Health insurance for freelancers in Germany

On day one, an entry-level private tariff is usually cheaper. Over 20–30 years, public can be cheaper for freelancers with growing families and stable income. There's no universal answer.

Yes. The portion of either public or private premium that covers basic medical care is deductible as a special expense (Sonderausgaben) on your German tax return.

Public: ask your Krankenkasse to recalculate based on the most recent tax return — premiums drop. Private: nothing changes — you pay the contracted premium regardless of income.

No. Self-employed and freelance workers are completely free to choose. You can start in private from day one, regardless of income. The only exception is artists and writers under the Artists' Social Insurance scheme (Künstlersozialkasse), who join public by default but can opt for private.

Public premiums for the self-employed are based on income, with a minimum assumed monthly income of around €1,179 and a ceiling of €5,512.50 (2026 values). That puts public contributions between roughly €220 and €1,030 per month, plus long-term care insurance. Private is often cheaper, especially for higher earners.

Yes. Freelancers should add daily sickness allowance (Krankentagegeld) to their plan, since they have no employer paying continued salary. You choose the daily amount and the waiting period (typically 22 to 43 days). It pays out tax-free if you are unable to work due to illness.

You need valid German health insurance. Both public and private are accepted by the Ausländerbehörde. Many freelancers on a residence permit for self-employment go with private because of faster approval and English-language support.

If your gross salary is above the income threshold, you can stay in private. Below it, you must switch to public by default. There are exceptions for people over 55 who have been privately insured for long enough. We always run the numbers before you switch so there is no surprise.