Term
Health insurance of sole traders
Compulsory public health insurance of a self-employed person, paid by them as monthly advances to their health insurer. The advances depend on income from the tax return, at least on the minimum assessment base, followed by an annual reconciliation.
Updated
What it means
Health insurance of sole traders is the compulsory public health insurance of a self-employed person, such as a sole trader or someone with another business activity. The self-employed person pays contributions themselves as monthly advances to their health insurer.
The amount of the advances depends on business income from the latest tax return, but at least on the minimum assessment base. After the year ends, the health insurer carries out an annual reconciliation and determines any underpayment or overpayment.
Unlike social insurance of sole traders, which arises only after an income threshold is exceeded, the obligation to pay health insurance arises as soon as the business starts. Exceptions may apply where the state pays on the person's behalf or where they are also employed, which brings special rules.
How it works in practice
When starting or ending a business, the self-employed person must notify the health insurer within the statutory period. In some cases the data is passed on automatically through the single contact point, but the business owner should check that the insurer has registered the change.
Advances are due monthly by a set day of the following month. Late payment leads to late payment interest. If the person's income changes or they also become an employee, the amount of the advances may change, as determined by the insurer after the annual reconciliation.
The insurer announces the result of the annual reconciliation, and any underpayment must be paid within the set deadline. An overpayment is refunded on request or offset. At the same time the insurer sets the advances for the next period based on the new income.
What to watch out for
Self-employed people who are also employees, or whose income is low, often ask whether they must pay advances even on the minimum base. The rules have changed and depend on the specific situation, so it is best to confirm the obligation directly with the health insurer.
Health insurers can recover arrears through a statement of arrears, which is an enforcement title. Debts may also restrict access to some health services or participation in public procurement, so payments are worth monitoring.
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