If you live in Germany but work for an employer or clients abroad, your health insurance options depend on how your work is classified here. Freelancers follow the standard freelancer options. People on a foreign employment contract are usually treated as freelancers and should check for a German subsidiary, ask about the 50% employer contribution, and choose between public health insurance, expat health insurance, or private health insurance (PKV) based on eligibility. People posted to Germany temporarily generally stay insured at home via A1/S1 forms.
What should I know before choosing health insurance if I live in Germany but work for a company or clients outside of Germany?
The right option depends on your specific employer and circumstances, so this article gives general guidance only. We also recommend speaking to a tax adviser: health insurance is one part of the picture, but your tax situation is usually the more complicated one. The sections below cover the three most common cases — freelancing for foreign clients, holding an employment contract abroad, and being posted to Germany temporarily.
I live in Germany and freelance for clients outside of Germany — what health insurance applies to me?
If you freelance for clients outside of Germany, you are treated as a normal freelancer in Germany, and the standard freelancer health insurance options apply to you. You can use our health insurance recommendation tool, or read our articles for freelancers, to find the option that fits your situation.
I live in Germany but have an employment contract with a company outside of Germany — what are my health insurance options?
In most cases, holding an employment contract with a company outside of Germany means you are considered a freelancer in Germany. We recommend the following steps:
Check whether your contract can be transferred to a German subsidiary of your employer.
Ask your employer whether they can pay the 50% employer contribution toward health insurance, which is standard practice in Germany.
Your remaining options depend on whether you qualify for voluntary public health insurance, which generally requires recent prior public (state) health insurance in the EU or EEA.
If you have not had public health insurance in the EU or EEA in the past 2 years, you generally cannot join public health insurance voluntarily, so you should sign up for expat health insurance or private health insurance (PKV).
If you do meet the requirements, you can join public health insurance as a voluntary member, or instead choose expat health insurance or private health insurance (PKV). Where you are eligible, we strongly recommend public health insurance or private health insurance (PKV).
I've been posted to Germany for a temporary assignment — do I need German health insurance?
If you have been sent to Germany for a temporary assignment, you generally do not need to take out German health insurance. Your employer should have issued you the A1 and S1 forms (more info). Using these forms, you can usually stay insured in your home country for up to 24 months and avoid paying social contributions twice, while still having access to healthcare in Germany. This can also apply if you are a freelancer whose activity remains registered in your home country and who is in Germany only temporarily. To use this arrangement, obtain the A1 and S1 forms from your health insurance provider in your home country and present them to any public health insurance provider in Germany. Please note that we cannot process these applications.