Getting into German public health insurance after being privately insured

Getting INTO German public health insurance for the first time or BACK INTO German public insurance after being privately insured

Germany´s dual system of public and private health insurance is mind-boggling at the best of times...

Newcomers to Germany of whatever nationality must take out compulsory public health insurance if their annual gross salary is under 64,350 euros (from January 2021). Employees earning over that can choose between voluntary membership of public insurance or private insurance.

What about the self-employed/freelancers/non-working?

That depends 😊

If they are moving from a European country to Germany and have been publicly insured the previous 12 months in that country, they can apply for voluntary membership of German public insurance…but MUST do so within 3 months of registering in Germany…otherwise, it is too late. They must also PROVE they have been publicly insured for at least 12 months in that other country. They can also choose private insurance if they wish... whatever their income (though a "reasonable" income and good health are a prerequisite for German private providers).

Those self-employed/freelancers who have never been insured in another European country generally have no access to public insurance…even if they are EU citizens!

This is an annoying situation for the thousands upon thousands of freelance non-EU citizens who arrive to work in Germany every year.
These non-EU citizens need health insurance for their residence/work permits and vice versa 😊

This affects more and more English teachers, IT consultants and artists (whether singers, composers, journalists, graphic designers etc ) who can then usually get neither public nor private German insurance at the beginning.

Solution for artists? If non-EU citizens, then they can only generally take out a legally acceptable private international insurance to start with and then apply to the Artists´ Foundation (KSK). If accepted..then into public insurance they can go by a quirk of law by becoming de facto “ employees “ of the KSK!

How else can a non-EU or EU freelancer currently privately insured either by design or obligation get into public insurance? By getting married to a publicly insured person and by earning under 470 euros a month net (from January 2021)! Then they can get into family insurance at no extra cost! OR by giving up their freelance activity or reducing their economic activity to reduce their net profit to 
under 470 euros a month net (from January 2021) (still have to get married though!), OR by becoming an employee for the first time in Germany under the erste Beschäftigung rule.

What about employees who are privately insured and want to get into public insurance for the first time or return to it?

  • by reducing their salary to under 64,350 euros gross a year…in light of corona, this situation is not entirely unimaginable.
  • by becoming unemployed and onto ALG1 benefits or AIG2 and Sozialgeld.
  • by leaving Germany, going to work in another European country for at least 12 months and joining that country´s public health system. Upon return, that employee starting a fresh German labour contract – even on a HIGH income – can choose between private insurance or VOLUNTARY MEMBERSHIP of German public insurance.
  • quote a few people HAVE to have private health insurance if they are working for an EU Organisation, NATO; European Central Bank etc. Upon leaving such an organization and becoming employees with a normal German labour contract , they can join or rejoin German public insurance even if on a high salary.

What about those who are over 55?

It is a well-known fact that people cannot switch from private to public insurance if employed in Germany and have already reached their 55th birthday.

This applies, however, only to Pflichtversicherte (mandatory members ) and NOT Freiwillige Versicherte ( voluntary members ).

SO: some scenarios for those over 55….
  • an employee is privately insured in Germany, goes to work in another European country and joins their public health insurance. On return, they CAN get into German public insurance whatever the new income back in Germany and AGE IS IRRELEVANT.
  • NATO; EU, etc, as previously mentioned. They can get into German insurance as voluntary members even on a high salary. AGE IS IRRELEVANT.
  • Self-employed person who is privately insured can join their spouse´s public insurance as a family member if they deregister their business or earn under 455 euros net a month. AGE IS IRRELEVANT.
  • Over-55 year olds coming to Germany for the first time and moving from a European countrywith its public health system can  join Germany public insurance as voluntary members even on a high salary or as self-employed. AGE IS IRRELEVANT.
  • German citizens who have never lived in Germany but then move to Germany are entitled to voluntary membership of public insurance if they have not been privately insured or self-employed in the previous five years. AGE IS IRRELEVANT.
  • PENSIONERS who are privately insured and with a spouse with public insurance can ask for a reduction of their Vollrente to a Teilrente and  get onto their spouse´s public insurance as a family member if the partial pension (Teilrente ) is under 455 euro a month. They can increase their pension later back to the full value!