although in certain cases, private health insurance can offer significant long-term advantages.

Private Health Insurance (PKV)

Statutory Health Insurance (GKV)

Contribution Calculation:
For self-employed individuals, contributions to the statutory health insurance (GKV) are based on your taxable income as stated in your annual tax declaration — approximately 21% in total:
• 14.6% for health insurance and sickness benefits
•an additional income-based contribution (average 2.5%, depending on the insurer)
• approx. 4% for mandatory long-term care insurance

Examples:
🔹 Annual profit of €10,000
→ approx. €3,100/year (minimum contribution)
🔹 Annual profit of €50,000
→ approx. €10,600/year
🔹 Annual profit of €70,000
→ approx. €14,000/year (maximum contribution)

Advantages:
➡️ Cost-effective for large families with only one income
➡️ Lower contributions with lower taxable income
➡️ Based on social solidarity — higher earners support those with lower income

Disadvantages:
➡️ The government determines which treatments are covered
➡️ Services are provided within the principle of cost efficiency (§12 SGB V)
➡️ Longer waiting times for specialist appointments
➡️ High out-of-pocket costs for treatments outside the standard coverage

Contribution Calculation:
Premiums for private health insurance (PKV) depend on several individual factors such as age at entry, health condition, occupation, and chosen plan.

The contributions are highly personalized, but as a general tendency:
🔹 Entry age 25: €300–€700/month
🔹 Entry age 35: €450–€900/month
🔹 Entry age 45: €550–€1,300/month

Your entry age plays a crucial role — premiums do not increase with age later on, since ageing reserves (Alterungsrückstellungen) are built into the premium to keep the premium stable over time.

Advantages:
➡️ You are the direct contractual partner of your doctor, giving you full freedom to choose who treats you and to agree on the best therapy at eye level
➡️ Faster access to specialists and appointments
➡️ Flexible plan design, e.g. coverage for alternative practitioners

Disadvantages:
➡️ Expensive for large families, as there is no free family coverage
➡️ Medical underwriting required — access limited to those in good health
➡️ Serious long-term consequences if the wrong plan is chosen
➡️ Returning to statutory health insurance (GKV) can be difficult once insured privately

Choosing between statutory (GKV) and private health insurance (PKV) in Germany is a complex and long-term decision — it should not be based solely on premium differences. Your personal circumstances, career plans, health condition, and long-term outlook all play a decisive role in determining which system suits you best.

Eligibility for private health insurance depends on your health status, which means that joining early can be an important advantage.
However, once insured privately, switching back to the statutory system is difficult, so your choice should be made carefully.

A qualified and independent consultation is strongly recommended to avoid costly mistakes and ensure that your decision supports both your financial stability and long-term health security.

Let’s take a look at the key differences between the two systems:

Get in Touch

Making an Informed Decision: GKV or PKV

What Clients Say

Switching from Public to Private Health Insurance

"Mona was super helpful finding the right health insurance for me. She answered all my questions I had throughout the process, explained all the different insurance options and vas very friendly!

Overall great service, thank you Mona!"

Setting up Expat Insurance

"Mona was genuinely one of the kindest and most patient people I have met. She was recommended to me and took the time to email me a questionnaire, explain a few options, and then she called me via Zoom and helped me set everything up right there and then. I asked a lot of questions as the insurance matters quite a bit for immigration and she was able to comprehensively answer each one.

I highly, highly recommend making your life easier and going with Mona for all insurance needs."