Every person who is not subject to compulsory insurance in Germany can join the voluntary insurance if they fulfil the requirements.
Who is a voluntary member of public insurance?
Self-employed and freelancers (artists and publicists can signup through KSK)
Job seekers
Mini jobbers (monthly income up to €556)
Students over 30 years of age
Employees over 55 years of age
Employees with a yearly income above €73,800
The requirements of getting public health insurance for voluntary members
Voluntary public health insurance is, in most cases, an extension of already existing EU/EEA state insurance, which means that you can transfer to German voluntary public health insurance if your EU/EEA state insurance ended less than 3 months ago and, prior to that, it was active for at least 12 full consecutive months, or at least 24 months within the last 5 years, with possible interruptions.
Special rules:
Employees with a yearly income above €73,800 are also so-called voluntary insured since they can also choose between public and private health insurance. However, the eligibility rules for them are a bit different. When starting their first employment contract in Germany they can always choose between public and comprehensive private insurance. No further eligibility is required to access public health system. However, rules change for the next employment contracts. If a person commits to private instead of public health insurance on their first employment, it is not possible to switch to public health insurance as long as their salary is above the mentioned threshold. That is valid for someone that is returning from abroad for a new employment as well.
Employees over 55 years of age are presented with an additional obstacle, even if their salary is under the private threshold (€73,800). Someone coming from abroad that never lived in Germany can access public health system without any setbacks despite being over 55 years of age. However, switch from private to public insurance is almost impossible. If a person lived in Germany in the last 5 years, they need to prove they were insured at least one day with public health insurance in order to be eligible.
Costs
Voluntary public health insurance costs are based on your (pre-tax) income and are generally calculated at around 21% of gross income (2024). The total cost is made up of health insurance (15.6%) + long-term care insurance (2.4-4%, depending on age and having children) and a small fee of around 1.8-4%, depending on the chosen provider.
However, the German system assumes you'll be earning at least €1248 per month, so even if you earn less than that you'll still be paying the minimum of around €250 each month. And no matter how much you earn, the highest contribution you'll make tops out at around €1150 per month.