Self-Employed or Employed as Expat in Germany: What Typically Changes for Your Health Insurance
- Self-employed (§ 21): Care Expatriate from €58/month (HanseMerkur · 100% private · up to 5 years)
- Employed under JAEG (§ 18a): DAK ~17.8% of gross (mandatory statutory · employer pays half · free Familienversicherung)
- Entry / status-change bridge: Care Economy from €30/30 days (Schengen-conform · cancellable when GKV starts)
Three rules that prevent every typical lane mistake:
- 1Match the residence permit category to the lane: § 21 self-employed → Care Expatriate from €58/month (up to 5 years) · § 18a employed under JAEG → DAK 17.8% of gross (open-ended).
- 2Plan the bridge: Care Economy from €30 / 30 days (up to 2 years) covers the entry-to-permit gap, the status change between the two lanes, and the gap between Ausländerbehörde appointment and contract start.
- 3Plan the family: Employed lane = DAK Familienversicherung is free for spouse and children. Self-employed lane = each family member needs a separate Care Expatriate or Care Economy contract under § 36 AufenthG.
Status change ahead? 30-second self-employed vs employed lane finder →
Inside: the JAEG threshold that decides the lane in one number · why a freelancer who lands a part-time job loses the § 21 lane the same day · the bridge tariff that covers both directions of the status change
Sources: § 5 Abs. 1 Nr. 1 SGB V (statutory employees) · § 6 Abs. 6 SGB V (JAEG €77,400 in 2025) · § 18a AufenthG (Skilled Worker) · § 21 AufenthG (Self-employed) · § 36 AufenthG (Family Reunification) · DAK-Gesundheit tariff sheet 2026 · HanseMerkur Care Expatriate / Care Economy AVB
Long-Stay Coverage
Care Expatriate by HanseMerkur Versicherungsgruppe / Advigon
Residence Documents
Proof for visa or immigration authority documents
Fast Confirmation
PDF confirmation available after successful application
Over 10,000 policies issued · Since 2009
Self-employed or employed: pick the right German health-insurance lane before the residence-permit appointment — Care Expatriate for § 21, DAK for § 18a under the JAEG, Care Economy for the bridge.
Self-employed vs employed expat — side-by-side health insurance comparison
Quick answer: "What changes for health insurance when an expat in Germany is self-employed instead of employed?" — these seven points are the ones the Ausländerbehörde and HR / Personalabteilung typically check first. Each row shows the recognised lane on both sides (Care Expatriate § 21 vs DAK § 18a under JAEG), with Care Economy as the universal bridge.
Residence permit basis
§ 21 AufenthG (Selbständige Tätigkeit) — viable business plan, financing, expertise
§ 18a AufenthG (Skilled Worker) — concrete job offer, recognised qualification
Statutory cover obligation
Not statutory by default — voluntary GKV possible, recognised incoming (Care Expatriate) is the typical lane
Mandatory statutory under JAEG €77,400/year (§ 5 Abs. 1 Nr. 1 SGB V) — DAK-Gesundheit ~17.8% of gross
Who pays the premium
100% the freelancer / self-employed — no employer contribution
Split 50/50 between employer and employee (each ~8.9% of gross) — free Familienversicherung
Recognised long-term incoming product
Care Expatriate from €58/month (HanseMerkur, ages 18–74, up to 5 years) — accepted for § 21 AufenthG
Above the JAEG: Care Expatriate from €58/month is accepted as PKV equivalent; under the JAEG: DAK statutory
Bridge cover for entry / status change
Care Economy from €30/30 days — Schengen-conform until the § 21 permit and Care Expatriate are in place
Care Economy from €30/30 days — covers the entry-to-contract-start gap until the employer registers GKV
Family cover (partner / children)
Each family member needs a separate Care Expatriate or Care Economy contract under § 36 AufenthG
Spouse and children join DAK as Familienversicherung free of charge — registered via the same Mitgliedsbescheinigung
Status change inside Germany
From employed to self-employed: cancel GKV with confirmation, switch to Care Expatriate before the new permit appointment
From self-employed to employed: GKV obligation triggers from the contract start date; cancel Care Expatriate the day GKV starts
Avoid the mistakes that can delay your application
Visitor insurance may be too short
For multi-month or multi-year stays, Care Expatriate can be a better fit than short visitor coverage.
Statutory or private?
Freelancers, self-employed people and some incoming long-stay cases may need private incoming coverage instead of German statutory insurance.
Residence proof requested?
Care Expatriate can provide PDF confirmation after successful application for visa or immigration documents.
Renewal stress later
A longer coverage term can reduce repeated renewal pressure during projects, residence processes or long stays.
What picking the wrong lane can cost a self-employed or employed expat
One wrong insurance choice can cost you money, time and your application deadline
A medical incident can become expensive fast — but the wrong certificate can also delay your visa, enrollment, residence permit or work start.
🏥
€500–€1,500
Emergency doctor visit
One urgent doctor or emergency-room visit can already create a painful bill — before tests, medication or follow-up treatment are added.
🏨
€2,000–€10,000+
Hospital treatment
If observation, surgery, overnight stay or specialist treatment is needed, costs can quickly move from hundreds to thousands of euros.
🧳
Up to 5 years
Short visitor cover may be too weak
For long stays, freelance work or residence documents, short visitor insurance may be too short or not the right proof.
- Wrong or incomplete proof can delay your visa, enrollment or authority process.
- Cheap home-country policies may miss the exact coverage, dates or repatriation wording required.
- The cheapest policy can become expensive if it is the wrong proof for your situation.
Before you apply, check: coverage amount, validity dates, destination area and repatriation cover.
Status change ahead? Lock in the right lane this week — switching after the permit appointment costs weeks of delay and re-purchase at higher entry-age premiums
Why act before your residence documents are due
Long-stay proof can become urgent during visa, residence permit, project or relocation steps. Short visitor cover may not be enough.
Long stay, different proof
Care Expatriate can fit longer incoming stays up to 5 years, depending on age and selected plan.
Residence documents need clarity
Your proof should match destination, coverage period and long-stay purpose.
Do not wait for renewal stress
Preparing longer coverage early can reduce repeated extension pressure.
Private or statutory?
Freelancers, self-employed people and employees on assignment without German statutory insurance may need a different route than employees.
From decision to recognised cover — in 3 steps (both lanes)
10 minutes online for Care Expatriate (self-employed lane) or Care Economy (bridge), the policy document is issued by email in German + English and is accepted by every Ausländerbehörde and HR department. For the employed lane under the JAEG, DAK takes over under § 5 SGB V the day the employer registers the work contract.
Long-term stay covered in 3 steps
Care Expatriate can cover longer incoming stays up to 5 years, depending on age and selected plan.
-
Choose your plan
Care Expatriate for expats, freelancers, self-employed people, employees on assignment without German statutory insurance, or seniors up to entry age 74.
-
Complete the application
Enter passport, destination, stay details and requested coverage period online. Additional questions may apply depending on the plan.
-
Submit your proof
Receive PDF confirmation after successful application and submit it to the embassy, consulate or immigration authority if requested.
What expats say about Care Expatriate for the self-employed § 21 lane in Germany
“My biggest worry was that the embassy wouldn't accept the insurance.
The proof was accepted immediately — no questions asked.
That saved me a lot of stress.”
Georges
Cameroon
“I needed proof of insurance urgently for my visa appointment.
The confirmation arrived within minutes by email.
Everything worked first time at the embassy.”
Olga
Russia
“Found the best solution and best service for health insurance for foreign visitors and guests in Germany.
Fast, simple and affordable.
Highly recommended!”
Michael
Germany
“The online sign-up was done in just a few minutes.
When I actually had to see a doctor, the billing went smoothly.
I was really covered — not just on paper.”
Yunhee
Australia
Now choose your plan
The 3 recognised products for self-employed and employed expats
Care Expatriate
from only €58.00 / month (coverage up to 5 years)
For foreign nationals with longer stays: expats, self-employed professionals, freelancers, employees on assignment without German statutory insurance, retirees & seniors up to age 74
- Proof of insurance for visas & immigration authorities quickly available (PDF)
- Coverage up to 5 years – less renewal stress
- Doctor, hospital, prescription medication & dental treatment coverage
- For longer stays in Germany, Austria, the EU/Schengen Area, Liechtenstein or Switzerland
- Suitable for expats, self-employed professionals, freelancers, employees on assignment without German statutory insurance, retirees & seniors
- More planning security for residence permits, projects or jobs
- 24/7 assistance + digital insurance card
- Age-based rates: from €58/month ages 13–40 · from €68 ages 41–60 · from €246 ages 61–74
- Coverage term: 3 months to 5 years · entry age 0–74
- Reputable insurance carrier
Why Care Expatriate?
For foreign nationals with longer stays who need solid health insurance and proof of coverage for authorities — suitable for expats, freelancers, self-employed professionals, employees on assignment without German statutory insurance, retirees & seniors up to age 74.
Why a 5-year coverage term?
More planning security: less renewal stress and a lower risk of a coverage gap if your stay lasts longer.
- 🏛️ HanseMerkur Insurance Group Hamburg – Advigon Insurance AG
- 📄 Instant proof of insurance for visas & immigration authorities (PDF)
- 🔒 Doctor, clinic, dental treatment & repatriation coverage
- 🏷️ From €58 / month · coverage up to 5 years
→ Complete the application, receive your instant PDF, submit your proof
DAK-Gesundheit Employees
currently 17.8% of gross income
(employer pays half · plus long-term care insurance)
For foreign employees with a social-security-covered job in Germany
- Statutory health insurance for employees in Germany
- Employer pays half of the health insurance contribution
- Family coverage for spouse & children may be possible under statutory rules
- Doctor, dentist, hospital, pharmacy & prescription medication coverage
- Health insurance card for medical treatment in Germany
- EU/EEA coverage via the European Health Insurance Card
- Save €120 per year with DAK Garantietarif 120 possible
- Optional: DAK Fit & Travel with additional benefits up to age 39
- Mandatory long-term care insurance also applies
- Reputable statutory health insurance provider
Why DAK-Gesundheit?
For foreign employees in Germany who need statutory health insurance with a health insurance card, employer contribution and possible family coverage.
Why statutory health insurance as an employee?
More security in everyday working life in Germany: the employer pays half, family members may be covered free of charge under certain conditions, and medical treatment is handled easily through the health insurance card.
- 🏛️ DAK-Gesundheit
- 📄 Membership certificate for employers & authorities
- 🔒 Doctor, dentist, clinic, pharmacy & prescription medication
- 🏷️ Currently 17.8% of gross income · employer pays half
→ Complete the application, start your membership, receive your health insurance card
Care Economy
from only €30.00 / 30 days (coverage up to 2 years)
For guests, tourists, family visits, job seekers & the German Opportunity Card
- Proof of insurance for visas & immigration authorities within minutes
- Affordable coverage from €1.00 per day
- Doctor, hospital & dental emergency coverage
- Suitable for Schengen visas, the Opportunity Card & family visits
- Flexible coverage from 1 day up to 2 years
- Coverage in Germany, the EU & the Schengen Area
- 24/7 assistance + digital insurance card
- Age-based rates: from €1.00/day up to age 64 · from €2.95/day for ages 65–74
- Coverage term: 1 day to 2 years · entry age 0–74
- Reputable insurance carrier
Why Care Economy?
For anyone who needs fast, affordable proof of health insurance — ideal for guests, visitors, tourists, family visits or job seekers, with doctor/clinic coverage subject to the policy terms and benefits.
Why a 2-year coverage term?
More flexibility when plans are uncertain: if your visa, trip or stay is extended, you avoid last-minute renewal stress and reduce the risk of a coverage gap.
- 🏛️ HanseMerkur Insurance Group Hamburg – Advigon Insurance AG
- 📄 Instant proof of insurance for visas & immigration authorities (PDF)
- 🔒 Doctor, clinic, dental emergency & repatriation coverage
- 🏷️ From €30 / 30 days · up to 2 years possible
→ Complete the application, receive your instant PDF, submit your proof
Need the residence-permit explainer? Why insurance is almost always required. Already employed? HR insurance-proof checklist. Compare every expat lane in the foreigners hub.
Full price tables — Care Expatriate · DAK-Gesundheit · Care Economy
Quick answer: Three recognised products cover both lanes: Care Expatriate from €58/month for the self-employed § 21 lane, statutory DAK at ~17.8% of gross under the JAEG for the § 18a employed lane (employer pays half, free Familienversicherung), and Care Economy from €30/30 days for entry and status change.
Self-employed (§ 21 AufenthG) — Care Expatriate
HanseMerkur incoming, ages 0–74, up to 5 years, accepted by the Ausländerbehörde for § 21 AufenthG, certificate issued in German + English (3 tiers — Basic / Comfort / Premium):
| Care Expatriateworldwide without USA, Canada and Mexico |
Basic
|
BestsellerComfort
|
Premium
|
|||
|---|---|---|---|---|---|---|
|
Deductible / yr
150,–
|
Deductible / yr
150,–
|
Deductible / yr
500,–
|
Deductible / yr
0,–
|
Deductible / yr
500,–
|
Deductible / yr
1.000,–
|
|
| Entry age:0–12 (€ / month) | 64,– | 104,– | 81,– | 191,– | 149,– | 117,– |
| Entry age:13–40 (€ / month) | 58,– | 84,– | 63,– | 181,– | 141,– | 109,– |
| Entry age:41–60 (€ / month) | 68,– | 103,– | 77,– | 256,– | 201,– | 156,– |
| Entry age:61–74 (€ / month) | 246,– | 322,– | 248,– | 432,– | 336,– | 263,– |
All prices per month/person in euros. Deductible applies per insurance year. As of 2026.
Employed under JAEG (§ 18a AufenthG) — DAK-Gesundheit
Statutory under § 5 Abs. 1 Nr. 1 SGB V, ~17.8% of gross salary, employer pays half, free Familienversicherung for spouse and children (DAK button price: 17.8% of gross (open-ended)):
| DAK-Gesundheit for employees (statutory) | |
|---|---|
| General contribution rate |
14.6 % of gross
+ 3.2 % DAK supplement = 17.8 %
|
| Employer / employee share |
8.9 % each
Paid 50/50
|
| Compulsory long-term care |
approx. 3.6 % standard
4.2 % childless from age 23 · reductions depending on number of children
|
| Total (incl. care, childless) |
≈ 22.0 % of gross
Depending on long-term care variant
|
| Family co-insurance |
possible
Spouse & children covered under statutory conditions
|
| Sickness pay (Krankengeld) |
from day 43
70 % of gross, max 78 weeks
|
| Compulsory insurance limit (JAEG) |
€77,400 / year
= €6,450 / month (as of 2026)
|
2026 contribution rates: 14.6 % general + 3.2 % DAK supplement = 17.8 %; split 50/50 between employer and employee (8.9 % each). Compulsory long-term care approx. 3.6 % standard, 4.2 % childless from age 23, reductions depending on number of children. Family co-insurance possible under statutory conditions. As of 2026.
Entry & status-change bridge — Care Economy
Schengen-conform incoming, ages 0–74, 1 day to 2 years, cancellable the day the new lane (DAK or Care Expatriate) is in place:
| Care Economy Duration |
Bestsellerup to 64
|
up to 64
|
Bestseller65+
|
65+
|
|---|---|---|---|---|
| no deductible | with deductible | no deductible | with deductible | |
| up to 90 days | €1.18/day | €1.00/day | €3.48/day | €2.95/day |
| 91–180 days | €1.59/day | €1.35/day | €4.37/day | €3.70/day |
| 181–365 days | €2.30/day | €1.95/day | €5.84/day | €4.95/day |
| 366–730 days | €2.83/day | €2.40/day | €9.32/day | €7.90/day |
All prices per day/person in euros. Minimum premium €10 per person and term. Deductible is the share you pay yourself. Entry age 0–74. As of 2026.
FAQ — Self-employed or employed as expat in Germany
Frequently Asked Questions
What changes for health insurance when an expat in Germany switches between self-employed and employed?
The residence permit category and the statutory obligation change. Self-employed under § 21 AufenthG are not statutory by default and typically use <a href="/en/insurance-plans/care-expatriate/overview/" class="text-primary underline underline-offset-2">Care Expatriate from €58/month</a> (HanseMerkur, up to 5 years). Employees under § 18a AufenthG and below the JAEG (€77,400/year in 2025) are mandatorily statutory under § 5 Abs. 1 Nr. 1 SGB V — typically <a href="/en/insurance-plans/dak-gesundheit-angestellte/overview/" class="text-primary underline underline-offset-2">DAK-Gesundheit at ~17.8% of gross</a>, employer pays half. The bridge for entry or status change is <a href="/en/insurance-plans/care-economy/overview/" class="text-primary underline underline-offset-2">Care Economy from €30/30 days</a>.
Can an employed expat in Germany stay on Care Expatriate above the JAEG threshold?
Yes. Above the JAEG (€77,400/year in 2025) the employee is no longer mandatorily statutory under § 5 Abs. 1 Nr. 1 SGB V and may stay on a recognised incoming / private product. <a href="/en/insurance-plans/care-expatriate/overview/" class="text-primary underline underline-offset-2">Care Expatriate from €58/month</a> is accepted by HR as PKV equivalent and by the Ausländerbehörde for § 18a AufenthG. Below the JAEG, GKV via DAK is mandatory and Care Expatriate cannot replace the Mitgliedsbescheinigung. See the full <a href="/en/guide-health-insurance-germany/health-insurance-expats-germany/expat-job-start-what-hr-and-employer-require-as-insurance-proof-germany/" class="text-primary underline underline-offset-2">HR proof checklist</a>.
What about partner and children when switching between self-employed and employed?
Statutory employees: spouse and children join DAK as Familienversicherung free of charge. Self-employed under § 21 AufenthG: each family member needs a separate <a href="/en/insurance-plans/care-expatriate/overview/" class="text-primary underline underline-offset-2">Care Expatriate from €58/month</a> contract under § 36 AufenthG. When switching from self-employed to employed, the family can cancel Care Expatriate the day DAK Familienversicherung starts. The full long-stay flow is in the <a href="/en/guide-health-insurance-germany/health-insurance-expats-germany/residence-permit-expats-why-health-insurance-almost-always-matters-germany/" class="text-primary underline underline-offset-2">residence-permit explainer</a>.