No threshold, and no employer paying half
For employees, going private is a question of income. They may switch only above a gross salary of 77,400 € a year in 2026, and their employer then pays roughly half of the premium. Neither applies to you. You may choose from your first day of self-employment, and you pay the full amount yourself in both systems.
| Voluntary statutory cover | Private cover | |
|---|---|---|
| What the premium follows | Your income, up to a ceiling of 5,812.50 € a month in 2026 | Your age and health when you join, and the benefits you choose. Not your income. |
| When income falls | The contribution falls with it, down to a minimum | The premium stays where it is |
| Children and a non-earning spouse | Covered without extra contribution | Each person needs their own policy and their own premium |
| Benefits | Set by law, and changeable by law | Set by contract, and cannot be reduced unilaterally |
What each system actually costs you
In the statutory system the contribution is a percentage of your income, currently 16.3 % including the average supplementary rate, plus long-term care insurance. It is capped, because income above 5,812.50 € a month is not counted. At that ceiling the health insurance contribution reaches 1,226.44 € a month, or 1,261.31 € if you have no children.
Private premiums do not work that way. They depend on your age when you join, your health at that moment and the cover you pick. The average across all fully privately insured people in Germany is 617 € a month. That figure is an average, not a quote, and it says nothing about what you personally would pay.
The part that catches people outA bad year does not lower a private premium
This is the single most important difference for anyone whose income is irregular. In the statutory system a weak year lowers your contribution. In the private system it does not. The premium was calculated for your age and your cover, and it stays there whether you bill 120,000 € or 30,000 €.
If your income swings, weigh that more heavily than any list of benefits. There are ways to soften it, a higher deductible for example, or a benefit-reduction option inside your own policy, but they need to be chosen before the difficult year, not during it.
One exception worth knowingArtists and publicists have a third route
If you work as an artist or a publicist, the Künstlersozialkasse may apply to you. It acts in place of an employer and pays a share of your contributions, which changes the arithmetic completely. It is worth checking whether you qualify before you compare anything else.
Common questions
I am self-employed. Is private cover automatically the better choice?
No. Freedom of choice is not the same as the right choice. You carry the full premium alone in both systems, and a private premium does not fall when your income does. If your income is irregular, that matters more than any benefit table.
Can I switch back to the statutory system later?
Only if you become compulsorily insured again, for example by taking employment below the income threshold, or through family insurance via a spouse. From age 55 the return is effectively closed, with very narrow exceptions. Treat the decision as one you may not be able to undo.
I have just started out and earn very little. What now?
Voluntary statutory cover has a minimum contribution based on a notional minimum income, so it does not drop to nothing. Private cover ignores your income entirely. Which is cheaper in your first year depends on your age, and the honest answer needs your actual figures, not a rule of thumb.
Does my family cost extra?
In the statutory system a non-earning spouse and your children are covered without an additional contribution. In the private system every person needs their own policy and their own premium. For a family on one income this often decides the question on its own.