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Applying for family insurance in the statutory health insurance


As a member of a statutory health insurance company, you can co-insure family members free of charge under certain conditions. You can apply for family insurance for your relatives from your statutory health insurance company.

The following family members can also be insured:

  • Your spouse or registered partner, if he or she earns little or no income of their own
  • Your children up to certain age limits,
  • Grandchildren and stepchildren who live in your household or whose livelihood you provide, as well as foster children

If you are insured as a parent in different statutory health insurance companies, you can choose where you want to insure your child(ren) family.
 

Process flow

You can submit the application for family insurance by post or – in the case of many statutory health insurance companies – hand it in in person at the office or submit it online.

  • Fill out the application form of your 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 whether it is the initial application or the verification of the requirements.
  • The health insurance company will check whether you are entitled to family insurance and inform you of the result.
     

Requirements

You can apply for family insurance if:

  • You have statutory health insurance
  • Your family members live in Germany

Your spouse or partner:

  • is not self-employed or self-insured by law, for example as an employee or pensioner;
  • is not covered by private health insurance, for example as an employee, civil servant or retired civil servant;  
  • is not exempt from compulsory health insurance and
  • earns little or no income. The exact income limit is set anew by the legislator every year.

Your children are

  • under 18 years of age or
  • under 23 years of age and not yet employed, or
  • under 25 years of age and are still attending school, studying or completing unpaid school-based vocational training

Children with a disability can remain permanently covered by family insurance if they are unable to provide for their own livelihood as adults.

You can insure your grandchildren and stepchildren within the limits mentioned above, provided that they

  • live in your household, or
  • They mainly provide for their livelihood.
  • Foster children who live permanently in the same household are also among the children who can be insured for the family.

If your spouse or partner is not insured by law, but is private, for example, you may only insure joint children free of charge if:

  • your partner's salary is below the statutory annual salary limit, or
  • Your partner earns less than you.

Which documents are required?

  • current salary statement or current income tax assessment of your partner (in copy), if he or she does not have statutory health insurance
  • for children aged 23 and over: certificate of school or study

In individual cases, further documents such as pension notices or proof of capital assets are 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?

There are no deadlines for you.

Processing duration

It usually takes about 1 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 promptly, whereby the statutory processing deadline is observed in order to protect patients' rights.
Please note that the stated processing time is an average value for all health insurance companies. It may vary in individual cases.
The exact processing time also depends on the complexity of the individual case and can 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

- Online procedure possible: Many statutory health insurance companies offer an online procedure.

- Written form required: no

- Personal appearance required: no

Appeal

  • Contradiction
  • Appeal to the Social Court

Technically approved by

Federal Ministry of Health

Professionally released on

25.10.2021

Author

The text was automatically translated based on the German content.

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