If you live in Germany and work for an employer based outside Germany, you are generally treated as self-employed for German health insurance purposes, even though you hold an employment contract. That affects which income threshold applies to you and whether anyone contributes toward your premium. If you've been posted to Germany on a temporary assignment with A1 and S1 forms, see our article on living in Germany while working for a company abroad instead.
Am I eligible for Private health insurance (PKV) if I live in Germany and work for an employer outside Germany?
Yes, in most cases. Because you're treated as self-employed rather than as an employee of a German company, you're not compulsorily insured in public health insurance, so private health insurance is available to you as your main health coverage. Our Standard, Plus, and Premium plans have no end date, so you can stay on the same policy for as long as you live in Germany instead of having to move to something else when a time-limited policy expires. Meeting the income threshold makes you eligible to apply, but you are not automatically covered — acceptance also depends on the health assessment that is part of every application.
Why am I treated as self-employed if I have an employment contract?
Eligibility depends on how your work is classified in Germany, not on whether you hold an employment contract. A contract with a company that has no German entity generally does not make you an employee for German social insurance purposes, so you're assessed as self-employed. If your employer does have a German subsidiary, it's worth asking whether your contract can be transferred to it — that would make you an employee of a German company, and the employee eligibility rules would apply instead.
What income do I need to earn to be eligible if my employer is outside Germany?
The self-employed thresholds apply to you rather than the employee threshold, and the figure depends on how long you've been resident in Germany. The current figures are in our article on the income thresholds for private health insurance.
Does my employer abroad contribute toward my private health insurance premium?
Possibly, but you should not count on it. The obligation for German employers to cover up to 50% of health and nursing care insurance costs comes from German employment law, and it does not automatically extend to an employer based outside Germany. Some employers abroad agree to pay the equivalent amount voluntarily, so it's worth asking yours directly. Unless your employer confirms otherwise, plan for paying the full premium yourself.
How does the health assessment affect my eligibility for private health insurance?
Meeting the income threshold does not guarantee acceptance, because private insurers also assess your health history. The assessment can result in full coverage at the standard price, coverage with a risk surcharge, coverage that excludes treatment related to an existing condition, or a declined application. Medical checkups may be required if you are over the age of 55, if you have certain health conditions, or if you had no comprehensive health coverage at any point in the last 12 months.
What documents do I need to provide if I don't have a German employment contract?
Because there's no German employment contract to verify, we ask for other evidence that your income meets the threshold for the coming 12 months. This can include your employment contract with the company abroad, recent payslips or bank statements, and your most recent tax declaration. Within the application, we'll tell you which of these apply to your situation and reach out if anything further is needed after you apply.
How do I sign up for private health insurance if I work for an employer outside Germany?
Get your personal quote and coverage details in under two minutes.
Apply for coverage. From the quote page, you'll be able to sign up online within 15 minutes. We'll process your application within a few days and reach out if more information is needed. Otherwise, your application will be confirmed automatically, and your coverage will start on the date you've selected in the application.
What are my options if I'm not eligible for private health insurance?
If you don't meet the income threshold or your application is declined, two routes are usually open to you:
Public health insurance (GKV) as a voluntary member, if you held public health insurance in the EU, EEA, Switzerland, or the UK recently enough to qualify. Where this route is available, it's generally the one we'd recommend.
Expat health insurance or long-term expat health insurance, which offer visa-compliant coverage where neither public nor private health insurance is accessible. Expat health insurance is generally accepted for first-time visa applications, and long-term expat health insurance for visa renewals and residence permit extensions.
If your employer has a German subsidiary, transferring your contract there is worth exploring before falling back on either of these, since it would open up the employee route.
More detail is in our article on health insurance options if you're not eligible for public or private health insurance.