Please enter a search term.
Please note:You can only obtain complete information if you indicate the place of residence, the place of business or the building project, depending on the procedure.

Applying for exemption from compulsory health insurance


In Germany, there is a general obligation to take out health insurance. It is determined by law who is compulsorily insured in the statutory health insurance and who is exempt from insurance.

In exceptional cases, you can be exempted from compulsory health insurance. The exceptions mainly apply to persons who were previously exempt from insurance and who are subject to compulsory insurance due to the statutory provisions.

Exemption from insurance means that you have to voluntarily take out statutory insurance or take out a contract with a private health insurance company. In order to be exempt from compulsory health insurance, you must prove that you are covered in the event of illness.

You can apply for exemption from compulsory insurance at the statutory health insurance company.

As a rule, you cannot undo the exemption. For example, switching from private to statutory health insurance is only possible under certain conditions.
 

Process flow

  • You can submit the application for exemption from compulsory insurance by post or – in the case of many statutory health insurance companies – hand it in in person at the office.
  • Address the application to the statutory health insurance fund with which you are insured or, if you are not covered by statutory health insurance, to a statutory health insurance fund that is open to insured persons at your place of residence or employment.
  • Fill out the application form of the statutory health insurance company and submit it to the health insurance company together with the required documents. As a rule, there are different forms depending on the reason for exemption.
  • The health insurance company will check whether you can be exempted from compulsory insurance and inform you of the result.
     

Requirements

The prerequisite for exemption from compulsory insurance is that you are entitled to coverage in the event of illness, e.g.

  • have private health insurance.
  • continue to receive allowance or free medical care and your salary in the event of illness. This is the case, among other things, with civil servants, in the police service or in the Bundeswehr.

You can apply for an exemption from compulsory insurance if:

  • the statutory annual salary threshold for compulsory insurance is increased. You have become subject to compulsory insurance because your annual income is now below the annual salary limit.
  • You receive unemployment benefits and have not had statutory health insurance in the past 5 years.
  • You reduce your weekly working hours by at least 50 percent and you have been exempt from insurance for at least 5 years.
  • You reduce your weekly working hours due to care or family care leaves.
  • You work a maximum of 30 hours per week part-time during parental leave.
  • You take up part-time employment after parental leave, care or family care leave, you have also been exempt from insurance for at least 5 years and your income would be above the annual salary limit if you were employed full-time.
  • You become subject to compulsory insurance due to drawing a pension
  • You participate in a measure, such as pension insurance, for participation in working life.
  • You are starting a course of study.
  • You are engaged in an unpaid professional activity, such as an internship.
  • As a person with a disability, you are employed in an institution, for example a recognised workshop for disabled people.

Which documents are required?

  • Proof of your entitlement to coverage in the event of illness, for example a confirmation from your private health insurance.
  • Depending on the special case, additional documents may be required. Please contact your statutory health insurance company for more information.
     

What are the fees?

You don't have to pay anything for the application.

What deadlines do I have to pay attention to?

  • You must submit the application within 3 months of the start of compulsory insurance. The exemption from compulsory insurance then starts on the 1st day of the next calendar month.
  • You will be exempted retroactively if you or your co-insured relatives have not yet made use of statutory health insurance benefits. For example, you must not have received any medical examinations or prescription medication from the pharmacy.
  • The exemption from compulsory insurance is valid for as long as the reason for exemption exists.
     

Processing duration

It usually takes about 3 to 4 business days to process.

In order to process and make a decision quickly, your health insurance company must have the necessary information and, if necessary, documents complete and meaningful. The health insurance company decides on applications in a timely manner.

Please note that the stated processing time is an average value for all health insurance companies. It may vary on a case-by-case basis, but the exact processing time also depends on the complexity of the individual case and may be extended accordingly. The same applies if documents or records are sent to you or your health insurance company by post.

Applications / forms

  • Forms: yes
  • Written form required: no
  • Informal application possible: yes
  • Personal appearance required: no
  • Online service available: no

Appeal

  • Contradiction
  • Appeal to the Social Court

Technically approved by

Federal Ministry of Health (BMG)

Professionally released on

19.01.2023

Author

The text was automatically translated based on the German content.

Source: Serviceportal Niedersachsen (Portalverbund des Bundes und der Länder)