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An expat's guide to Health Insurance - Choices for Freelancers

Entrepreneurship, Tips for small businesses · 13/12/16 13:15 · Monika Butterweck


Your health is the most important thing in your life. It's also the solid foundation of a successful career. But some things are unpredictable. This is why health insurance is mandatory in Germany! There's no way around it, and the market is big. As a freelancer, you have a variety of choices to go for. Here's our guide through the jungle of German insurance.


Gesetzliche Krankenversicherung

Most Germans are members of a Gesetzliche Krankenversicherung (state health insurance system; GKV). As an employee, membership in one of the GKV’s is mandatory if you earn less than 4800€ a month. However, as a freelancer, you have the right to choose if you want to be member of a GKV or a private insurance company.

Health insurance in the GKV covers a standard set of benefits, with some companies offering additional plans, e.g. a Zahnzusatzversicherung for dentistry work or plans covering homoeopathy.

The membership fee (Beitrag) in a GKV costs around 14,6% of your income. The minimum monthly income taken into account for calculating your Beitrag is 1.038,33 € per month. If your income is lower than that, you still have to pay 14,6% of that 1.038,33 €. On the other hand, the maximum income taken into account is 4.537,50 €. So, if your income is higher than that, you still only have to pay 14,6% of this sum. If your income is in between those numbers, your Beitrag will be calculated accordingly.

health insurance expat freelancer germany private


Private Krankenversicherung

As a freelancer, you have the right to become a member of a Private Krankenversicherung (private health insurance, PKV) at any time. As opposed to an employee, you don’t have to earn a certain amount of money to be eligible.

The PKV can be less expensive than a membership in the GKV. This depends on many factors though. If you’re young and in a good state of health, your costs will be lower, than if you’re older with a chronic disease. You can keep the costs low, by adapting your plan to your needs. But as life goes on, unexpected things can happen. In case of an accident or a complicated illness, things can get very expensive if treatment for it is too specific and not covered by your plan. Also, if you decide for a private health insurance plan, you have to pay up to 1000€ of medical costs yourself, per year. You can choose a plan with less co-payment (Selbstbeteiligung), but then your Beitrag will be way higher.

PKV comes with perks, as well. Depending on your plan you can expect easier access to specialists as well as a better treatment in hospitals. More expensive plans guarantee the chief physician taking care of you personally. But it comes at a cost. It’s important to do your research, otherwise you can end up overpaying. You can, however, get yourself an inexpensive plan in the beginning and later adapt it. But be aware: once you have joined a PKV, changing back into the GKV is very difficult. You could be stuck with a relatively high Beitrag even if your income would decline.



Expatriate Health Insurance

An an expat, you have an alternative to the German health insurance system. You can buy an expatriate/international health insurance in your home country. Those plans can be very inexpensive, when compared to the German government insurance scheme, but they can also be quite risky. When purchasing a plan like this, make sure your insurance company is BaFin approved. Only BaFin approved companies can provide their service in Germany. Also, have a look at what your insurance actually covers. International health insurance plans often only cover a fraction of what the GKV must offer as a minimum. Be careful, otherwise your inexpensive health insurance could end up costing you much more than the GKV or PKV. 


What to choose? Pros and Cons

We can’t tell you what to choose, as you know yourself and your needs best.

So we present you with some pros and cons for all of the three options, as no health insurance is no option in Germany.

Gesetzliche Krankenversicherung (GKV):



Stable cost, depending on your income 

No perks like PKV

Standardised set of benefits 

Long waiting, no special treatment

Little extra cost 

Just for standard procedure

Covers you and your non-working family members


Good price level (min. 188 €/ month)



Private Krankenversicherung (PKV):


Expatriate Health Insurance:


Whatever you choose, stay healthy!


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