PKV or GKV as a self -employed person? (Image: Maranda Vander Grand, unsplash)
If you are self -employed, sooner or later are you faced with a decision that has more influence on your finances and security than many initially think: statutory or private health insurance?
In contrast to employees, they are not restricted by income limits on this question. You have the choice – regardless of how much or little you earn. And that is exactly what makes the decision easier.
Because both models have their advantages and disadvantages- financially and in terms of content.
So that you do not lose track, we look at the differences here – understandable, understandable, practical and with everything you need to know as a self -employed person.
What the self -employed should know from the start: you have the free choice
As Self -employed or freelancer You may decide whether you insure health or privately.
And regardless of your income. This is a big difference to employees who can only switch to private health insurance from a year gross of currently 73,800 euros (as of 2025).
However, there is an exception: If you work as an independent managing director of a corporation (e.g. a GmbH), your freedom of insurance depends on whether you are subject to social security contributions. Here, their actual influence on society plays a role. Otherwise, if you work independently, you can usually insure yourself either voluntarily or privately.
Important: A health check is always due in private health insurance. Anyone who has previous illnesses must expect surcharges – or can even be rejected in extreme cases. This does not exist in the statutory insurance. Everyone is recorded there – no matter what it looks like in terms of health.
Costs: What do you pay in SHI and PKV every month?
The contribution to statutory health insurance depends on your income.
And not just according to your profit, but according to what the tax office counts as a “total income” – so also Rental incomeCapital gains and the like. The contribution rate is 14.6 %, plus an additional contribution that each health insurance company sets itself (an average of about 1.6 %). For the self -employed, the maximum contribution is around 843 euros a month.
The minimum contribution starts at around 206 euros. So if you earn little or just start, you can get in with a low contribution – if you earn well, you pay more.
The situation is different in private health insurance: here is not looking for your income, but for age, health and the tariff chosen.
This means that if you are young, healthy and single, you will start in some cases from 180 to 200 euros a month. Many tariffs are between 300 and 600 euros.
Important: at a young age, they often pay more than would actually be necessary – this serves to set up retirement provisions so that the contribution does not explode in old age.
GKV vs. PKV in performance comparison: What do you get for your money?
The services also differ noticeably.
In the SHI you get solid basic care – the medical “mandatory equipment”. What is legally defined is adopted. This is usually sufficient, but large extras such as a single room in the hospital, chief physician treatment or shorter waiting times for specialist dates are not easy here.
It looks very different in the PKV. You can put together your own insurance cover yourself – according to the modular principle. If you value comfort, for example, single rooms, dentures at a top level, access to specialists or alternative healing methods can be packed in.
Services chosen once cannot be easily canceled later – this ensures long -term planning.
Insurance family or not?
A real plus point of the SHI is the non -contributory family insurance.
Spouses and children without their own income are insured free of charge. This makes the model particularly interesting for the self -employed with family – especially if the partner does not work or only work part -time.
Each family member has to pay their own contribution in PKV. That can be really expensive. For a family of four, a sum quickly comes together, which is twice or three times as high as in the GKV. So if you have or plan children, this is a point that you should not underestimate when deciding.
Change back to the GKV: possible, but not always easy
The decision for the PKV should be carefully considered – because the way back to statutory health insurance is often difficult for the self -employed.
Those who stay independent permanently have little chance of switching back to the GKV. But there are exceptions:
If you end your independence and take up employment subject to social security contributions (at least 20 hours/week and income must be from self -employment above profit), you can go back in. Even in the event of unemployment with ALG-I cover (only if you voluntarily paid into unemployment insurance during self-employment) is the possibility.
Other options would be family insurance through the spouse – albeit with income limits – or a return via detours, e.g. B. over a year of GKV in foreign countries or the federal voluntary service. But: the older you are, the more difficult it gets. A change is almost impossible from 55.
Think in the long term – especially when it comes to age
What many forget: Even if you, as a young self-employed person, benefit from cheap PKV contributions, this can change in old age.
There are retirement provisions, but with increasing age the contribution often increases noticeably. If you hide the topic early, you can later get into financial bottlenecks.
This looks more relaxed in the SHI: in retirement age, the income subject to contributions often drops – and thus also the contribution. In addition, legally insured persons in the pension often only pay contributions to their statutory pension, not to their entire income. This is also a point that plays a role with long -term planning.
Conclusion: Which health insurance fits you as a self -employed person?
There is no general answer. Both models are justified – but not everyone fits in every model.
- PKV is interesting for young, healthy self -employed with a high or stable income – especially if no children have to be insured.
- The SHI offers more planning security, especially if you have health restrictions, want to insure children or fluctuate their income.
If you want to stay independent in the long term, you should think through the step to the PKV well – and not just look at the cheap entry tariff. Inexpensive does not always mean well. Especially in the power sector and in the case of stability in old age, the chaff quickly separates from wheat.
In the end, only helps: take a close look, arithmetic, compare – and, if in doubt, obtain technical advice. Because the change of health insurance is not a little thing, but a decision that will shape your finances and health care for many years.
FAQ: PKV or GKV as a self -employed
What does the GKV cost as a self -employed person?
The contributions in statutory health insurance (GKV) depend on the self -employed of the income – and that on the complete income, i.e. including rental income, interest etc. The contribution rate is 14.6 % plus an additional contribution (each health insurance company itself specifies – usually 1.5 % to 1.7 %).
This results in the tip up to around 843 euros a month if you earn well. The minimum contribution is currently around 206 euros – you pay this if your income is low or not at all. Important to know: As a self -employed person, you make the full contribution alone, there is no employer grant.
But there is also no health check and family members can be insured free of charge – this is a plus point, especially for families.
How expensive is PKV for the self -employed?
In private health insurance (PKV) it is not looking for income – here age, health state and the chosen tariff determine the contribution.
A young, healthy self -employed can start with 180 to 300 euros a month, but it is usually 300 to 600 euros. Upwards – depending on what you want: chief physician treatment, single room, dental additive and so on. Important: PKV often offers better performance, but every performance has its price.
And: A separate contract must be concluded for each family member – this can really go into money. In addition, the contributions can increase in old age, even if retirement provisions are formed. If you stay with it in the long term, you have to calculate this right from the start.
Can you stay in the GKV as a self -employed person?
Yes, absolutely. The self -employed may remain insured by law voluntarily – without any income limit.
Many do this, especially if they have a family or previous illnesses where the PKV either becomes expensive or rejected. The SHI is reliable, offers solid basic care and you can later switch to PKV later when your life situation changes. The other way around, it is more complicated – the way back from PKV to the SHI is often only possible via detours.
So if you want to plan in the long term or to stay flexible, you don’t drive so badly with the SHI.