Voluntarily insured in statutory health insurance: who, what it costs, what it means

Voluntarily insured in statutory health insurance means membership in statutory health insurance without a legal obligation. If you meet none of the grounds for compulsory insurance in SGB V, you first leave compulsory insurance. Under § 9 SGB V, you can then continue your insurance voluntarily, provided you were a statutory member before.

If compulsory membership ends, the mandatory follow-on insurance under § 188 (4) SGB V applies. Your membership then continues automatically as voluntary insurance, unless you actively object within two weeks.

Voluntarily insured people carry more personal responsibility than compulsory members, above all for reporting all of their income to the statutory health insurance fund.

Voluntary statutory membership is an option for several groups, each with its own trigger.

Employees are exempt from compulsory insurance as soon as their regular annual earnings exceed the Jahresarbeitsentgeltgrenze of €77,400. After that, they can stay in the statutory health insurance fund or switch to private health insurance. The self-employed usually meet no grounds for compulsory insurance and have a free choice between both systems. Civil servants are mostly exempt from compulsory insurance and often pay a voluntary contribution themselves without an employer contribution. That is why private health insurance together with Beihilfe (i)BeihilfeThe state healthcare allowance for civil servants. The Beihilfestelle pays a fixed share of medical costs, the Beihilfesatz, and private insurance covers the rest.More about Beihilfe → is usually the cheaper route for them.

For students, free family insurance often ends at age 25. After that comes compulsory student insurance up to age 30 at the latest, and only then voluntary membership. Pensioners stay voluntarily insured if they do not meet the qualifying insurance period for the Krankenversicherung der Rentner (i)KVdR · Krankenversicherung der RentnerStatutory health insurance for pensioners. Whether you qualify depends on how long you were in statutory insurance during your working life., which means they miss the so-called nine-tenths rule in the second half of their working life.

For voluntarily insured people, all types of income count towards the contribution. Besides earnings from work, this includes income from self-employment, from renting and leasing, and investment income. The upper limit is the Beitragsbemessungsgrenze of €69,750 per year, which equals €5,812.50 per month. At the lower end, the minimum assessment basis of €1,318.33 per month applies. The self-employed pay contributions on it even if their actual income is lower.

The general contribution rate is 14.6 percent with entitlement to Krankengeld (i) from day 43. The reduced rate without this entitlement is 14.0 percent. On top of this comes the fund-specific Zusatzbeitrag of 2.9 percent on average.

For the self-employed, full recording of all income remains a pitfall. We recommend that you add up all sources of income from self-employment, renting and capital before you join. Total income often reaches the maximum contribution, which considerably puts the supposed advantage over private health insurance into perspective.

The range of contributions is considerable. If you reach the income maximum, you pay a health insurance share of €1,017.19 per month, including the average Zusatzbeitrag (i).

If you believe that as a voluntary member you automatically pay little, you should know both limits.

Once you join voluntary statutory health insurance, a minimum commitment of twelve months applies. If you want to switch earlier, you need a special reason. The special right of termination applies as soon as the statutory health insurance fund raises its Zusatzbeitrag (i). Switching to another statutory health insurance fund is possible once these twelve months have passed.

Switching to private health insurance requires the legal conditions, above all exemption from compulsory insurance. The twelve-month commitment does not apply when you switch to private health insurance. Think about the way back early, because from age 55 a return to statutory health insurance is blocked in many cases.

We have supported over 5,000 applications with health questions. The most common question from self-employed people is whether they should stay voluntarily in the statutory health insurance fund or switch to private health insurance. The answer depends on the level of income, the size of the family, the state of health and long-term life planning.

We recommend a serious check of private health insurance to self-employed people with an income above €60,000 per year and no family to insure with them. At this income level, the statutory contribution is already close to the maximum contribution, which is reached from €69,750. If you are in good health, a private plan often offers more benefits for a comparable premium.

Yes, for voluntarily insured people. Unlike compulsory members, who only pay contributions on their earnings from work, voluntary membership adds up all types of income up to the Beitragsbemessungsgrenze (i). This can raise the monthly contribution considerably.

The statutory health insurance fund usually asks for your latest income tax assessment. If there is no assessment yet, it charges provisionally on the basis of an income declaration and corrects the contribution retroactively once you submit the assessment.

That depends on the qualifying insurance period. If you do not meet the nine-tenths rule in the second half of your working life, you do not fall under the Krankenversicherung der Rentner (i) and stay voluntarily insured. Then rental and investment income can also be subject to contributions.

Twelve months after joining. An early special right of termination arises as soon as the statutory health insurance fund raises its Zusatzbeitrag (i). This rule does not apply when you switch to private health insurance, only when you switch between statutory health insurance funds.