Private or statutory health insurance for the self-employed: which system fits better?

Under the statutory requirements, people whose main occupation is self-employment can choose voluntary statutory health insurance or private health insurance. Unlike employees, they do not have to pass a Jahresarbeitsentgeltgrenze (i)JAEG · JahresarbeitsentgeltgrenzeThe annual income threshold in Germany. Employees who earn more than this per year may leave statutory health insurance and switch to private health insurance.More about JAEG → to enter private health insurance.

The biggest difference lies in how contributions are calculated. For people voluntarily insured in statutory health insurance, § 240 (1) SGB V says that their entire economic capacity should be taken into account. In private health insurance, by contrast, the premium is calculated for the cover agreed in the contract.

In 2026 the Beitragsbemessungsgrenze of health insurance is €5,812.50 per month or €69,750 per year, according to the Federal Ministry of Health 2026.

In 2026, self-employed people without entitlement to Krankengeld (i) pay the reduced health insurance contribution rate of 14.0% plus the additional contribution of their fund. If you choose the statutory Krankengeld entitlement from the seventh week, you pay the general contribution rate of 14.6% plus the Zusatzbeitrag. The average Zusatzbeitrag (i)ZusatzbeitragThe additional contribution each statutory health insurance fund charges on top of the general rate. Its level differs from fund to fund.More about Zusatzbeitrag → in 2026 is 2.9%, and each statutory health insurance fund can deviate from it.

At the maximum contribution, a self-employed person with statutory Krankengeld (i) pays a health insurance contribution of €1,017.19 per month in 2026, according to the Federal Ministry of Health 2026.

For a childless insured person aged 23 or over, long-term care insurance of 4.2% is added in 2026. At the Beitragsbemessungsgrenze (i) of €5,812.50, this comes to €244.13 per month.

€1,017.19 for health insurance plus €244.13 for long-term care insurance gives a childless self-employed person a calculated total of €1,261.32 per month.

Our model client is self-employed, born in 1992 and has no relevant pre-existing conditions. In 2026 the private plan costs €439 per month with an annual deductible of €600, including private Pflegepflichtversicherung (i)PflegepflichtversicherungCompulsory long-term care insurance. Everyone with health insurance in Germany must have it, privately insured people through their private insurer. (PKV-Welt sample calculation 2026).

On top of this come €43.08 per month for Krankentagegeld (i) of €120 per day from day 43. The total premium is therefore €482.08 per month.

This difference is not a general saving from private health insurance. Our private figure applies to exactly this model person, while the statutory figure shows the maximum contribution in 2026. How the private premium changes with other deductibles is shown in the costs for the self-employed.

This is exactly why the decision should not be based on the largest possible price difference. With a lower profit, the statutory contribution is lower, while the private premium does not automatically fall with your income.

We would not advise a self-employed person to choose private health insurance only because it is €50 or €100 cheaper when they start their business.

In the first years of self-employment, it is often hard to judge how stable the income will be in the long term. In this situation, the income-based contribution principle of statutory health insurance has an advantage. If the economic capacity subject to contributions falls, the contribution can change as well.

For an established self-employed person, the decision looks different. If the income has been stable for several years, there is enough liquidity for weaker business phases and the desired private benefits are affordable, the income link of statutory health insurance loses part of its advantage.

Our advice rule here is simple. Private health insurance should be affordable from regular, predictable income. A short-term premium saving is not a sufficient basis for this.

For people voluntarily insured in statutory health insurance, the business profit is not the only relevant figure. Under § 240 (1) SGB V, the contribution assessment must take the entire economic capacity into account. This means that income from capital and from renting and leasing can also become relevant.

For a self-employed person with several sources of income, this can make a considerable difference. If you earn larger rental income alongside your business, do not look only at your business profit for the statutory comparison.

Timing also plays a role. Under § 240 (4a) SGB V, contributions from self-employment are first calculated provisionally on the basis of the last income tax assessment or, when you start your business, on the basis of the expected income. Once the tax assessment is submitted, the final contribution is set for the calendar year concerned.

This can lead to refunds. Back payments are also possible.

A single self-employed person compares differently in financial terms than a self-employed person with a spouse and several children.

Under § 10 SGB V, spouses and children can be covered free of charge through family insurance if the statutory requirements are met. The Federal Ministry of Health confirms that children, spouses and civil partners in family insurance do not pay their own statutory contribution.

In private health insurance, by contrast, every person needs their own cover. For families, this can change the whole calculation considerably.

The claim that private health insurance is cheaper on a high income is therefore too general. A childless self-employed person with a high and stable income can reach a different result than a sole earner with a spouse and three children.

Apart from costs, statutory and private health insurance differ in how the scope of benefits is defined.

In statutory health insurance, the entitlement to benefits follows from the Social Code. Among other things, § 11 SGB V names benefits for the treatment of illness, prevention and medical rehabilitation. Statutory health insurance funds can also offer certain extra benefits under their statutes.

In private health insurance, under § 192 (1) VVG the insurer undertakes to reimburse medically necessary treatment to the agreed extent. The chosen plan conditions therefore define the contractual scope of benefits.

Before switching, a self-employed person should therefore be clear about which medical cover they actually want to buy. In our view, a low private premium with weaker insurance conditions is not a sensible answer to the question of the system.

Which plans and benefit areas we check for the self-employed is covered separately in our article on the best private health insurance for the self-employed.

The health insurance contribution alone does not fully reflect the cover of a self-employed person.

Self-employed people voluntarily insured in statutory health insurance initially have no statutory entitlement to Krankengeld (i) and therefore pay the reduced contribution rate. They can choose an entitlement to Krankengeld from the seventh week with their statutory health insurance fund and then pay the general contribution rate of 14.6%, according to the Federal Ministry of Health 2026.

In private health insurance, loss of earnings is covered by Krankentagegeld agreed in the contract. § 192 (5) VVG explicitly describes Krankentagegeld (i) as compensation for the loss of earnings caused by inability to work.

In 2026, around 99% of our self-employed clients choose Krankentagegeld (i) starting from day 43 (PKV-Welt advice practice 2026).

In the system comparison, we therefore compare statutory health insurance with Krankengeld (i) against private health insurance with Krankentagegeld (i). Anything else would compare different levels of cover.

Business founders with fluctuating income. If you are just building your business and cannot yet judge whether the income will carry you in the long term, statutory health insurance gives you a contribution logic based on income. In this situation, we would not justify a switch to private health insurance only by a lower starting premium. The business should first build an economic basis from which the private premium can be paid safely, even in weaker months.

Established self-employed person with a stable income. With income that is predictable over the long term, private health insurance more often becomes interesting. Income does not raise the private plan premium. At the same time, the insured person can choose the scope of benefits in the contract. If you have high income subject to contributions, you will at some point reach the Beitragsbemessungsgrenze (i) of €69,750 per year in 2026 in statutory health insurance. For this group, the comparison should focus more on benefits, long-term affordability and overall cover.

Self-employed person with a family. With a spouse who has no relevant income of their own and several children, free family insurance in statutory health insurance can carry considerable financial weight. Private health insurance can still be a good fit if the family consciously wants to pay for the desired scope of benefits and the separate premiums. The premium calculation must then be made for the whole family.

For the self-employed, we often consider statutory health insurance the sounder starting point if the income still fluctuates strongly or if free family insurance offers a considerable financial advantage.

Private health insurance becomes more interesting for us if the income is predictable over the long term, there are sufficient reserves and the medical scope of benefits fixed in the contract is highly important to you.

The specific monthly amount comes only second. In 2026 our model client pays €482.08 including Pflegepflichtversicherung (i) and Krankentagegeld (i), while the statutory maximum contribution for a comparable childless self-employed person in 2026 comes to €1,261.32. For us, this difference alone would still not be a sufficient reason to change systems.

A good decision therefore answers the question of your economic and family situation first. Only then do we compare the specific costs. If you want to look at the question of the system regardless of your occupation, you will find the basics under private or statutory insurance.

• Federal Ministry of Health, social insurance calculation values 2026.
• Federal Ministry of Health, contributions to statutory health insurance 2026.
• Federal Ministry of Health, financing of long-term care insurance 2026.
• § 240 SGB V, income of voluntary members subject to contributions.
• § 10 SGB V, family insurance.
• § 11 SGB V, types of benefits in statutory health insurance.
• § 192 VVG, benefits of the insurer and Krankentagegeld (i).
• PKV-Welt sample calculation 2026, self-employed person, born in 1992, no relevant pre-existing conditions, plan with a deductible of €600 including private Pflegepflichtversicherung (i), Krankentagegeld (i) of €120 from day 43 for €43.08 per month.
• PKV-Welt advice practice 2026, around 99% of the self-employed people we advise choose Krankentagegeld (i) starting from day 43.