Voluntary health insurance: Your guide to optimal cover and fair contributions
09.04.25
3
Minutes
Katrin Straub
Managing Director at nextsure
Voluntary health insurance offers flexibility, but also raises questions. Secure comprehensive protection by understanding your options in detail. This article examines all aspects, from contributions to your rights.
The topic in brief and concise terms
Voluntary statutory health insurance secures continued membership in the GKV for people who are not compulsorily insured, such as self-employed people or high earners, with contributions based on total income.
The scope of benefits of voluntary statutory health insurance is the same as that of compulsory insurance, including the option of contribution-free family insurance.
Contributions are levied up to the contribution assessment ceiling (2025: EUR 5,512.50/month); a minimum assessment basis applies (2025: EUR 1,248.33/month).
Quick Facts: Voluntary health insurance explained briefly
Voluntary health insurance offers people who are not subject to compulsory insurance the option of remaining in the statutory system with full benefits. Contributions are based on total financial capacity up to the contribution assessment ceiling. Here are the most important points about voluntary health insurance:
Target group: Primarily self-employed people, freelancers, employees above the annual earnings threshold (JAEG) and people after the end of family insurance.
Contribution amount: Based on income, with minimum and maximum contributions. For 2025, the monthly minimum assessment basis is EUR 1,248.33.
Scope of benefits: Corresponds to that of those with compulsory insurance, including the option of free family insurance.
Freedom of choice: Those affected can often choose between voluntary statutory health insurance (GKV) and private health insurance (PKV). A switch back to GKV is often only possible later with difficulty.
Application deadlines: As a rule, membership must be completed within three months of the end of compulsory insurance.
Check the requirements: Who can use voluntary health insurance?
Not everyone can join the statutory health insurance scheme voluntarily. The statutory health insurance scheme sets out clear rules, often based on income thresholds or occupational status. The annual earnings threshold was €69,300 in 2024 and is expected to rise to €73,800 in 2025.
Groups of people entitled to voluntary insurance
Voluntary insurance is open to various groups that meet certain criteria. These typically include:
Employees above the JAEG: Anyone who exceeds this threshold becomes exempt from compulsory insurance and can choose.
Self-employed people and freelancers: Can take out voluntary statutory or private insurance. Important for the self-employed.
People after family insurance ends: For example, children who reach the age limit or earn their own income.
Civil servants and judges: Under certain conditions, often following previous statutory insurance.
Students: After the end of student compulsory insurance (e.g. from the age of thirty-one or the fourteenth semester).
Pensioners: If the requirements for health insurance for pensioners (KVdR) are not met. Find out more about the health insurance for pensioners.
A key requirement is often a prior insurance period in the statutory health insurance scheme: during the last five years, at least twenty-four months, or immediately before that at least twelve months insured. Exceptions exist (e.g. career starters above JAEG). Individual clarification with the health insurance fund is always advisable.
Keeping costs under control: calculating contributions to voluntary health insurance
Contributions to voluntary health insurance are based on the insured person's overall economic capacity (employment and investment income, rental income, other income).
Understanding contribution rates and assessment thresholds
The standard contribution rate is 14.6 per cent, plus the fund-specific additional contribution. Self-employed persons without entitlement to sickness benefit pay a reduced rate of 14.0 per cent plus the additional contribution. Contributions are levied up to the contribution assessment ceiling (2025: EUR 5,512.50/month). A minimum assessment basis of EUR 1,248.33 per month (2025) ensures that a minimum contribution is payable even with low or no income (approx. EUR 175 without long-term care insurance and additional contribution). This is supplemented by long-term care insurance contributions (currently 3.4 per cent or 4.0 per cent for childless persons over 23).
Calculation examples for different income situations
Examples (assumption: additional contribution 1.7 per cent, standard contribution rate 14.6 per cent, long-term care insurance 3.4 per cent): A self-employed person with EUR 2,500 in monthly income (with entitlement to sickness benefit) pays around EUR 492.50. A voluntarily insured employee with a monthly salary of EUR 6,000 (above the BBG 2025) has a personal cost of around EUR 543.00. A person with no earned income living off EUR 1,000 in rental income pays around EUR 238.43 based on the minimum assessment basis.
Accurate calculation is essential in order to assess the financial burden. You can also find out more about the upper limit in statutory health insurance.
Make use of the range of benefits: What voluntary health insurance offers
Voluntarily insured people receive the identical range of benefits as compulsory insured members in the GKV, covering all medically necessary treatments, preventive care and rehabilitation in accordance with Book Five of the German Social Code (SGB V), as well as comprehensive medical care.
Standard benefits and family insurance
Standard benefits include, among others:
Medical and dental treatment
Hospital treatment
Provision of medicines, dressings, therapies and aids
Home nursing care
Maternity benefits
A major advantage is the contribution-free family insurance for spouses and children (subject to certain income thresholds). This distinguishes the GKV from the PKV, where each family member is insured separately.
Additional benefits and options
Many health insurers offer optional plans and additional benefits beyond standard benefits. For the self-employed, a plan with entitlement to sickness benefit is important, as it secures financial support from the seventh week of incapacity for work. Without this option, there is no entitlement to sickness benefit. Our expert tip: Clarify whether sickness benefit makes sense for your situation, despite higher contributions. Protection against loss of income can be essential. The exact terms and additional offers vary depending on the health insurer; it is always worth comparing.
Expert knowledge: Master legal basics and design tips
Voluntary health insurance is based on clear statutory regulations in Book Five of the Social Code (SGB V). In particular, Section nine of SGB V regulates the requirements for joining, lists groups of people and defines prior insurance periods. Section 240 of SGB V is crucial for the assessment of contributions and takes into account the person’s entire economic capacity.
Important sections and current rulings
In addition to Sections 9 and 240 of SGB V, Sections 188 of SGB V (commencement) and 191 of SGB V (end) are also relevant. Recent rulings by the Federal Social Court clarify the interpretation (e.g. taking partner income into account, minimum contributions). Find out about changes, such as the reduction in the minimum assessment basis for self-employed people on 1 January 2019.
Practical tips: optimise contributions and avoid pitfalls
Here are some expert tips for structuring your voluntary health insurance:
Submit proof of income correctly: Self-employed people should submit tax assessments promptly in order to correct estimates and avoid back payments. The deadline is generally three years after the calendar year.
Check entitlement to sickness benefit: Carefully weigh up whether the standard contribution rate with entitlement to sickness benefit or the reduced rate without sickness benefit is right for you.
Compare additional contributions: The insurer-specific additional contribution can have a noticeable impact on your monthly costs. Comparing health insurers can save several hundred euros a year.
Observe deadlines for switching and cancellation: The notice period is generally two months to the end of the month. Switching to another statutory health insurance provider is possible after a 12-month commitment period. When switching to private health insurance, this commitment period often does not apply.
Our expert tip: If your income changes significantly (e.g. a drop of over twenty-five per cent), you can apply for an adjustment to advance payments, even without a new tax assessment notice. This increases your flexibility. Planning and knowledge of the rules help to optimise health insurance costs and avoid unpleasant surprises.
Switching and cancellation: Navigate the process with confidence
Voluntary health insurance is not always permanent. Changing health insurers or cancelling is possible under certain conditions. The notice period is usually two months to the end of the month. What matters is when the cancellation is received by the health insurer.
Switching from voluntary statutory health insurance to private health insurance
Members of voluntary statutory health insurance can generally switch to private health insurance at any time. The usual twelve-month tie-in period often does not apply here. An informal cancellation with the statutory health insurer and proof of subsequent cover with a private health insurer are required.
Switching to another statutory health insurer
Switching to another statutory health insurer is possible after a twelve-month tie-in period. The new insurer handles the cancellation via the electronic notification procedure. A special right of cancellation applies in the event of an increase in the additional contribution; then cancellation with two months' notice is possible, even without the tie-in period having been fulfilled.
Ending voluntary membership through compulsory insurance
Voluntary membership ends automatically when compulsory insurance takes effect (e.g. employees below the annual earnings threshold (JAEG), unemployment benefit I, family insurance). Inform your health insurer immediately. Knowing these switching and cancellation arrangements gives you the confidence to respond flexibly to changes.
The choice and design of 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 the better fit, or how you can optimise contributions, we will be happy to advise.
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More useful links
The Federal Ministry of Health offers information on health-related topics and articles.
The Federal Ministry of Health provides specific information on people with statutory health insurance.
The National Association of Statutory Health Insurance Funds provides a PDF document with uniform principles for assessing contributions for voluntary members from 2025 onwards.
Wikipedia offers a comprehensive overview of voluntary health insurance in Germany.
The PKV (Association of Private Health Insurance) offers a statistical report for 2023 as a PDF document.
The PKV figures portal offers 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 expenditure in Germany.
The German Pension Insurance provides information on health and long-term care insurance for pensioners.
FAQ
What is the annual earnings threshold for voluntary health insurance?
The annual earnings threshold (JAEG), also known as the compulsory insurance threshold, is expected to be EUR 73,800 per year in 2025 (EUR 6,150 per month). Employees whose regular annual salary exceeds this amount are exempt from compulsory insurance and can opt for voluntary statutory or private health insurance.
What benefits do I receive in voluntary health insurance?
Voluntarily insured persons receive the same range of benefits as those compulsorily insured under statutory health insurance. This includes medical treatment, hospital stays, medicines and the option of family insurance at no additional cost.
How are contributions for self-employed people in voluntary health insurance calculated?
For self-employed people, the entire income up to the contribution assessment ceiling is taken into account. You can choose between the general contribution rate (14.6 per cent plus additional contribution) with entitlement to sickness benefit or the reduced rate (14.0 per cent plus additional contribution) without sickness benefit.
Is there a minimum contribution in voluntary health insurance?
Yes, contributions are based on a minimum assessment basis of EUR 1,248.33 per month (2025). The minimum contribution is around EUR 175 (at a contribution rate of 14.0%) plus supplementary and long-term care insurance.
What deadlines do I need to observe when joining voluntary health insurance?
Joining voluntary health insurance must generally be notified to the health insurance fund within three months of the end of the previous compulsory insurance or family insurance.
Can I add my family to my policy as a voluntarily insured person?
Yes, a major advantage of voluntary statutory health insurance is the option to include spouses (with little or no income) and children in family insurance free of charge.
