Health Insurance upon Return from Abroad

Return to the old health insurance fund is usually possible

Health insurance is mandatory in Germany. Everyone who lives in Germany must have health insurance. This also applies to anyone returning to Germany from abroad.

These principles apply to persons returning to Germany:

  • Anyone who previously lived in Germany and was insured with a statutory health insurance fund returns to that statutory health insurance fund. However, this does not apply to persons who had been privately insured in the intervening time.
  • Persons who were working abroad in the EU and were insured with a statutory health insurance fund can join a German statutory health insurance fund upon their return. 
  • Persons privately insured while abroad must take out private health insurance. Those who were privately insured before leaving Germany can re-insure with their old insurance company. 
  • Private health insurance companies must offer a “basic tariff” (Basistarif) to those who cannot afford the monthly premiums. The “basic tariff” is roughly equivalent to statutory health insurance in terms of cost and benefits.

If a person has not previously had health insurance in Germany, their professional situation determines the type of insurance they will need:

  • Persons employed abroad and subject to social security contributions will become part of the statutory health insurance system.
  • Self-employed persons who have never been covered by statutory health insurance must take out private insurance.
  • Those who did not have health insurance abroad must take out private insurance.

For persons returning from non-European countries, the question of which system they fall under is often difficult. Anyone who is uncertain about their insurance status should apply to join a statutory health insurance fund. The statutory health insurance fund will then review the requirements and make a binding decision as a public body. This clarification can also take place before the return.

Returning to Germany as a retiree
Retirees who move from an EU country to Germany remain insured in the country from which they receive their pension payments. All persons who have worked for a long time in another EU country and draw their pension from there also remain members of the health insurance system in that country. They must obtain form E121 from their statutory health insurance fund in that country and submit it to a German health insurance fund. The German health insurance fund then provides the health services and settles the costs with the statutory health insurance fund in the EU country from which the pension flows.

Here you can find out more about health insurance for retirees returning from abroad.

When is new private health insurance in Germany possible?
Anyone who moves to Germany and falls outside the statutory health insurance system must take out private health insurance. However, this is often not possible for older people and people with pre-existing conditions. In these cases, private health insurance companies will not enter into a contract for a standard insurance policy (called tariffs in Germany).

Private health insurance companies are nevertheless obligated to accept all persons who live in Germany and belong to the private insurance sector. For these persons they offer a “basic tariff” (Basistarif). The benefits offered are comparable to the benefits offered by statutory health insurance. Private health insurance companies are not allowed to reject applications by people who qualify to be insured under this tariff. Risk surcharges and exclusions from benefits are not permitted.

Persons residing in Germany who are without health insurance coverage should contact a private health insurance company of their choice and apply for health insurance under the “basic tariff”. The insurance coverage begins with the receipt of the application. Though a medical examination is usually required, the results of the examination do not change the obligation to accept the application, nor the amount of the premiums.

The premiums for the “basic tariff” must not exceed the maximum contribution for statutory health insurance. Currently the contribution is around [TextbausteinId=Basistarif] euros.