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 to Germany, you have 3 options:
- Public health insurance
This is the safest option. You can switch to private later if it makes more sense.5 If you have a low income, it’s the cheapest option.9 Public health insurers reject freelancers. You can only choose public health insurance if…- You had public health insurance in another EU country for 2 of the last 5 years8
- or you join the Künstlersozialkasse
- or you get insured through your family
- or you join a freelancer cooperative
- Private health insurance
If your income is over €60,000 per year, this is the best long-term solution. It can be better and cheaper than public health-insurance-calculator insurance.7 - Expat health insurance
If your income is below €30,000 per year, it might be your only option.2 It’s the cheapest health insurance, but it’s a temporary solution and the coverage is not great. Switch to private as soon as you can.6
If you already live in Germany, you have 3 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. - Keep your expat health insurance
This is a bad idea, but if you have no other option, it can work for a few years.
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.
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
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.
What to do next
If 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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Feather Insurance (2025) ⤴
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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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Seamus Wolf (June 2025) ⤴
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Seamus Wolf (June 2025) ⤴
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finanztip.de (January 2025), Feather Insurance (April 2025), Emily Archer (April 2025), Feather Insurance (June 2025) ⤴