German health insurance for freelancers

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:

What is the best option?

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.

Get health insurance

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.

How to apply for the KSK

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:

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 renew 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
  1. 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) 

  2. Reader feedback (February 2025) 

  3. Red Tape Translation 

  4. Seamus Wolf (June 2025) 

  5. VAB A2.3.1.12 (September 2025), Feather Insurance (2025) 

  6. Seamus Wolf (June 2025) 

  7. § 9 Abs. 1 S. 1 SGB V