Health Insurance for Free Lancers in Germany - clearly explained

Health Insurance in Germany can be complicated

In this article we will discuss health insurance options for free lancers from countries outside of the European Union (EU) and the European Economic Area (EEA) in Germany. After reading the article you are familiar with the terms incoming insurance, voluntary insurance, private insurance and how to access them. You will know what to do if you have a chronic disease or other pre-existing conditions.

So you received your residence permit as a free lancer in Germany. Congratulations!

As proof of health insurance you showed the immigration office proof of a timely limited incoming insurance that covers emergencies and acute illnesses. The benefit basket is quite limited but it was enough to get the permit.

At this point the question arises if those insurance plans can be a long term solution. Let’s dig into that!

What is the matter with so called incoming insurances?

They are a good starting point for getting settled in Germany since you need some kind of proof of insurance to receive your residence permit. If you are generally healthy without pre-existing conditions that is fine. However, as soon as you actually need medical assistance things tend to get complicated. Often, only visits in the emergency room are covered, but in-patient services are not – or the other way around. Pregnancy screenings and births are generally not covered. Also, the new onset of a chronic disease might be covered, however, after the health insurance is expired this new disease will most likely not be covered in the new contract. Or you will get rejected.

Private Health Insurance (PKV – Private Krankenversicherung)

Currently, your only realistic option is a plan in a private health insurance. Therefore, check this list of private health insurances: https://www.krankenkassen.de/private-krankenversicherung/pkv-liste/

Look for the beautiful german word Kranken(kosten)vollversicherung (Full Sickness Insurance).

Be aware that before you register with a chosen PKV the insurance provider is asking for a medical and dental check-up. You must pay this check-up by yourself. Private health insurances follow risk assessment to set the monthly fee. This means: the younger and healthier you are the less you pay. The older you get the more you pay. Pre-existing conditions are either excluded from the plan or increase the monthly contribution.

However, if you are chronically ill you should know about the following (maybe not very attractive) option: Basistarif

Basistarif in private health insurance

To be frank, we always feel silly advising this option because for most people it is not really an option due to the high price.

Basistarif in PKV is supposed to be an equivalent to the benefit basket of the statutory health insurance for for people who cannot access the statutory health insurance. Sounds weird, right? However, the monthly costs are usually the maximum price of the statutory health insurance. That is around 800 EUR per person per month. Pre-existing conditions are included and the care package is more or lett comparable to the statutory health insurance.

If you are entitled to social benefits (mainly citizens from other EU/EEA countries or people with a unlimited residence permit/Niederlassungserlaubnis) you can apply for benefits from Jobcenter. The Jobcenter will check if your monthly income and if by paying Basistarif you would be come entitled to social benefits, the Basistarif would then be reduced by 50 percent and Jobcenter would cover it. Quite bureaucratic but definietly worth it!

Statutory health insurance (GKV – gesetzliche Krankenversicherung)

As a free lancer you can access the statutory health insurance in Germany if you were enrolled in a public health insurance within the European Union. You need to prove your previous insurance of at least 24 months within the last five years or at least 12 months right before you want to enroll (legal basis).

After the previous insurance ends you need to register within three months for the voluntary insurance.

The majority of the German population is covered in the statutory health insurance. Generally all health conditions are covered with small contributions to medications. Pre-existing conditions are not excluded and the monthly fee is 14,6 percent of your monthly income.

All members of the public insurance enjoy the same benefit basket.

Free lancing artists and publishers (KSK – Künstlersozialkasse)

Artists might be eligible for KSK

If your field of work is related to art you should check if you qualify for Artists Social Fund (KSK – Künstlersozialkasse). KSK covers half the contribution to a public health insurance. Just as if you were employed, only that you are not.

We need to distinguish between different statuses. Therefore, you need to have a look at your residence permit and the so called ‘Zusatzblatt’ (additional paper).

Does either the permit or the ‚Zusatzblatt‘ mention „Erlischt bei Bezug von Leistungen nach SGB II, SGB XII und AsylbLG“ (that means you need to be able to make your own living. As soon as you apply for social benefits your residence permit will be terminated)?

If yes, for now you are not entitled to enroll in the voluntary insurance of the statutory health insurance. Your only access to Health Insurance in Germany is through private Insurance or Incoming Insurance

If you are interested in a personal video call to assess your situation you can book my services by email

kv.fragen@gmail.com