Freiwillige Krankenversicherung in Germany: Voluntary Public Health Insurance
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Freiwillige Krankenversicherung is voluntary membership in Germany’s public health insurance system, i.e., the GKV. This status is granted to people who are not required to be insured under the GKV but may remain in or join a public health insurance fund (Krankenkasse) provided they meet the conditions.
The information below is a general overview. Premiums, limits, and eligibility for switching depend on the year, income, family situation, employment status, and the rules of the specific health insurance provider.
What Is Voluntary Health Insurance?
In Germany, health insurance is mandatory for residents. Most employees, retirees, and students are covered by gesetzliche Krankenversicherung (GKV), that is, the public system. If a person is no longer subject to mandatory insurance, they may, in some cases, have the option to either remain in the GKV as a voluntarily insured person (freiwillig versichert) or switch to private health insurance (PKV).
The legal basis for voluntary membership is set forth in the German Social Security Code (§ 9 SGB V). In practice, this means that if the conditions regarding prior insurance coverage, income, or status are met, a person may remain in the public health insurance system even though they are no longer a mandatory member of the GKV.
In terms of the basic health care services provided, a voluntarily insured member of the GKV receives the same type of coverage as a mandatory member of the public health insurance fund. The main differences lie in status and the calculation of premiums.
Who Can Be Voluntarily Insured
Voluntary public health insurance is most common among the following groups:
- Employees with income above the Jahresarbeitsentgeltgrenze (JAEG);
- self-employed individuals and freelancers, provided they have access to the GKV;
- students after their student rate expires;
- retirees who are not covered by the mandatory health insurance for retirees (Krankenversicherung der Rentner);
- civil servants, if they choose the GKV over the PKV;
- People who were previously enrolled in the GKV and have lost their mandatory enrollment status.
The key factor is not only current income but also insurance history. If a person has recently arrived in Germany and has not previously been enrolled in the GKV, access to voluntary health insurance (freiwillige Krankenversicherung) may be limited. It is especially important for those who are just planning to work in Germany 10_PUBLISHED/content/en/Job Search in Germany Action Plan, Bewerbung, Visas, and Checking Job Listings or move to Germany with entrepreneurial status to verify this. In such situations, you should check with a specific health insurance provider before moving or changing your status.
How Premiums Are Calculated in 2026
In the voluntary GKV, the premium is usually calculated based on beitragspflichtige Einnahmen—the income that the health insurance fund considers for the calculation. Several figures are important for the year 2026.
| Indicator | Value in 2026 | What it means |
|---|---|---|
| General GKV Rate | 14.6% | Basic health insurance rate with entitlement to sick pay |
| Reduced Contribution Rate | 14.0% | Reduced rate if not eligible for sick pay |
| Average Zusatzbeitrag | 2.9% | This is a guideline; the actual Zusatzbeitrag depends on the Krankenkasse |
| Long-Term Care Insurance | 3.6% base rate | Long-term care insurance; a surcharge applies to childless individuals aged 23 and older |
| Long-Term Care Insurance for Childless Individuals | 4.2% | Rate including the surcharge for childless insured persons over 23 years of age |
| GKV/PV Contribution Assessment Threshold | 5,812.50 euros per month / 69,750 euros per year | Income above this amount does not increase the GKV/PV contribution |
| Annual Income Threshold | 77,400 euros per year / 6,450 euros per month | The threshold above which an employee may become exempt from mandatory insurance and choose between voluntary GKV or private health insurance (PKV) |
The total amount for each individual consists of the health insurance premium, the specific health insurance fund’s additional contribution (Zusatzbeitrag), and long-term care insurance (Pflegeversicherung). Therefore, two people with the same income may pay different amounts if they have chosen different health insurance funds or have different long-term care insurance statuses.
Minimum and Maximum Calculation Bases
For voluntarily insured individuals, there is not only an upper limit but also a minimum assessment basis. If actual income is below the minimum, the health insurance fund will still calculate the premium based on the established minimum assessment basis.
In 2026, the maximum assessment base for GKV and long-term care insurance is 5,812.50 euros per month. The minimum contribution base for many voluntary members in 2026 is listed by health insurance funds as €1,318.33 per month, but certain groups and special cases may be calculated differently. Therefore, it is best to check the minimum contribution in your health insurance fund’s rate schedule.
Example of the calculation logic:
- If income exceeds 5,812.50 euros per month, the premium is calculated only up to this threshold;
- If your income is below the minimum income threshold, the health insurance fund may calculate your premium based on the minimum income threshold;
- If your income falls between the minimum and maximum thresholds, the premium is based on your actual taxable income.
High-Income Earners
Employees are generally required to be insured under the GKV. If their regular annual income exceeds the Jahresarbeitsentgeltgrenze (JAEG), the employee becomes versicherungsfrei. In 2026, the general JAEG threshold is 77,400 euros gross per year.
Once the threshold is exceeded, a person is not required to switch to private health insurance (PKV). They may remain in the public health insurance system as a voluntarily insured member of the GKV. Typically, the health insurance provider notifies the individual in writing of the change in status.
When assessing income, regular payments are taken into account: salary, recurring bonuses, vacation pay, Weihnachtsgeld, and other predictable payments, provided they are not one-time payments. One-time and irregular amounts may be assessed differently.
For employees, contributions to the GKV and long-term care insurance (Pflegeversicherung) are usually split between the employee and the employer. However, there are exceptions: for example, in Saxony, the share of long-term care insurance contributions is allocated differently, and the surcharge (Zuschlag) for childless insured individuals is paid by the employee.
Self-Employed Individuals and Freelancers
For entrepreneurs and freelancers, voluntary health insurance (freiwillige Krankenversicherung) can be an important option because they are generally not required to have mandatory GKV coverage. If you are a self-employed person () or a sole proprietor (), it is best to check your eligibility for GKV before registering and changing your status. However, eligibility depends on your previous insurance coverage and your specific situation.
If a person was previously enrolled in the GKV and continues to meet the requirements for voluntary membership, the health insurance fund calculates premiums based on income from self-employment and other eligible sources of income. The following may be included in the calculation:
- income from a business or self-employment;
- rental income;
- investment income;
- pension and other regular payments;
- certain benefits or grants, if they are taken into account under the health insurance fund’s rules.
Self-employed individuals pay the full premium themselves, since there is no employer to cover half of it. Exceptions may apply to certain groups, such as those in creative professions through the Artists’ Social Insurance Fund (KSK), provided the KSK’s requirements are met.
To estimate premiums, the Krankenkasse typically uses a tax assessment or expected income. After filing a tax return, premiums may be adjusted.
Students Over 30
Students in Germany are often first covered under their parents’ insurance and then switch to student GKV. The student rate is usually limited by age and student status. After the preferential student period ends, a person can switch to voluntary health insurance (freiwillige Krankenversicherung) if they remain in the GKV.
For students over 30, the premium is usually significantly higher than the student rate because it is calculated according to the rules for voluntary insurance. The specific amount depends on income, the supplementary premium (Zusatzbeitrag) of the selected health insurance fund, and long-term care insurance (Pflegeversicherung). At Techniker Krankenkasse, for example, a separate supplementary premium of 2.69% has been in effect since 2026, so its calculation differs from that of health insurance funds with a different supplementary premium.
If a student works, receives a scholarship, or has income from self-employment or rental property, this may affect the calculation. Before changing your status, it is best to request a written calculation from your health insurance provider.
Retirees
Retirees receiving a German pension 10_PUBLISHED/content/en/Germany’s Pension System State Pension, bAV, Rürup, Riester, and Private Plans may be insured under the GKV either mandatorily through the Krankenversicherung der Rentner or voluntarily. The difference depends on their insurance history prior to retirement and whether they meet the requirements for mandatory pension insurance under the GKV.
If a retiree is voluntarily insured under the GKV, the health insurance fund may take into account not only the state pension but also other sources of income: occupational pensions, private pension payments, rental income, capital gains, and income from self-employment. As a result, the final premium can vary significantly among people receiving the same state pension.
Switching from private health insurance (PKV) to statutory health insurance (GKV) after age 55 in Germany is generally very limited. For people over 55, the possibility of switching systems must be assessed on a case-by-case basis, as there is usually no automatic right to return to the GKV.
People with Severe Disabilities
If a person who was insured under private health insurance (PKV) is recognized by the Federal Association of the Disabled () as having a severe disability (), they may, in certain cases, be eligible to transfer to the GKV. This is a complex legal situation: the timeframe, age, previous insurance coverage, and specific grounds must be verified through documentation and by contacting the health insurance provider.
Civil Servants
For civil servants (Beamte), medical expenses are often partially covered through a Beihilfe (subsidy). Therefore, many civil servants choose private health insurance (PKV), which covers the remaining portion of their expenses. However, GKV is also an option if the individual is willing to pay premiums in accordance with the rules of the public system.
An important practical detail: the conditions for a Zuschuss or pauschale Beihilfe for the GKV are not the same in all federal states. Before choosing between the GKV and the PKV, civil servants should check the rules of their federal state.
How to Enroll in Voluntary GKV
For employees with an income above the JAEG threshold, the transition to “freiwillig versichert” status often occurs automatically after notifying the health insurance fund. In other situations, you must submit an application to the health insurance fund and confirm your eligibility for voluntary membership.
Typically, the following may be required:
- passport or residence permit;
- Proof of previous insurance coverage;
- an employment contract or a pay stub;
- tax ruling for the self-employed;
- an estimate of expected profits for a new business;
- retirement documents;
- information on income from rent, capital, or other sources;
- Proof of enrollment, if the person is a student.
It is best to request a list of required documents from your chosen health insurance provider, as the set of documents required depends on your status.
When Voluntary Insurance Ends
Voluntary health insurance may end if a person’s status changes. For example:
- An employee once again becomes a mandatory member of the GKV if their income falls below the JAEG threshold;
- a person switches to private health insurance (PKV);
- Family coverage becomes available through a spouse;
- a change in country of residence;
- Conditions arise for another form of mandatory insurance.
If you lose your job, move, experience a change in income, or become self-employed, it is important to notify your health insurance provider in advance to avoid retroactive adjustments to your premiums.
FKV or PKV: How to Compare
The choice between voluntary GKV and PKV is not just about the monthly cost. It is important to consider your family situation, age, health, plans for children, long-term income, and the likelihood of returning to the GKV.
| Criterion | Voluntary GKV | PKV |
|---|---|---|
| Premium Calculation | Based on income up to the Beitragsbemessungsgrenze | Based on rate, age, health, and scope of coverage |
| Family | Free family coverage (Familienversicherung) may be available if conditions are met | Usually a separate policy for each person |
| Illnesses and Risks | Basic coverage is not dependent on medical risk | Surcharges, exclusions, or denial of coverage may apply upon enrollment |
| Payment for Treatment | Usually settled between the doctor and the health insurance provider | Often, the patient receives the bill first, followed by reimbursement |
| Re-enrollment in the GKV | Not required; the person is already in the GKV | Usually severely restricted after age 55 |
| Services and Coverage | GKV Standard | Depends on the selected PKV plan |
For a family with a non-working spouse or children, the GKV is often simpler and more predictable because, if the conditions are met, it is possible to include the family in the public health insurance system 10_PUBLISHED/content/en/Family Insurance in Germany Who Can Be Covered Under the GKV for Free. For a young single person with a high income, private health insurance (PKV) may seem cheaper at first, but long-term premiums and reimbursement rules need to be considered separately. It’s helpful to look at a detailed comparison separately: private health insurance in Germany.
Switching from GKV to PKV and Back
If an employee becomes “versicherungsfrei” because they have exceeded the JAEG, they may remain in the GKV on a voluntary basis or opt for private health insurance (PKV). To leave the GKV, you generally need to notify the health insurance provider and confirm that you have new, comprehensive insurance coverage. Notice periods vary depending on the situation, but a notice period of about two months to the end of the month is often required.
If a health insurance provider increases the additional premium (Zusatzbeitrag), the insured person may have a special right to terminate the policy (Sonderkündigungsrecht). However, even in this case, it is important to avoid any gap in coverage: the new policy must take effect immediately without a gap.
For employees, switching back from private health insurance (PKV) to the statutory health insurance system (GKV) is generally only possible when mandatory insurance applies, for example, if income falls below the JAEG threshold again. In practice, this is similar to switching to the statutory health insurance system, but with additional restrictions after having been in private health insurance (PKV). After age 55, switching back to the GKV is generally not possible, except in rare special circumstances.
What to Check Before Making a Decision
Before choosing between voluntary GKV and PKV, it’s a good idea to go through a short checklist:
- Are you eligible for voluntary membership in the GKV?
- What income will the health insurance provider take into account;
- What is the additional premium (Zusatzbeitrag) for the selected health insurance provider?
- Do you have children or a spouse who may be eligible for family coverage (Familienversicherung)?
- whether you are entitled to sick pay;
- How premiums will change if you become self-employed, retire, or move;
- Is it possible to return to the GKV if you choose the PKV?
- What rules apply in your state if you are a civil servant (Beamter or Beamtin)?
FAQ
Is voluntary health insurance (Freiwillige Krankenversicherung) private insurance?
No. This is voluntary membership in the public GKV system. Private health insurance is called private Krankenversicherung or PKV.
Do voluntarily insured individuals receive fewer benefits than mandatory GKV members?
The basic coverage under the GKV is the same across the board. The differences usually lie not in the list of covered medical services, but in eligibility for membership, the calculation of premiums, and the individual’s status.
Can you pay less if your income is low?
To a certain extent, yes, because the premium depends on income. However, the voluntary GKV has a minimum assessment base, so the premium does not automatically drop to zero even if your income is very low.
Do you need to report your income every year?
Self-employed individuals and those with fluctuating income usually need to verify their income with documentation, most often through a tax assessment. If income changes, the health insurance fund may recalculate the premiums.
Which Is More Important: JAEG or the Contribution Assessment Threshold?
These are different figures. The JAEG determines whether an employee can opt out of mandatory GKV and choose PKV or voluntary GKV. The Beitragsbemessungsgrenze caps the income on which GKV and long-term care insurance (Pflegeversicherung) premiums are calculated.
