Voluntary Health Insurance: Your guide to optimal protection and fair contributions
9 Apr 2025
4
Minutes
Katrin Straub
CEO at nextsure
Voluntary health insurance offers flexibility but also raises questions. Ensure comprehensive protection by knowing your options thoroughly. This article sheds light on all aspects, from contributions to your rights.
The topic in brief and concise terms
The voluntary health insurance ensures that non-compulsory insured persons such as self-employed or high earners remain within the statutory health insurance, with contributions based on total income.
The scope of the voluntary statutory health insurance corresponds to that of the compulsory insurance, including the option for non-contributory family insurance.
Contributions are levied up to the contribution assessment ceiling (2025: €5,512.50/month); a minimum assessment base applies (2025: €1,248.33/month).
Quick Facts: Private Health Insurance Explained
Voluntary health insurance allows individuals who are not obligated to have insurance to remain within the statutory system with full coverage. Contributions are based on the entire economic capacity up to the contribution assessment ceiling. Here are the key points about voluntary health insurance:
Target Group: Primarily self-employed individuals, freelancers, employees above the annual income threshold (JAEG), and individuals after the end of family insurance.
Contribution Amount: Income-dependent, with minimum and maximum contributions. For 2025, the monthly minimum assessment basis is 1,248.33 euros.
Coverage: Equivalent to that of those with mandatory insurance, including the option for free family insurance.
Choice: Affected individuals can often choose between voluntary statutory health insurance and private health insurance. Switching back to statutory health insurance is often very difficult later on.
Application Deadlines: Generally, the membership must occur within three months after the end of compulsory insurance.
Check eligibility: Who can use the voluntary health insurance?
Not everyone can voluntarily opt for statutory health insurance. The statutory health insurance outlines clear regulations, often based on income limits or the form of employment. The annual income threshold was 69,300 euros in 2024 and is expected to rise to 73,800 euros in 2025.
Groups eligible for voluntary insurance
Voluntary insurance is available to various groups that meet certain criteria. These typically include:
Employees above the JAEG: Those exceeding this threshold are exempt from compulsory insurance and can choose freely.
Self-employed and freelancers: Can opt for either statutory or private insurance. Important for the self-employed.
Individuals after the family insurance ends: For instance, children who reach the age limit or earn their own income.
Civil servants and judges: Under certain conditions, often with prior statutory insurance.
Students: After the end of compulsory student insurance (e.g., from the thirty-first birthday or the fourteenth semester of study).
Pensioners: If the requirements for health insurance for pensioners (KVdR) are not met. Learn more about the health insurance for pensioners.
An important requirement is often a prior insurance period in the SHI: At least twenty-four months in the last five years or at least twelve months immediately prior. Exceptions exist (e.g., career starters above JAEG). Individual clarification with the health insurance provider is always advisable.
Keeping Costs Under Control: Calculating Contributions for Voluntary Health Insurance
Contributions to voluntary health insurance are based on the entire economic capacity of the insured (employment and capital income, rental income, other earnings).
Understanding Contribution Rates and Assessment Limits
The standard contribution rate is fourteen point six percent plus the fund-specific additional contribution. Self-employed individuals without entitlement to sickness benefits pay a reduced rate of fourteen point zero percent plus the additional contribution. Contributions are levied up to the contribution assessment ceiling (2025: 5,512.50 euros/month). A minimum assessment basis of 1,248.33 euros monthly (2025) ensures that even with low or no income, a minimum contribution (approx. 175 euros excluding care and additional contribution) is incurred. Additional contributions to long-term care insurance apply (currently three point four percent or four point zero percent for those over the age of twenty-three without children).
Calculation Examples for Various Income Situations
Examples (assumption: additional contribution one point seven percent, standard contribution rate fourteen point six percent, long-term care insurance three point four percent): A self-employed person with a monthly income of 2,500 euros (with entitlement to sickness benefits) pays about 492.50 euros. An employee with voluntary insurance and a monthly salary of 6,000 euros (above the contribution assessment ceiling 2025) has a personal burden of approximately 543.00 euros. A person with no earned income, living from 1,000 euros in rental income, pays based on the minimum assessment basis approximately 238.43 euros.
Accurate calculation is essential to assess the financial burden. Inform yourself also about the ceiling in statutory health insurance.
Utilizing the range of services: This is what voluntary health insurance offers
Voluntary members receive the same range of benefits as compulsory insured members in the statutory health insurance, covering all medically necessary treatments, preventive care, and rehabilitation in accordance with the Fifth Book of the Social Code (SGB V), as well as the comprehensive medical care.
Standard Benefits and Family Insurance
The standard benefits include, among others:
Medical and dental treatment
Hospital treatment
Supply of medicines, dressings, remedies, and aids
Home nursing care
Maternity benefits
A major advantage is the contribution-free family insurance for spouses and children (under certain income limits). This distinguishes statutory health insurance from private health insurance, where each family member is insured individually.
Additional Benefits and Options
Many health insurance companies offer optional tariffs and additional benefits beyond the standard benefits. For the self-employed, a tariff with entitlement to sick pay is important as it provides financial support from the seventh week of incapacity for work. Without this option, the entitlement to sick pay is forfeited. Our expert tip: Consider whether sick pay is sensible for your situation, despite higher contributions. Securing income loss can be crucial. The exact conditions and additional offers vary depending on the insurance company; it's always worth comparing.
Expert knowledge: Master legal basics and design tips
Voluntary health insurance is based on clear legal regulations in the Fifth Book of the Social Code (SGB V). In particular, Paragraph nine of SGB V regulates the requirements for membership, lists groups of people, and defines prior insurance periods. Paragraph 240 of SGB V is crucial for the assessment of contributions and takes into account the entire economic capacity.
Important Paragraphs and Current Judgments
In addition to Paragraph nine and 240 of SGB V, Paragraph 188 of SGB V (commencement) and Paragraph 191 of SGB V (termination) are also relevant. Recent rulings by the Federal Social Court clarify the interpretation (e.g., consideration of partner's income, minimum contributions). Stay informed about changes, such as the reduction of the minimum assessment basis for the self-employed from the first of January 2019.
Design Tips: Optimise Contributions and Avoid Pitfalls
Here are some expert tips for designing your voluntary health insurance:
Submit income evidence correctly: The self-employed should promptly submit tax assessments to correct estimates and avoid additional payments. The deadline is usually three years after the calendar year.
Check entitlement to sickness benefit: Carefully weigh whether the general contribution rate with sickness benefit entitlement or the reduced rate without it is beneficial for you.
Compare additional contributions: The fund-specific additional contribution can noticeably affect the monthly burden. A comparison of health insurance funds can bring savings of several hundred euros per year.
Observe deadlines for changing and cancelling: The cancellation period is typically two months at the end of the month. A change to another statutory health insurance (GKV) is possible after twelve months of binding. When switching to private health insurance (PKV), this binding period often does not apply.
Our expert tip: In the event of a significant change in income (e.g., a decline of over twenty-five per cent), you can apply for an adjustment of advance payments, even without a new tax notice. This increases your flexibility. Planning and understanding the rules help to optimally manage health insurance costs and avoid unpleasant surprises.
Change and Termination: Navigating the Process with Confidence
Voluntary health insurance is not always final. Changing health insurance providers or terminating the policy is possible under certain conditions. The notice period is generally two months to the end of the month. What matters is when the cancellation is received by the health insurance company.
Switching from voluntary statutory health insurance to private health insurance
Voluntary statutory health insurance members can generally switch to private health insurance at any time. The usual twelve-month commitment period often does not apply here. A simple cancellation with the statutory health insurance and proof of subsequent insurance with a private health insurance is required.
Switching to another statutory health insurance
Changing to another statutory health insurance is possible after a twelve-month binding period. The new insurer handles the cancellation via the electronic notification process. There is a special right of termination if the additional contribution is increased; in this case, cancellation is possible with a two-month notice period, even without fulfilling the binding period.
Termination of voluntary membership due to compulsory insurance
Voluntary membership automatically ends when compulsory insurance takes effect (e.g. employees below the compulsory insurance income ceiling, unemployment benefit I, family insurance). Inform the health insurance immediately. Knowing these switching and cancellation procedures gives you the confidence to react flexibly to changes.
Your next step: Secure personalised advice at nextsure
Choosing and designing voluntary health insurance is an important, individual decision. This article provides an overview but does not replace personal advice. Every life situation is unique and requires a tailored solution. Whether voluntary statutory health insurance or private health insurance is more suitable, or how to optimize contributions, we are happy to clarify.
At nextsure, we are your digital insurance portal. We help you maintain clarity in the tariff jungle and find the optimal coverage.
Request an individual risk analysis now: Have your insurance situation checked free of charge and receive specific optimization suggestions.
More useful links
The Federal Ministry of Health provides information on health-related topics and contributions.
The Federal Ministry of Health specifically informs about statutory insured persons.
The National Association of Statutory Health Insurance Funds provides a PDF document with standard principles for contribution assessment for voluntary members as of 2025.
Wikipedia offers a comprehensive overview of voluntary health insurance in Germany.
The Association of Private Health Insurance (PKV) offers a statistical report for 2023 as a PDF document.
The PKV Statistics Portal provides statistics on private health insurance in Germany.
The homepage of the Federal Ministry of Health offers a comprehensive overview of health topics.
Destatis (Federal Statistical Office) provides information on health expenditures in Germany.
The German Pension Insurance provides information on health and long-term care insurance for pensioners.
FAQ
What is the annual income threshold for voluntary health insurance?
The annual income threshold for compulsory insurance (JAEG), also known as the insurance obligation threshold, is expected to be €73,800 annually (€6,150 monthly) in 2025. Employees whose regular annual salary exceeds this threshold are exempt from compulsory insurance and can choose to voluntarily insure themselves either through public or private health insurance.
What benefits do I receive in voluntary health insurance?
Voluntarily insured individuals receive the same range of benefits as those mandatorily insured under statutory health insurance. This includes medical treatment, hospital stays, medication, and the option of non-contributory family insurance.
How are contributions for self-employed individuals calculated in voluntary health insurance?
For self-employed individuals, the entire income is considered up to the contribution assessment ceiling. They can choose between the standard contribution rate (fourteen point six percent plus additional contribution) with entitlement to sick pay or the reduced rate (fourteen point zero percent plus additional contribution) without sick pay.
Is there a minimum contribution for voluntary health insurance?
Yes, contributions are based on a minimum assessment basis of €1,248.33 per month (2025). The minimum contribution is approximately €175 (at a contribution rate of fourteen percent) plus additional and long-term care insurance.
What deadlines should I be aware of when joining voluntary health insurance?
Notification of joining the voluntary health insurance must usually be given to the health insurance company within three months after the end of the previous compulsory insurance or family insurance.
Can I include my family in my insurance as a voluntary member?
Yes, a major advantage of voluntary statutory health insurance is the option to include spouses (with low or no income) and children in the family insurance without additional contributions.
