German health insurance for freelancers

By Nicolas Bouliane

This guide helps you choose the best health insurance for self-employment. All German residents need health insurance. You need it to apply for a freelance visa.

Your options

If you are self-employed, you can choose public, private or expat health insurance. Use my health insurance picker to compare options.

When you have a job, your employer pays half of your health insurance. If you are self-employed, you pay the full price yourself. If your health insurance cost €250 as an employee, it will cost €500 as a freelancer.

If you just moved from a EU country, you have 2 options:

  • Public health insurance 
    If you had public health insurance in your previous country, you can get public health insurance in Germany.8 You have 3 months to choose public health insurance.9 This is the safest option. If you have a low income, it’s the cheapest option.11 You can switch to private later if it makes more sense.5
  • Private health insurance
    If you earn more than €60,000 per year, private can be better and cheaper than public health insurance.7 If you had private health insurance in your previous country, it might be your only option.

If you just moved from a non-EU country, you have 3 options:

If you already live in Germany, you have 2 options:

  • Keep your public health insurance 
    If you have a low or unstable income, this is the safest option, because the price matches your income. You can switch to private later if it makes more sense.5
  • Private health insurance
    If you earn more than €60,000 per year, private can be better and cheaper than public health insurance.7 It might be your only option.
  • [Public health insurance]
    You can get free public health insurance through your family. You can get cheaper public health insurance if you join the Künstlersozialkasse. If you already have public health insurance, you can keep it. Otherwise, public health insurers will reject you.10

What is the best option?

The Künst­ler­so­zi­al­kas­se

If you are an artist, journalist, publicist or art teacher, join the Künstlersozialkasse (KSK). They pay half of your health insurance, and half of your public pension insurance. It’s always worth it.

If you earn less than €73,800 per year, you must switch to public health insurance after you join the KSK. It’s a good way to switch from private to public health insurance.

Joining the KSK takes a few months. While you wait, you need public, private or expat health insurance.

How to apply for the KSK

Insurance for a freelance visa

You need health insurance to apply for a freelance visa. Applications are often rejected because of invalid health insurance.4

How to apply for a freelance visa

If you already have a German residence permit, you usually need public or private health insurance. Expat health insurance is rarely accepted.

If you renew a freelance visa, you usually need public or private health insurance. Expat health insurance is rarely accepted.1

How to renew a freelance visa

If you applied for the Künstlersozialkasse, you can have expat health insurance plus a proof of your KSK application.3

How to choose

If you are self-employed, never choose health insurance yourself. It’s a complicated decision, and you can make big mistakes. The cheapest option today can be an expensive mistake later. The best option depends on your citizenship, your income, your health, and your plans for the future.

How to choose health insurance

Ask my health insurance expert to help you find better, cheaper health insurance.

Sources and footnotes

  1. Feather Insurance (2025) ⤴

  2. Emily Archer says that the amount is not fixed, but that insurers need to see that you can cover your insurance bills (April 2025), Seamus Wolf (April 2025) ⤴

  3. Reader feedback (February 2025) ⤴

  4. Red Tape Translation ⤴

  5. Seamus Wolf (June 2025) ⤴

  6. Seamus Wolf (June 2025) ⤴

  7. Seamus Wolf (June 2025) ⤴

  8. §5 Abs. 1 S. 13 SGB V ⤴

  9. eu-gleichbehandlungsstelle.de (June 2025) ⤴

  10. Seamus Wolf (June 2025) ⤴

  11. finanztip.de (January 2025), Feather Insurance (April 2025), Emily Archer (April 2025), Feather Insurance (June 2025) ⤴