Health insurance for creatives: how to get into KSK

For a newcomer in Germany, there are probably only a few topics being as shocking as the costs of health insurance for low income freelancers. Health insurance options in Germany are not well designed for that group. Luckily for freelancers with creative jobs, some of that burden can be alleviated thanks to a KSK membership in Germany.

The road to the KSK is littered with red tape and obstacles. Beyond the time it takes to assemble all the necessary supporting documents, comprehending all the German jargon requires a great deal of stamina and mental fortitude.

My hope is that this KSK guide in English for freelancers located in Germany will be a stepping stone to achieve this.

Feel free to ask questions in the comments section.

What is KSK in Germany? How does it work?

The Künstlersozialkasse was founded in 1983 as a government-sponsored health insurance and pension scheme for self-employed writers, artists, performers, designers and musicians. The idea was to aid people in typically unstable and low-paying professions with their social security payments. This also helps during retirement, avoid extreme poverty.

If you’re accepted into the exclusive circle of KSK customers, you only pay half of the monthly contributions for health insurance you’d ordinarily pay as a freelancer. The other half is split between the federal government and institutions that profit from art and cultural work, such as museums, publishing companies and theaters. Together, they cover what would normally be the employer’s share of your contributions, freeing artists up to only pay an employee’s share of contributions. This service is unique to KSK and the creative industry.

How is KSK linked to health insurance?

To eliminate any confusion: the KSK is not in itself a health insurance provider. The institution is instead responsible for redistributing social security payments. This means that you will need to choose a health insurance scheme in tandem with your KSK application. You can choose any public health insurance company, so take the time to find one with the coverage that best suits you.

Eligibility criteria – requirements to join the KSK

Doing the right job

According to the Bundesministerium für Arbeit und Soziales, KSK is obligatory for “Anyone who creates, practices or teaches music, performing arts or visual arts… works as a writer, journalist, is involved in the media or teaches journalism”.

The KSK determines which occupations fall under this category – and it’s here that the specifics matter. Thanks to the advent of internet culture, what constitutes an artist or a creative industry is much broader now than it was in 1983. Influencers, digital content creators and those who work in new media should be careful to define their jobs in unambiguous terms that the KSK will understand as related to the arts. Here are common cases

Performance Artists

• Included: Actors, comedians, magicians, dancers, and more.

Visual Artists

• Included: photographers, video editors, dancers, painters, graphic designers, web designers, game designers, UX designers, illustrators, and more.
• Photographers: artistic and press photographers are accepted; wedding and portrait photographers may not.
• Tattoo artists: almost always rejected.
• Web designers: must prove they do design, not programming or maintenance.
• Fashion designers: can’t sell their own clothes; designing is accepted, making clothes is not.

Musicians

• Included: Singers, DJs, audio designers, voice actors, and more.
• DJs: Must prove they create art; playing others’ music is not accepted.
• Orchestra musicians: Rarely accepted as they are rarely self-employed.
• Wedding singers: Sometimes rejected; acceptance is uncertain.

Publicists

• Included: Writers, journalists, bloggers, authors, reporters, copywriters, copy editors, YouTubers, influencers, some translators, and more.
• Translators: Verbatim translations are not creative enough and may be rejected.
• Publishers: Rarely accepted as they are distributors, not creators.
• Curators: Must make money from their own content, not administrative tasks.

Teachers

• Included: Art, design, writing, and music teachers.
• Requirements: Must teach others to become professional artists or publicists.
• Exclusions: Teaching refugees or elderly is not accepted as it is considered social work.
• Dance teachers: Covered if teaching dance as art, not entertainment, sport, or therapy.

If in doubt, check full list of accepted job titles.

It’s your main income source

If the job is part of the accepted occupation above, it should be:

• Your primary job: The creative work should be your main job and primary source of income. While you can have other income sources, this can complicate your application. Your work should be for profit, not a hobby, and you should charge for your services.
• A long-term commitment: you should plan to continue this type of work for the long term, not just a few months.
• Minimum Income:
  • You need to earn at least €3,900 per year as a freelance artist, publicist, or art teacher.
  • There’s no minimum income requirement in the first three years of your career.
  • After joining the KSK, your income can drop below €3,900 per year twice every six years.
  • There’s no maximum income limit.

You are self-employed

You can be either a Freiberufler or a Gewerbetreibender; both are acceptable. Your activity should meet all requirements for self-employment:

• Multiple clients: you shouldn’t be working exclusively for one agency, orchestra, theatre group, film production, or art school.
• Independent worker: this means choosing your own rates, work hours, and location.
• Entrepreneurial risks: take the risks associated with self-employment. This means not having protections like seasonal contracts or sick pay from an employer.
• Not an employer: although you can hire other freelancers.

You are based in Germany

You must work from Germany at least 25% of the time, even if your clients are elsewhere.

• You don’t need German clients to join the KSK.
• All German residents can join the KSK; citizenship is not required.
• Your nationality does not affect your application.

There’s also grey areas when it comes to claimants with employees; to be eligible for KSK, you are not permitted to have more than one paid employee, although you can commission freelancers to work for you as frequently as you like, or hire mini jobbers.

How are contributions calculated?

As a member of a public insurance scheme, your contributions are determined by an income forecast for the year, so naturally, the less you earn, the less you pay. At the end of each year, the KSK sends its members a form to fill in to provide an estimate of your income for the upcoming year. To be perfectly clear: it is based on your estimated profit. That is: your estimated income minus your estimated expenses.

If your circumstances change and your predicted income increases or decreases, you can revise your contributions at any time.

Your KSK payment is distributed to cover health insurance, nursing care and pension, all of which require a different amount of your income. . Half of that is paid by you, the other half by KSK:

• 14.6% for public health insurance.
• 3.05-3.3% for nursing care.
• 18.6% for pension insurance.

Approximate KSK contributions example:

You work as cross media artist for theaters and events. Your estimated yearly profit is 10 000€. You are single with no kids.

Rentenversicherung – Pension Insurance = 18,6%
You pay 9,3% = 930€ yearly or 77,50€ monthly.

Krankenversicherung – Health insurance = 14,6%
You pay 7,3% = 730€ yearly or 60,83€ monthly.
 
Pflegeversicherung – Nursing care= 3,05%
You pay 1,525% = 150€ yearly or 12,71€ monthly.

Total contributions: 1810€ yearly or 151.04€ monthly.

Please note that the figures contained in this application guide for KSK in Germany are purely indicative.

How do I apply for KSK?

Documents to support your KSK application

Standard documents

• KSK application form
• Passport: include a photocopy.
• Residence permit (if relevant) include a copy together with the Zusastzblatt.
• Direct debit authorization: optional but recommended for automatic KSK payments.

Documents to prove you have a creative profession

Pick and chose what’s relevant. Remember: you want to paint a picture the reviewer will understand. Your application must tell a story that is easy to understand, and easy to support with evidence. There is no absolute rule.

• Simple business plan: required if you just started your business. It explains how your business works.
• Examples of your work: Websites, art, photographs, published content, newspaper articles, concert tickets. Whatever that might be for you.
• Proof of creative career: school diplomas, scholarships, certificates, prizes won.
• Membership to artistic or journalistic associations: certificate of membership.
• Letters of reference from clients: explains the type of work done for clients.
• Advertising material: Posters, photos, business cards, social media profiles, personal website. Documents must be less than 1 year old and can be from another country.

Documents to demonstrate regular income

• Invoices with bank statements: Include invoices for artistic or journalistic work and screenshots of bank transactions proving payment.
• Contracts: cnclude full contracts with signatures.
• Other sources of income: affiliate income, patreon sponsors.
• Income tax assessments (Steuerbescheid): include tax returns for the last 3 years if possible. Documents must be less than 6 months old and can be from another country.
• Proof of upcoming projects: helps to prove future income.

Health insurance Documents

• Proof of health Insurance (Mitgliedbescheinigung): Obtain from health insurer or broker or get a vorläufige Mitgliedsbescheinigung if not yet insured.
• Public health insurance exemption form & private health insurance contract: Required if you want to keep private health insurance after joining KSK.

Documents for students and parents

• Enrolment certificate: get that from university after paying registration fees.
• Proof of parenthood (Nachweis der Elterneigenschaft): children’s birth certificates, recent tax assessments, or proof of child allowance.

English application guide for KSK: What to know before applying

The application process is hard

Without mincing words, applying to the KSK is a journey, so strap in for the long haul. The red tape surrounding the KSK is unforgiving, so you should do everything you can to ensure the application process goes as smoothly as possible. This involves submitting all supporting documents and invoices in an organised portfolio, so hold onto everything work-related. Your supporting evidence should reflect the extent of your work, requiring you to provide exhaustive documentation, including invoices for administrative work, any published articles and invitations to events. If you work for an organisation as part of your freelance work, it will strengthen your application to provide a letter of intent or contract. 

Other benefits are sometimes not compatible

In most cases, KSK cannot be used in conjunction with other government benefits. This will have an impact if you have been claiming Arbeitslosengeld or Mutterschaftsgeld. If you become pregnant while applying for or using KSK, you must inform them immediately about your plans for claiming Mutterschaftsgeld and taking parental leave.

Your coverage stays the same

Nothing changes between you and your Krankenkasse after you become a KSK member. You can sign up with any German public health insurance company – and you are always entitled to all of the benefits, as your full contributions are still being paid. To ensure that you get all the coverage you need, make sure you first consult a reliable comparison of all the available packages. 

It takes a long time to receive an answer

Since the system that governs an individual’s eligibility is so complex, the KSK will painstakingly trawl through your application and supporting evidence, looking out for inconsistencies, missing information, ambiguities, or really any reason to reject your application. Even if you come prepared with an organised portfolio of pay slips and supporting documents, it takes KSK at least three months to make a decision about your eligibility. During this period, you are legally obliged to pay for your health insurance in full, ironically as a ‘freiwillig’ customer. Of course, the more comprehensive your documentation, the quicker this process will be. 

You can appeal a negative decision

If KSK determines that you are ineligible, you can also appeal the decision by submitting a new application with further evidence. This process takes some time in itself; if your portfolio is lacking evidence, the KSK will send you further forms to complete before a decision is made. Make sure you give this supplementary form just as much care and attention as you did the application form, as it will be decisive in the outcome of your application. If the appeal is rejected, you can re-apply from scratch. It would then take the best part of a year to be accepted. There is no limit to how many times you can apply. If your application is accepted, KSK will reimburse you the difference for every month since your application date. 

You can use a private Krankenkasse together with KSK

In this case, costs are structured differently. A private health insurance still compatible with a KSK membership under some conditions, as detailed here. It only concerns a small minority as this is relevant for high-earners and newcomers.

• You were a freelancer for less than 3 years.
• or
• You earn more than 73,800€ per year for 3 years in a row.

KSK, part-time employment & non-creative work

The KSK was founded with the intention of supporting full-time freelancers, although that’s not to say that part-time employees and freelancers with a minijob are necessarily excluded from KSK. Theoretically, it is possible to support yourself with part-time employment or non-creative freelance work, but there are a few caveats:

• Your creative freelance work must remain your main source of income,
• You can earn a salary (from employment) on the side if the total yearly income does not exceed your income from your creative freelance work.
• You can do non-creative (as per KSK’s own criteria) self-employed work as long as it doesn’t earn more than 556€ per month profit.

KSK must be informed about any employment relationship and any changes in order to reassess your contributions. Find further information about the KSK and part-time employment, in German, here.

Termination of KSK membership: that can happen too

KSK members don’t really get the option to leave – if you’re eligible, you are legally obliged to use the service – but there’s plenty of ways to get kicked out if you don’t tread carefully. Earn more than 556€ per month from non-creative freelance work? Out. Earn less than 3900€ per year from your creative job twice within a six-year period? Out.

But it’s not only financial reasons that could see you dropped from KSK. KSK can terminate your membership under any of the following conditions:

• Your work isn’t predominantly artistic or journalistic in nature
• You are only active in Germany temporarily
• You have more than one full-time employee
• You take on a senior management role at a GmbH, also in a freelance capacity
• Your documents are incomplete or suspicious
• You do not respond to correspondence from the KSK.

The KSK carry out regular random checks of their members’ bank statements to ensure no one is cheating the system. If you fail these checks – even through an innocent oversight – it could cost you your eligibility. It’s therefore vital that you maintain an open line of communication with the KSK and inform them of any changes as promptly as possible.

Losing your membership to KSK will automatically convert your insurance status to a regular freelancer, meaning you will have to pay your insurance contributions in full. 

I don’t think I can manage an application on my own, where can I get help?

This English KSK application guide would not be complete without pointers on where to get help. The KSK offers little guidance in English surrounding the form, but there are resources online to help you out. There’s a DIY application manual crafted by Feminine Health care research group zine, which takes you through the application process step-by step and dishes out helpful tips.

You can also find help in this dedicated Facebook group about the KSK.

You can also turn to free consultations with your local artist’s union or association. They often provide dedicated office hours and services about KSK memberships. In Berlin you can turn to BBK but there are other similar organization every where else in Germany part of the BBK Bundersverband or Deutscher Künstlerbund.

For a more personal & handheld approach, you can book a coaching session with an expert advisor for a fee. They will assist you in putting together a perfect application to give you the strongest possible chance of being accepted into the KSK first time around. A reputable coach on this matter is Red Tape Translation.

KSK application guide English – FAQ

I hope this long English guide to KSK for Germany served as good introduction and will help you along the way to a successful KSK application. Feel free to ask questions in the comments.

Sources: 1, 2, 3, 4, 5