A German Address, a Foreign Payslip
Remote work has created a large group in an awkward position: living and registered in Germany, but employed by a company that has no German presence. For health insurance this is genuinely tricky, because Germany’s system assumes your employer is inside it — deducting and paying contributions for you. When the employer is abroad and unregistered here, that machinery is missing, and you have to actively establish how you are insured rather than letting a German employer do it.
The starting truth: if you are resident in Germany, you must be insured here — living in the country carries the obligation regardless of where your employer sits. The question is which route applies given your unusual employment set-up.
The Common Situations
- Foreign EU employer, you work in Germany: social-security coordination rules can make German rules apply, and the foreign employer may have obligations here — but in practice many such workers end up arranging their own cover
- Employer uses an employer-of-record (EOR): if your foreign company engages a German EOR/payroll provider, you are effectively employed under German rules — the normal GKV/PKV logic then applies
- You are treated as self-employed / freelancer: if you invoice the foreign company rather than being employed, you are self-employed in Germany for insurance purposes — which opens PKV as a genuine choice
Where PKV Fits
The route into private cover usually runs through one of two doors: being self-employed in Germany (invoicing the overseas company), which frees you from the income threshold, or being a high earner under a German-payroll arrangement above it. If you are effectively a self-employed remote worker, PKV is often a natural fit — a comprehensive German tariff with worldwide cover suiting an internationally connected working life. Clarify your true status first, because it decides everything downstream.
Getting It Right
Establish your insurance status deliberately: are you employed under German rules (via an EOR), employed abroad with German coordination, or self-employed here? Each has a different insurance path, and the wrong assumption can leave a gap or the wrong contributions. Because these set-ups are individual and cross-border, this is a situation where confirming your status — with the relevant authorities or an adviser — before choosing a policy pays off.
The Bottom Line
Living in Germany while employed by a foreign company means you must insure here, but the route depends on your precise status: German-payroll employee via an EOR, coordinated foreign employment, or effectively self-employed. That status determines whether GKV applies or PKV opens up. Pin it down first — then, if you are self-employed here, a worldwide-cover PKV tariff often fits the remote life well.
Frequently Asked Questions
Compare PKV Tariffs for Your Situation
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