+49 228 97735-44· German & English spoken
    Health Insurance for Foreigners in Germany
    All tariffsFind a tariff
    Find a tariff
    Care Expatriate — § 21 self-employed lanefrom €58/month (up to 5 years)
    Self-employed and employed expats follow two completely different German health-insurance lanes — picking the wrong one delays the residence permit

    Self-Employed or Employed as Expat in Germany: What Typically Changes for Your Health Insurance

    4.9/5· 10,000+ policies since 2009458 customer responses · our own survey
    Self-employed or employed expat in Germany — what changes for health insurance (Care Expatriate § 21, DAK § 18a / § 5 SGB V)
    § 21 self-emp.
    Expatriate €58/mo
    § 18a employed
    DAK ~17.8%
    Bridge
    Economy €30/30d

    Three rules that prevent every typical lane mistake:

    1. 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).
    2. 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.
    3. 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

    4.9/5458 customer responses · our own survey

    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.

    🏛️ Authority-approved📄 Instant proof🔒 DAK / HanseMerkur🏷️ Transparent pricing
    4.9/5· Over 10,000 policies placed since 2009
    from 458 customer responses · our own survey, not independently verified · How this rating works

    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

    Self-employed (§ 21)

    § 21 AufenthG (Selbständige Tätigkeit) — viable business plan, financing, expertise

    Employed (§ 18a)

    § 18a AufenthG (Skilled Worker) — concrete job offer, recognised qualification

    Statutory cover obligation

    Self-employed (§ 21)

    Not statutory by default — voluntary GKV possible, recognised incoming (Care Expatriate) is the typical lane

    Employed (§ 18a)

    Mandatory statutory under JAEG €77,400/year (§ 5 Abs. 1 Nr. 1 SGB V) — DAK-Gesundheit ~17.8% of gross

    Who pays the premium

    Self-employed (§ 21)

    100% the freelancer / self-employed — no employer contribution

    Employed (§ 18a)

    Split 50/50 between employer and employee (each ~8.9% of gross) — free Familienversicherung

    Recognised long-term incoming product

    Self-employed (§ 21)

    Care Expatriate from €58/month (HanseMerkur, ages 18–74, up to 5 years) — accepted for § 21 AufenthG

    Employed (§ 18a)

    Above the JAEG: Care Expatriate from €58/month is accepted as PKV equivalent; under the JAEG: DAK statutory

    Bridge cover for entry / status change

    Self-employed (§ 21)

    Care Economy from €30/30 days — Schengen-conform until the § 21 permit and Care Expatriate are in place

    Employed (§ 18a)

    Care Economy from €30/30 days — covers the entry-to-contract-start gap until the employer registers GKV

    Family cover (partner / children)

    Self-employed (§ 21)

    Each family member needs a separate Care Expatriate or Care Economy contract under § 36 AufenthG

    Employed (§ 18a)

    Spouse and children join DAK as Familienversicherung free of charge — registered via the same Mitgliedsbescheinigung

    Status change inside Germany

    Self-employed (§ 21)

    From employed to self-employed: cancel GKV with confirmation, switch to Care Expatriate before the new permit appointment

    Employed (§ 18a)

    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.

    1. 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.

    2. Complete the application

      Enter passport, destination, stay details and requested coverage period online. Additional questions may apply depending on the plan.

    3. 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

    4.9/5458 customer responses · our own survey
    5/5
    “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 from Cameroon

    Georges

    Cameroon

    5/5
    “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 from Russia

    Olga

    Russia

    5/5
    “Found the best solution and best service for health insurance for foreign visitors and guests in Germany.
    Fast, simple and affordable.
    Highly recommended!”
    Michael from Germany

    Michael

    Germany

    5/5
    “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 from Australia

    Yunhee

    Australia

    Now choose your plan

    4.9/5458 customer responses · our own survey

    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)
    Income-based
    No flat rate — contribution scales with gross salary
    Family covered free
    Spouse without income + children co-insured
    Mandatory under JAEG
    Gross < €77,400 / year → statutory insurance required

    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.

    How long should the health insurance run?

    Quick answer: Usually for as long as the stay is planned to last — and not shorter. The premium is set by the entry age at the start of the contract and stays in that age band for the whole term. Anyone who extends later typically signs a new contract at the age they are by then.

    Term comparison over five years — example values, Basic, age band 13–40 (€58/month)
    Term Premium/month Total Renewals needed Pre-existing-condition gap
    12 months €58 €696 4 possible (2×)
    24 months €58 €1,392 2 possible (1×)
    60 months €58 €3,480 0 none

    Is a 41st birthday coming up?

    In the 13–40 age band the Basic premium is €58/month; in the 41–60 band it is €68/month (example values). The difference is around €10 a month — roughly €600 over 60 months. What counts is the age at the start of the contract, not the age during the term. Concretely: someone who chooses a 60-month term at 40 pays the 13–40 band for five years, rather than the 41–60 band from their 41st birthday onwards.

    When the renewal falls due

    A policy with a twelve-month term typically expires at close to the point the residence permit (Aufenthaltstitel) also needs extending. Both then fall in the same weeks: new contract, new proof of cover, new appointment at the foreigners' authority (Ausländerbehörde) — often under time pressure. A longer term decouples the two dates. There is also the practical effort: every renewal means passport details, proof of address and personal information again — usually gathered by relatives in Germany while the insured person is still abroad.

    What is different at renewal

    Conditions that first arise during a running contract are, as a rule, covered within that contract. In a contract taken out later they typically count as a pre-existing condition — and pre-existing conditions are usually excluded in incoming tariffs. The older the insured person, the more likely it is that a diagnosis falls between two contracts, and that diagnosis then usually counts as pre-existing in the follow-up contract. A continuous term avoids that gap.

    A gap can also open up between two contracts — days without cover, which may become visible when the residence permit is next extended. A continuous term avoids that.

    A fixed term also means planning certainty for the family: the premium is set for the whole duration, with no annual recalculation.

    For context: Care Expatriate can be taken out up to the age of 74.

    Monthly or a single payment?

    Quick answer: Both are possible, and the price is the same — there is no discount for paying in one go. The difference lies in the risk: if a direct debit goes unpaid, that can affect the insurance cover — and the residence permit rests on that cover. With a single payment the cover no longer depends on an ongoing bank debit. That matters above all where the premiums are paid by relatives in Germany: a job change, a change of bank or one tight month then has no bearing on the insured person's residence status.

    Where the premium is transferred from abroad, one payment replaces up to sixty individual transfers — each with its own bank charges and exchange rate.

    What happens on an early return?

    If the stay ends earlier than planned, the contract can be cancelled in writing. The overpaid premium is, as a rule, refunded minus a €5 processing fee (source: Care Concept FAQ). So someone who pays 60 months in advance and returns after two years gets the premium for the unused months back — the financial risk of paying in one go is therefore €5, not the remaining balance.

    And if the visa is not granted?

    If the entry visa is not granted, or entry does not take place for other reasons, the application can be cancelled in writing before the insurance cover begins. Premiums already paid are, as a rule, refunded minus a €5 processing fee (source: Care Concept FAQ).

    FAQ — Self-employed or employed as expat in Germany

    Frequently Asked Questions

    What changes in health insurance when switching from employee to self-employed in Germany?

    GKV becomes voluntary (freiwillige Versicherung) — DAK-Gesundheit costs ~€200/month minimum (14.6% of income floor €1,178). Alternative: switch to Care Expatriate from €58/month under § 21 AufenthG for self-employment permits.

    Can a self-employed expat stay in DAK-Gesundheit?

    Yes, voluntarily. DAK-Gesundheit accepts freelancers under § 9 SGB V — contribution 14.6% + 1.7% Zusatzbeitrag on declared income. Minimum ~€200/month, maximum ~€900/month. Family Insurance (§ 10 SGB V) covers spouse and children under 25 free.

    Does the Ausländerbehörde treat self-employed expats differently?

    Yes — § 21 AufenthG (self-employment) requires a business plan, IHK statement and insurance proof. Care Expatriate from €58/month is standard; voluntary DAK-Gesundheit (~€200/month) is also accepted with a Mitgliedsbescheinigung.

    Can I switch back from private (Care Expatriate) to GKV when I get employed again?

    GKV is mandatory under § 5 SGB V if the new gross salary is below €77,400/year (JVEG 2026). Yes, automatically. Care Expatriate cancels monthly with proof of DAK enrolment. No waiting period.

    Is self-employed insurance more expensive than employee GKV in Germany?

    Usually yes for voluntary GKV (~€200–900/month for freelancers) but cheaper for private (Care Expatriate €58–432/month depending on age). Employee GKV is 8.9% of gross (employer pays the other 8.9%), which is often the cheapest option.

    Do I need health insurance as a self-employed expat in Germany?

    Yes – health insurance is mandatory for everyone in Germany (§ 193 VVG). Self-employed expats must arrange their own coverage. Care Expatriate starts at €58/month and is typically accepted for residence permits.

    What changes when switching from employed to self-employed in Germany?

    Your mandatory statutory health insurance coverage ends. You must actively apply for voluntary continuation within 3 months, or choose private insurance. Without action, you risk a gap – Care Economy can bridge the transition.

    How much does freelancer health insurance cost in Germany?

    Voluntary statutory insurance starts at approx. €200/month (income-dependent, up to ~€900/month at the maximum assessment basis). Care Expatriate offers a plannable alternative from €58/month – accepted for residence permits and freelance visa.