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Which health insurance makes sense for the self-employed in Germany?

In short

What makes sense for the self-employed in Germany depends mainly on profit, age and family. In public health insurance you pay at least about EUR 270 to 290 and at most around EUR 1,200 to 1,270 a month in 2026. A good private tariff at 35 usually costs EUR 600 to 1,000, regardless of profit. Private cover tends to pay off with a high, stable profit, good health and no children who would otherwise be covered free.

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Which health insurance makes sense for the self-employed in Germany?

What it costs

Guide values from published statutory figures and tariff examples, monthly contributions 2026.

Example	Typical range
Public, minimum contribution with care	about EUR 270 to 290 a month
Public, maximum contribution with care	about EUR 1,200 to 1,270 a month
Private, 35, good tariff without care and sickness benefit	about EUR 600 to 760 a month
Private, 35, total with care, surcharge and sickness benefit	about EUR 800 to 1,100 a month
Private, 35, basic tariff with high deductible	from about EUR 350 to 450 a month

Guide values as of October 2026.

Public contributions include the fund's additional rate and care insurance with or without the childless surcharge.

The basic tariff is a guide value from our quoting practice.

Your private premium depends on age, health and tariff; we obtain the exact quote after the health assessment.

Worked example

Freelancer, 35, healthy, no children, EUR 6,500 profit a month

This is the comparison when profit is above the contribution ceiling.

Public with sick pay, maximum contribution with care	about EUR 1,260
Private, good tariff with EUR 600 deductible	about EUR 620 to 700
Private long-term care insurance and surcharge	about EUR 100 to 140
Daily sickness benefit EUR 150 from day 43	about EUR 40 to 70

Privately she pays about EUR 760 to 910 today, around EUR 350 to 500 less. She should set this difference aside, because the private premium rises with age and stays the same in weak years.

Public: contribution based on profit

In public insurance the self-employed are voluntary members and pay the full contribution alone. It is based on the profit in your tax assessment, at least EUR 1,318.33 and at most EUR 5,812.50 a month.

If you earn little, you still pay the minimum. If you earn more than the ceiling, you pay the maximum, however high your profit is above it.

A partner without income and children are usually covered free of charge. For families this is the main advantage of public insurance.

Monthly profit	Public with care, about	Private, about
up to EUR 1,318	EUR 270 to 290	the same, by age and tariff
EUR 3,000	EUR 615 to 650	the same, by age and tariff
EUR 5,000	EUR 1,030 to 1,090	the same, by age and tariff
from EUR 5,812.50	EUR 1,200 to 1,270	the same, by age and tariff

Private: premium based on risk

Private insurance charges by entry age, health and the benefits you choose. Your profit plays no role, not even in weak years.

Each person needs a separate contract, children included. On top come compulsory private long-term care insurance, a daily sickness benefit and, until 60, the statutory 10 percent surcharge.

Do not forget sick pay

When you are ill, you earn nothing as a self-employed person. In public insurance you only get sick pay from day 43 if you explicitly choose it and pay the higher contribution rate.

Privately you agree a daily sickness benefit with a fixed daily amount and your own waiting period. It should cover your running costs, both private and business.

When private insurance does not fit

With fluctuating or low profits, public insurance is usually safer because the contribution falls with income. A private premium stays the same and rises over the years.

If you plan children and your partner has no income, private cover quickly gets expensive. And if you want to return later, the only route into public insurance is usually a job subject to compulsory insurance before 55.

Step by step

Look at your profit for the last three years and estimate it realistically going forward.
Clarify family plans: partner with or without income, children.
Calculate the public contribution with your profit and your fund's additional rate.
Get private quotes with the same scope, including care insurance and sickness benefit.
Size the daily sickness benefit to your running costs.
Decide not only on today's premium but also with old age in mind.

Checklist

Profit permanently well above the minimum
Reserve for weak years and premium increases
Sick pay or daily sickness benefit in place
Family and children included in the calculation
Health questions answered completely
Retirement savings also cover the premium in old age

Common mistakes

Switching to private in the start-up year because profit is still low, then struggling with the fixed premium in weak years
Working without sick pay or sickness benefit and being left without income during a long illness
Forgetting children and partner in the private comparison
Believing you can return to public insurance at any time

Questions and answers

Frequently asked

Which option is cheaper for the self-employed?

With a low or fluctuating profit usually public insurance. With a high, stable profit, good health and no dependants, private cover is often cheaper at first.

Do I have to have health insurance as a self-employed person?

Yes, health insurance is compulsory in Germany. You choose between voluntary public insurance and private health insurance.

What is the minimum public contribution in 2026?

It is calculated on at least EUR 1,318.33 income and with care insurance is usually about EUR 270 to 290 a month.

What is the most I pay in public insurance?

The ceiling is EUR 5,812.50 profit a month, which means about EUR 1,200 to 1,270 with care insurance, depending on the fund and number of children.

Is private insurance worth it for founders?

Rarely. Profit is often uncertain in the first years and the private premium does not fall with it. Many wait until their profit has stabilised.

Can I return to public insurance as a self-employed person?

Usually only through a job below the income threshold that is subject to compulsory insurance, and from 55 hardly at all.

Can I deduct the contributions from tax?

Yes, the share for basic cover and long-term care counts in full as special expenses. For your individual case, ask your tax adviser.

Sources

NAMMERT insurance broker

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