Private health insurance costs for the self-employed: premium, statutory comparison and deductible

Private health insurance calculates the premium regardless of your current profit. A successful business year therefore does not automatically change the agreed plan premium. In voluntary statutory health insurance, the contribution depends on your economic capacity up to the Beitragsbemessungsgrenze, as § 240 (1) SGB V requires.

Self-employed people with voluntary statutory insurance do not pay contributions in 2026 only on the profit from their self-employed work. For 2026, the Federal Ministry of Health also names income from capital assets and from renting and leasing as possible income subject to contributions. § 240 SGB V looks at your entire economic capacity for this.

In 2026, statutory contributions on earned income are first set provisionally and later set finally on the basis of the income tax assessment, § 240 (4a) SGB V. A better business year can therefore lead to a back payment. If your actual income is lower, you may in turn receive a refund.

In 2026, the Beitragsbemessungsgrenze (i) is €5,812.50 per month or €69,750 per year, according to the Federal Ministry of Health 2026. For self-employed people with a statutory entitlement to sick pay, the maximum health insurance contribution in 2026 is €1,017.19 per month, based on the average Zusatzbeitrag of 2.9%. The 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 → of your individual fund can differ from this.

For statutory long-term care insurance, the rates in 2026 are 3.6% with one child and 4.2% for people without children, according to the Federal Ministry of Health 2026. Based on the ceiling for 2026, this gives €209.25 or €244.13 per month (PKV-Welt calculation 2026 based on the Federal Ministry of Health values for 2026).

In statutory health insurance, the child in this comparison is covered free of charge through family insurance under the conditions of § 10 SGB V. In private health insurance, the child costs €166.41 per month in 2026 with the same insurer, with a €0 deductible (PKV-Welt example calculation 2026).

The gap is not a general advantage of private health insurance. With a lower income, the statutory contribution can fall. In private health insurance, entry age, health, scope of benefits and plan design change the premium you can actually get.

For 2027, the monthly ceiling will be raised once by an extra €300 on top of the regular update, according to the Federal Ministry of Health 2026. On October 7, 2026, the federal cabinet set the ceiling at €6,375 per month or €76,500 per year. The Federal Council still has to approve it.

The values for 2027 include the regular update and the extra increase of €300 per month. What else changes is explained in our news item on the new income thresholds.

If the average Zusatzbeitrag (i) stays at 2.9% in 2027, a ceiling of €6,375 gives a health insurance contribution of around €1,115.63 per month (PKV-Welt model calculation 2027). For self-employed people, a higher ceiling has its full effect on their own burden as soon as their income subject to contributions is above the ceiling.

A self-employed person should only compare an online premium once the deductible, the Pflegepflichtversicherung (i) and the Krankentagegeld (i) are visible. A premium of €300 or €350 may be calculated with a high deductible or may leave out important components. This is why our example shows price and benefits together.

What matters is not the lowest monthly premium but the total annual burden. For our example client in 2026, we can calculate the same plan with three deductible levels. In the example, the benefits stay the same. In all three versions, the Krankentagegeld (i) costs an extra €43.08 per month in 2026 (PKV-Welt example calculation 2026).

Compared with a €0 deductible, the version with a €600 deductible saves €1,160.28 in premiums per year in 2026 (PKV-Welt example calculation 2026). Even if the full €600 is used, the calculated annual burden before tax and no-claims refund remains €560.28 lower.

Between a €600 and a €1,200 deductible, the premium difference in 2026 is €686.64 per year (PKV-Welt example calculation 2026). The additional deductible is €600. Even if it is fully used, the version with a €1,200 deductible is still €86.64 lower in this model calculation.

This calculation does not decide the plan on its own. Tax effects, the no-claims refund, liquidity and a later reduction of the deductible also belong in the review. A lower deductible later can count as an extension of benefits and can trigger new health questions, as the Association of Private Health Insurers explains in 2026.

Self-employed people have no continued pay from an employer. In statutory health insurance, if you choose the general contribution rate, you are entitled to sick pay from the 43rd day in 2026, according to the Federal Ministry of Health 2026. In private health insurance, this income protection must be agreed to match your actual need.

In 2026, our example covers €120 per day from the 43rd day for €43.08 per month (PKV-Welt example calculation 2026). In our advice work, around 99% of our self-employed clients in 2026 choose a start from the 43rd day, because this balance of ongoing premium and their own bridging period suits them best (PKV-Welt advice practice 2026, as of September 2026).

With a need of €120 per day, a calculated €5,040 must be bridged for the first 42 days (PKV-Welt model calculation 2026). You should have this liquidity reserve. In addition, health insurance and Pflegepflichtversicherung (i) keep running during a longer period of incapacity for work, as the Association of Private Health Insurers points out in 2026. How the amount and the qualifying period affect the premium is explained in the article on Krankentagegeld.

For self-employed people, we often prefer solid mid-range plans with a good contractual option right. This keeps the ongoing premium manageable, and later extensions of benefits can be possible without new health questions under the terms of the plan.

This makes particular sense for young businesses. If income rises sharply later, an existing option right can make it easier to extend your cover. Scope, deadlines and conditions are set out in the terms of each plan and must be checked before you sign.

If your income falls or your premium rises, there are several cost levers within an existing private health insurance contract. Which of them make sense depends on the plan, your state of health, liquidity and the level of benefits you want.

In 2026, § 204 (1) VVG gives insured people the right to change to other plans of their own insurer with similar cover, with acquired rights and ageing reserves credited. For higher or more extensive benefits, the insurer may set additional health conditions.

A no-claims refund should not be built into the monthly premium as a fixed amount. Whether it is actually paid out depends on your use of benefits and on the terms of the plan. In 2026, the Association of Private Health Insurers describes the no-claims refund as a plan-dependent benefit for claim-free years.

In 2026, our example plan treats certain preventive check-ups independently of the deductible and the no-claims refund (PKV-Welt plan example 2026). This is a specific benefit feature of this plan and must not be applied to other plans.

In 2026, the minimum assessment basis for self-employed people with voluntary insurance is €1,318.33 per month, according to the Federal Ministry of Health 2026. Based on the average Zusatzbeitrag (i), the minimum health insurance contribution with an entitlement to sick pay is €230.71 per month in 2026, plus long-term care insurance in each case.

With low or strongly fluctuating income, statutory health insurance can therefore be cheaper. Private health insurance does not automatically become cheaper after a bad business year. Self-employed people should therefore also factor the stability of their income and their savings into the decision. The other criteria that count for the choice of system are covered in the comparison statutory or private health insurance.

In private health insurance, each family member needs their own contract. In our example, a child costs €166.41 per month in 2026 with the same insurer and a €0 deductible (PKV-Welt example calculation 2026). Together with the self-employed person in the plan with a €600 deductible and their Krankentagegeld (i), the monthly family burden is €648.49.

In statutory health insurance, the child can be covered free of charge through family insurance under the conditions of § 10 SGB V. This is why, for self-employed people with a family, we compare the costs of the household and not only the premium of the self-employed person.

In 2026, premiums for private basic cover and for private Pflegepflichtversicherung (i) can be claimed as special expenses under § 10 (1) No. 3 EStG. The tax-deductible share is not automatically the same as the whole private premium. Under § 10 (1) No. 3 EStG, Krankentagegeld (i) is not part of the tax-deductible basic cover.

Statutory health and long-term care contributions are also taken into account for tax. A fair comparison must therefore look at both systems under the same tax assumptions. The specific tax effect depends on your personal situation. We do not provide individual tax advice.

An online premium of €439 is only relevant if you actually meet the health requirements for this premium. This is why we first prepare your health history and check your insurability anonymously before a formal application is made.

From more than 5,000 applicants we have taken through the health questions up to September 2026, we know that insurers can assess the same history differently (PKV-Welt experience 2026). Only after this check is a premium reliable enough for a cost comparison.

With a €600 deductible, our example for 2026 costs a total of €482.08 per month, including private Pflegepflichtversicherung (i) and €120 Krankentagegeld (i) from the 43rd day. In 2026, the same plan costs €578.77 per month with a €0 deductible and €424.86 per month with a €1,200 deductible, each including the same Krankentagegeld (PKV-Welt example calculation 2026).

The right version follows from premium, own risk, health, liquidity, option rights and the benefits you want. For self-employed people, this combination matters more to us than the lowest possible entry price.

• Federal Ministry of Health, contributions to statutory health insurance 2026, accessed September 11, 2026.
• Federal Ministry of Health, financing of long-term care insurance 2026, accessed September 11, 2026.
• Federal Ministry of Health, FAQ on the act to stabilize statutory health insurance contribution rates 2026, accessed September 11, 2026.
• § 240 SGB V, income of voluntary members subject to contributions.
• § 10 SGB V, family insurance.
• § 204 VVG, plan change.
• § 10 EStG, provision expenses.
• Association of Private Health Insurers (PKV-Verband), deductible in private health insurance, accessed September 11, 2026.
• Association of Private Health Insurers (PKV-Verband), no-claims refund in private health insurance, accessed September 11, 2026.
• Association of Private Health Insurers (PKV-Verband), benefits and reimbursement, accessed September 11, 2026.
• PKV-Welt example calculation 2026, self-employed person, born in 1992, no relevant pre-existing conditions. Plans with a deductible of €0, €600 and €1,200, Pflegepflichtversicherung (i) included in each case, Krankentagegeld (i) of €120 from the 43rd day for €43.08 per month.
• PKV-Welt plan example 2026, single room, shortened dental limit schedule and preventive check-ups defined in the plan, independent of deductible and no-claims refund.
• PKV-Welt example calculation for a child 2026, a child costs €166.41 per month with the same insurer and a €0 deductible.
• PKV-Welt advice practice 2026, as of September 2026, around 99% of the self-employed clients we advise choose a Krankentagegeld (i) start from the 43rd day.
• PKV-Welt experience 2026, as of September 2026, more than 5,000 applicants taken through the health questions.