Health Insurance

Please note, that this was written in 2013. Things might have changed since then. If you are in the process of moving to Germany do take your time to verify what is written here.

Moving to Germany without a Health Insurance is unthinkable. The Health System in Germany might not be the same as where you come from. At least compared to Denmark there are several differences. The Germans think that the entire world does things like they do, and therefore things tend to become a bit complicated as they do not understand a word of what you are talking about. Be prepared for the challenges to come.

Before you even start to pack, you need to find and contact the so called “Krankenkasse” (Health Insurance) in Germany where you want to become a member. There are numerous and they are not giving you the same coverage. So you need to find out what your needs are going to be before you find the one suiting you. The next thing you have to figure out is if you want to be in the “Gesetzliche Krankenkasse” which is more or less the basic membership, or if you want to become a Private member of the “Krankenkasse”. As Private member you do get a slightly better treatment, but it will also become more and more expensive the older you become. And have you first chosen to be in the Private you can’t return to the other one.

As you might have figured out already you do not just pack your suitcase, move to Germany and then start working the next day. This is fairly unrealistic. I took a few weeks of vacation and used some of my Flex-hours. In other words I had one month free to do what has to be done. And it wasn’t a day too much. This though has one drawback. On paper you are then working in one country and living in another. This means you pay taxes in one country (where you are working), but need the social system in the other country in case you get sick. Unfortunately you have your Health Insurance in the country where you work. Do you start to see the problems coming??? This means the German Krankenasse needs to know where it can get its money from in case you get sick. And of course this means exchange of an excessive amount of paper between the countries. Guess who has to make sure this works – right – You! Especially the German Krankkenkasse thinks that the entire world works as they do, and this means you will have to be able to tell the differences. I’ve therefore made this page hoping I can give you a hint on what to look for before you even start.

When you have found the Krankenasse of your interest you might be asked to request and have your previous Health Insurance fill out a document called E-104. This document is actually only made for persons coming from Iceland, so you might wonder why the German Krankenkasse es so keen on this. I can’t tell you why. When I moved the Danish authorities were aware that the German Krankenkasse makes a huge bunch of mistakes in this process, so they just filled out the paper and that was all about it. Well – if your new Krankenasse absolutely want this E-104 you will have to tell the Krankenkasse that THEY have to supply the document and in 2 copies! The Document is in two sections. Section A has to be filled out by the German Krankenkasse and Section B is for you previous Health Insurance. They can choose to mail the document to your previous Health Insurance, but I was told that this was a very bad idea. Have they first mailed one document to a certain address, they think this is the address for everyone coming from your country. This will, for future request, mean an excessive amount of work for people who already have enough to do, and things do start to get a little too complicated. THEREFORE – have the 2 documents handed out to you personally and do bring it to your previous Health Insurance yourself. They will then keep one document as reference in case questions arise on a later time. But as already said – the document might not even be needed.

When you have told you previous city that you are moving you will now be in a situation where you live in Germany, but work in your previous country. This means the exchange of papers have just started. This is also the point where things can get a bit dangerous. You will when you move have to bring a document called E-106 with you. No problem, but it might take some time to get this filled out. It can take days and weeks. Until the day where you have this document in your hand, you will be without Health Insurance in any of the two countries. You also have to rely on postal services. And that takes time too. Getting a Mail from Denmark to Germany took no less than 7 days! This is at the same time good and bad. Good because it gives you time to go to the new city and report your arrival (filling out all the necessary papers). Now this is Germany. You have a new home and a new address, but the postal service’s here are not always thinking. They look at your letter and see your name. They have never seen it before, so they decide not to give you your letter. You can point at your mailbox as much as you want. Formalities have to be in order. I just don’t know how to bring them in that state. I had a rather long and intense with the Postman here before he realized that I was right and had a right to receive my own letters. So if you E-106 comes before you have settled this discussion with your postman – you are pretty much “fucked” (sorry for this expression, but I haven’t been able to find anything better). Before you get your E106 you do NOT have any kind of Health Insurance!

When your E-106 finally arrives, you hand this over to your new Krankenkasse. Now they can see where to get the money in case you get sick while you are moving.

Believe it or not – all this paperwork is made, to make it easier to move between countries. It’s fairly hard to believe, but it’s a fact.

If you now think that everything is working you are utterly wrong. When you moved from your previous country to Germany you had to hand over your previous Health Insurance card. The first month you are in Germany you will now need a so called blue Health Insurance Card – this handed out from you previous Health Insurance. It can take up to a month to make this – which by the way is just about the exact time you have chosen to use to move to Germany. When I received mine it had 3 days left. Good to know that you at least had a 3 day coverage. If you in that period have vacation and you need to go back to your own country you need a third card of which hardly anyone has heard of. This card is apparently very difficult to produce and it takes more than a month to get ready. I can therefore only say – do not get sick while you are in your previous country.

In Germany the employer pays your Krankenkasse. And when that starts all the paperwork stops. You can again allow yourself to be ill – Perhaps just not the first 3 month while you are on trial in the new company. If you are unlucky and your Krankenkasse gets a bit stiff – it can become a problem that the company pays after a month of work and not at the start of a month. This just as a warning.

If you weren’t ill already all the stress you have had figuring all this out might get you ill. I can therefore only wish you the best of luck. And do start out early. Knowing what I had to go through I would now start at least 2 month before the move.


Be aware, that you are not allowed to work in Germany without a Social Security Number – Sozialversicherungsnummer. This number tells the state, that you are allowed to live and work in Germany. There are jobs where you as a foreigner have to carry an official document on you with this number. There are officials travelling around checking for this, and if you do not have it on you they can more or less kick you out of the country. You will have to request this number through your Krankenasse. It can take up to – and this is not a lie – 14 weeks to get. On the other hand you can’t get a job until you have a membership of a Krankenkasse, so even the Germans can see that this isn’t going to work at all. Therefore you can get a temporary document with the number. This does not take all that long. As said – it can take up to 14 weeks to get the number – so please start out early applying for it. You have to make sure that your new company has this number.

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