Health insurance and pension as a creator in Germany

Creators talk about taxes all the time. About health insurance and pensions, almost never — even though the health insurance contribution is the bigger item for many, and it arrives late, once you have grown used to the income. This article sorts out what is coming and when. It does not replace advice from your health insurer or a professional, and that sentence is meant seriously.

The one question everything hangs on

For health insurance there is really only one distinction that matters: are you self-employed as your main occupation, or on the side?

As long as OnlyFans runs alongside a job, studies or training, and the emphasis clearly sits there, you stay in your existing cover. As an employee you keep paying through your employer, as a student through student cover. Additional contributions may fall due on your profit, but your status stays the same.

Once the balance tips, everything changes: whoever is self-employed as their main occupation insures themselves — and pays alone what employer and employee otherwise split.

How insurers decide what counts as "main occupation"

There is no single number that flips the switch. Insurers look at several points together:

• Time: how many hours a week go into the self-employment compared to the other activity?
• Income: where does the larger share of your money come from?
• Staff: do you employ anyone?

Roughly: anyone spending more than half their working time on the self-employment, or earning more from it than from their job, gets classified as main occupation. The exact thresholds change, and individual insurers interpret them differently.

The practical advice: ask your insurer before they ask you. A phone call describing your situation costs nothing. A reclassification applied retroactively across two years can hurt badly.

What it costs once you pay yourself

As someone self-employed in their main occupation, you pay the full contribution for health and long-term care insurance. Two things regularly come as a surprise:

There is a minimum contribution. The insurer calculates on a notional minimum income, even if you earn less. So in a weak month you still pay. Reduced rates exist for new businesses — you have to ask for them yourself.

The contribution starts as an estimate. Your insurer sets it based on what you declare and corrects it later against your tax assessment. Anyone who estimated too low in year one gets a back payment in year two — on top of the ongoing contributions. This is exactly where creators get squeezed who could not yet judge their income in the first year.

For planning, budget a low double-digit percentage of your profit for health and care insurance combined. The exact rates change annually; your insurer will tell you the current ones in a single sentence.

Family cover: the point most people miss

Anyone covered through a partner or parents pays nothing — as long as their own income stays below a certain threshold. That threshold is low, in the range of a few hundred euros a month.

Cross it and family cover ends. Not gradually, but entirely. And because insurers often only notice when the tax assessment arrives, the claim comes with a delay, for a period in which the money has long been spent.

If you are on family cover and your income is growing: keep an eye on that threshold and report it yourself as you approach it.

The pension trap for creators with one agency

The point almost nobody knows — and it hits precisely those creators who work with an agency.

In Germany, self-employed people are generally not subject to compulsory pension insurance. But there are exceptions, and one is called employee-like self-employment. Simplified, it applies when both are true:

• You employ nobody subject to social insurance, and
• you work permanently and essentially for a single client.

Anyone earning their entire income through one agency can fall under this. Compulsory pension insurance then applies, with contributions to match — and where the obligation is established later, retroactively.

Whether it applies in your case depends on the specifics: how the collaboration works, who carries the business risk, whether there are other income streams. This is exactly the question worth having checked once by someone qualified to answer it. The German pension insurance offers a formal status determination procedure for this.

And the pension itself?

Whoever is not covered gets nothing — that is the uncomfortable flip side of the freedom. A creator income can be good for years and still produce not a single pension entitlement.

Three routes are open:

• Voluntary contributions into the statutory pension scheme. Flexible, and you can fill in past years.
• Private provision, from a simple ETF savings plan to subsidised contracts.
• Real assets, such as property — with every advantage and drawback that entails.

Which fits depends on your situation. What does not fit is the most common variant: doing nothing, because the topic is unpleasant and retirement seems far away.

If you move abroad

The moment a move abroad is on the table, both topics change fundamentally — different systems, different obligations, and the question of what happens to entitlements already earned. We covered this in more depth in the articles on relocating abroad as a creator and setting up a company abroad. Short version: plan first, move second — not the other way round.

The three things that actually matter

1. Call your health insurer before your status changes. The call takes ten minutes and prevents the most expensive surprises.
2. Set money aside for more than tax. Anyone who only builds a tax reserve gets caught cold by the first contribution back payment. Budget for both together.
3. Have the pension question checked once if your income essentially comes from one agency. Settled once, it is settled for years.

We support our models with these questions and work with tax advisers who know creator income. What we do not do: tell you which insurance to buy — that is someone else's job, and rightly so.