Return to Germany: what to clarify about health insurance before you move

Three things: how you are insured today, what your contract or insurer says about leaving and returning, and what you can prepare for a return before you go. There is no blanket assurance about a return.

Write down the answers and have your Krankenkasse (German health insurance fund) or insurer confirm them: Am I insured under statutory or private insurance? Does my cover end when I leave, or does it continue? Is there a continuation or Anwartschaft, until when and on what terms? Which deadline applies for notifying my return?

Your answers place you in one of the cases below: return with a job, return without a job and return aged over 55. Health information does not belong in messages, but in the application.

Persons are subject to compulsory insurance if they have no other entitlement to cover in case of illness and were last covered by statutory health insurance, or have so far been covered by neither statutory nor private health insurance (§ 5 (1) no. 13 SGB V, German Social Code Book V). According to the GKV-Spitzenverband (the national association of statutory health insurers), this compulsory insurance applies to anyone returning after a stay abroad who has no other entitlement to cover in case of illness, provided the conditions are met. Membership begins with the return to Germany. When asking how you were last insured, initially only periods count in which you were subject to German health insurance law; periods in the EU, EEA and Switzerland are treated equally. The catch-all compulsory insurance applies, among other cases, when someone was in the meantime not subject to German law, in particular because of a stay in a state without an intergovernmental arrangement. Anyone last insured privately, by contrast, falls under the obligation to take out private health cost insurance (§ 193 (3) VVG, German Insurance Contract Act).

Sources: [2], [3], [4]

That depends on how your job is paid and how you were last insured. Ask your Krankenkasse before you start how it classifies you, and cancel a private contract only once that is clarified.

Clarify with the new employer and your Krankenkasse whether you are subject to compulsory insurance. Bring proof of your earlier insurance. If you are privately insured or have an Anwartschaft, ask your insurer how long you have to cancel after compulsory insurance begins.

Have the Krankenkasse confirm from when you are a member, and cancel international health insurance only once this date is fixed in writing. Health information does not belong in these messages.

Anyone employed in Germany as an employee for pay is subject to compulsory insurance (§ 5 (1) no. 1 SGB V) as long as regular annual earnings do not exceed the annual earnings threshold (§ 6 (1) no. 1 SGB V). If you become subject to compulsory insurance by law, you can cancel private health insurance and an existing Anwartschaft within three months after compulsory insurance begins, retroactively to that date (§ 205 (2) VVG).

Sources: [2], [5], [6]

Then it depends on whether you have other cover and how you were last insured in Germany. You clarify this before moving with your Krankenkasse or insurer.

Before you come back, you should know whether you were last insured under statutory or private insurance and whether you have an Anwartschaft. Ask your Krankenkasse or insurer what applies from the day of your return, and plan the transition so that no day is left without cover. An Anwartschaft does not replace cover, because it provides no benefits.

Anyone with no other entitlement to cover who was last covered by statutory health insurance is subject to compulsory insurance (§ 5 (1) no. 13 SGB V). Anyone last insured privately falls under the obligation to take out private health cost insurance (§ 193 (3) VVG). An Anwartschaft insurance in PKV gives no entitlement to benefits and therefore, according to the GKV-Spitzenverband, does not count as other cover in case of illness.

Sources: [2], [4]

A fixed maximum duration cannot be read from the law. How long a stay abroad can last without changing your return depends on the individual case and on your policy terms.

Ask your Krankenkasse or insurer in writing about the limits: How long may I stay abroad? How long may an Anwartschaft run? What do you require as proof of my cover abroad, and by when must I notify my return?

Also plan fixed checkpoints: every year, check whether your plan abroad still holds, whether terms of your contract have changed and whether an Anwartschaft is still possible. Enter the deadlines in your calendar.

The provision on catch-all compulsory insurance (§ 5 (1) no. 13 SGB V) names no maximum duration for a stay abroad. Particularly with a stay abroad, some insurers limit the Anwartschaft in time, require proof of your health insurance abroad or do not let cover revive if treatment is one of the reasons for your return.

Sources: [2]

That depends on your insurance periods of the last years and on what you return with. From 55, special rules apply. Whether they affect you is determined bindingly by your Krankenkasse, before you create facts.

For the conversation with the Krankenkasse, bring your insurance periods of the last years, stating whether you were insured under statutory, private or no insurance in Germany, and the periods in which you were exempt from insurance or released from compulsory insurance. Ask whether the special rule is applied to your case.

For each of these periods, write down how you were insured and collect the certificates. Plan the conversation with the Krankenkasse several months before the return, not only afterwards.

Anyone who becomes subject to compulsory insurance after reaching the age of 55 is exempt from insurance if in the preceding five years they were not covered by statutory insurance and for at least half of this time were exempt from insurance, released from compulsory insurance or not subject to compulsory insurance (§ 6 (3a) SGB V). The rule does not apply to persons subject to compulsory insurance under § 5 (1) no. 13 SGB V.

Sources:

Only when you know from which day your cover in Germany applies and when you know the cancellation terms of your international contract. Do not cancel in advance just because the return is approaching.

Check your contract: Which notice period and minimum term apply? Is there a special right of cancellation? Is premium refunded for unused time? Also ask your future Krankenkasse or insurer about the start of cover and plan the handover so that both periods follow on seamlessly.

Keep the cancellation confirmation and have the date on which the contract ends confirmed. Health information does not belong in these messages, but in the application.

According to the GKV-Spitzenverband, membership in the catch-all compulsory insurance begins with the return to Germany.

Sources: [3]