Guide
Health insurance for the self-employed
Information only · figures are 2026 · no guarantee
Health insurance is compulsory in Germany, and that does not change when you go freelance. What does change is that nobody enrols you automatically — you choose your own cover and you carry the full cost. The main decision is between the statutory system (GKV) and private insurance (PKV). Here is how each one works for the self-employed, with 2026 figures.
You are not automatically in GKV
As an employee, statutory health insurance is deducted from your salary and your employer pays half. The self-employed do not get that. When you become a freelancer you have to set up cover yourself and pay the whole contribution. Most freelancers can stay in the statutory system as a voluntary member (freiwillig versichert), or switch to a private policy — but the choice, and the paperwork, are on you.
Statutory cover (GKV): income-based contributions
In the statutory system your contribution is tied to your income rather than your age or health. Your fund (Krankenkasse) applies its percentage rates to your income, but only up to a ceiling called the Beitragsbemessungsgrenze. In 2026 that ceiling is €5,812.50 per month: income above it is not counted toward your contribution. That makes GKV predictable and family-friendly, since non-earning spouses and children can often be co-insured at no extra premium.
Private cover (PKV): risk-based premiums
Private health insurance works differently. Premiums are not based on your income but on the plan you pick and your individual profile — age and health when you join. PKV can offer broader benefits and, for some younger, healthy, higher-earning freelancers, a lower starting price. The trade-offs are that premiums are individual, family members are each insured (and priced) separately, and moving back to GKV later can be difficult. Whether PKV suits you is a genuinely personal calculation.
Care insurance (Pflegeversicherung)
On top of health cover, Germany has a separate mandatory long-term care insurance — the Pflegeversicherung. It funds support if you ever need nursing or daily-living care, and it is not optional: it comes bundled with your health insurance in both systems. In GKV it is an additional income-based contribution; in PKV it is a separate private care policy. Budget for it as part of your total insurance cost, not an afterthought.
Making the choice
There is no universally "cheaper" option — the right answer depends on your income, age, health, and whether you need to cover a family. Because the decision has long-term consequences (especially the difficulty of returning to GKV from PKV), many freelancers talk it through with an independent insurance adviser, and with a Steuerberater for how contributions interact with their tax return, before committing.
Frequently asked
Am I automatically in the statutory system when I go self-employed?
No. Employees are enrolled in statutory health insurance (GKV) through their job, but the self-employed are not. When you become a freelancer you have to arrange cover yourself — either as a voluntary GKV member or through a private (PKV) policy.
How are voluntary GKV contributions calculated?
They are income-based. Your statutory fund looks at your total income and applies its contribution rates up to the Beitragsbemessungsgrenze — the assessment ceiling, which is €5,812.50 per month in 2026. Income above that ceiling is not counted. Care insurance is added on top.
Which system is cheaper, GKV or PKV?
It depends entirely on your income, age, health and family situation, so there is no single answer. GKV cost tracks your income; PKV premiums are risk-based and individual. This is a decision to weigh carefully, ideally with an independent insurance adviser.
Context: statutory health insurance (GKV) and long-term care insurance (Pflegeversicherung) are governed by the Sozialgesetzbuch (SGB V and SGB XI); private cover (PKV) sits outside them. Figures shown are for 2026.