This guide helps you choose the best health insurance for freelancing in Germany. All German residents need to health insurance. You also need it to apply for a freelance visa.
Your options
Use my health insurance picker to know your options.
Health insurance is more expensive for freelancers, because your employer does not pay half of it. For example, if your health insurance cost €250 per month as an employee, it will cost €500 per month as a freelancer.
There are 3 long-term health insurance options:
- Public health insurance
This is the safest option, because the cost is proportional to your income, and you can change your mind later. It costs 18.8% to 21.7% of your income. The minimum cost is around €230 per month. You can only choose public health insurance if…- You already have public health insurance
- or you had public health insurance in Germany for 2 of the last 5 years7
- or you had public health insurance in another EU country for 2 of the last 5 years7
- or you get free health insurance through your family
- or you join the Künstlersozialkasse
- or you join a freelancer cooperative
- Private health insurance
This option makes sense if you make over €60,000 per year. If you join at a young age, it’s better and cheaper than public health insurance.6 Ask my insurance expert if it makes sense for you. If you choose private health insurance, it’s really hard to change your mind later. - Expat health insurance
If you make less than €30,000 per year, and you can’t get public health insurance, this is your only option.1 It’s the cheapest option, but the coverage is bad, and it’s a bad long-term option. Switch to public or private health insurance as soon as you can.4
If you apply for a National Visa, you also need expat health insurance for your visa application. It covers you from the day you arrive in Germany to the day you get public or private health insurance. I recommend Feather, but there are many other options. You can stay on expat health insurance, but it’s usually a bad idea.
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.
Joining the KSK takes a few months. While you wait, you need public, private or expat health insurance.
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.
Freelancer cooperatives
Freelancer cooperatives are a way to get public health insurance. You join the cooperative, and they become your employer. Since you are an employee, you can choose public health insurance. You still need to pay the full price for public health insurance: the employee’s half, and the employer’s half.
Smart is a popular option. Membership includes services like invoicing, accounting, and legal advice.
Insurance for a freelance visa
You must get health insurance before you apply for a freelance visa. Freelance visa applications are often rejected because of invalid health insurance.3
Your options depend on your situation:
- To apply for a National Visa
To apply for a freelance visa at the German embassy or consulate in another country, you need expat health insurance. I recommend Feather, but there are many other options. - To apply for a residence permit
To apply for a freelance visa at the immigration office in Germany, or to convert your National Visa into a residence permit, the rules are different.- If this is your first residence permit
You can have public, private or expat health insurance. Don’t choose insurance yourself; ask my insurance expert to help you. - If you had a different residence permit before
You need public or private health insurance. Expat health insurance is rarely accepted. Keep your public health insurance; it’s the safest option. - If you renew your freelance visa
You need public or private health insurance. Expat health insurance is rarely accepted.5
- If this is your first residence permit
If you are applying for the Künstlersozialkasse, you can use expat health insurance plus a proof of your Künstlersozialkasse application.2
How to apply for a freelance visa
How to get insured
The best option depends on your citizenship, your income, your health, and your plans for the future.
If you are self-employed, never choose health insurance yourself. Always ask an expert to help you. It’s a complex decision, and freelancers often make expensive mistakes. Choosing the wrong health insurance can also delay your freelance visa application.
What to do next
After you get insured, you can apply for a freelance visa and start your business.
You must pay for health insurance by bank transfer every month. You can sign a direct debit authorization to allow automatic payments.
When you are self-employed, you do not get paid sick leave. If you are too sick to work, you have no income. You must prepare for this.
Sick leave options for freelancers
Sources and footnotes
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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) ⤴
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Reader feedback (February 2025) ⤴
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Seamus Wolf (June 2025) ⤴
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VAB A2.3.1.12 (September 2025), Feather Insurance (2025) ⤴
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Seamus Wolf (June 2025) ⤴