1 Section 199a Subsection 1 Sentence 2 Sozialgesetzbuch V (social code, book V, SGB V) stipulates that the German National Association of Statutory Health Insurance Funds is responsible for determining which information about mandatory statutory health insurance must be provided by universities and the Stiftung für Hochschulzulassung to students and applicants for admission.
All students who are enrolled in a degree programme at a state or state-accredited university in the Federal Republic of Germany are subject to mandatory statutory health insurance. This includes students enrolled in a programme at a university in Germany whose permanent home or habitual abode is in a country other than Germany. Students who can demonstrate that they are entitled to benefits in kind from a non-German health insurance provider are not subject to mandatory statutory health insurance. Whether the health insurance a student has taken out with a non-German provider is considered to be sufficient depends, among other factors, on whether Germany has relevant arrangements with the country in which that student’s primary place of residence is located. Students enrolled in a programme/course at a distance learning institution whose permanent home or habitual abode is in a country other than Germany are not subject to mandatory statutory health insurance.
Students will cease to be subject to mandatory statutory health insurance no later than at the end of the semester in which they turn 30. Students will continue to be subject to mandatory statutory health insurance beyond that date if
- the nature of the training they are completing (e.g. a language course that culminates in the DHS test (German language test for university admission), provided that successful completion of that test is a prerequisite for admission to university),
- family-related reasons (e.g. the student’s need to care for a family member with care needs),
- their personal circumstances (e.g. a medical condition that renders the student unable to attend classes),
- or in particular if the fact that they obtained their higher education entrance qualification via second chance education
justify/justifies disregarding the age limit.
Exemption from mandatory insurance
Individuals who become subject to mandatory statutory health insurance upon their enrolment in a programme at a university have the option to request exemption from that insurance. If you want to request an exemption, you must submit your request to the competent public health insurance fund - this is usually one of the health insurance funds you could have chosen if you had not decided to request an exemption (cf. section ‘Choice of health insurance funds’ below) - within three months from the date on which you became subject to mandatory statutory health insurance. An exemption from mandatory statutory health insurance is irrevocable; you will remain exempt for the duration of your enrolment in your programme. For the exemption to become effective, you must demonstrate that you have some other form of health insurance coverage, e.g. have taken out private health insurance.
Students are not subject to mandatory student health insurance if they are co-insured through a parent, spouse or registered civil partner who is insured in the German statutory health insurance scheme. Non-contributory co-insurance in the statutory health insurance scheme is available to individuals under the age of 25 who are attending school, college or university or are completing a vocational training, provided that all other conditions are met. To find out what these conditions are, contact your competent health insurance fund. When you graduate from, or drop out of, university, your co‑insurance coverage will end at the end of the semester in which you graduated or dropped out but will end at the latest on the day before your 25th birthday.
If your school/college/university education or vocational training was interrupted or deferred by a period of voluntary military service, a Bundesfreiwilligendienst or Jugendfreiwilligendienst volunteer service or a comparable recognised volunteer service or a development volunteer service, your co-insurance coverage will continue beyond your 25th birthday for a period corresponding to the duration of your service period but for not longer than 12 months.
Insurance in the statutory health insurance scheme on a voluntary basis
Students who cease to be subject to mandatory statutory health insurance (e.g. when they reach the applicable age limit) will be insured in the statutory health insurance scheme on a voluntary basis. If you do not wish to remain insured in the statutory health insurance scheme on a voluntary basis, you can terminate your membership of that scheme. Please bear in mind, however, that you must declare your intention to leave the scheme to your health insurance fund within two weeks from the date on which it informed you that you have the option to terminate your membership. For your termination of membership to become effective, you must demonstrate that you have some other form of health insurance coverage, e.g. have taken out private health insurance.
Students engaging in gainful employment
Students who engage in gainful employment that is not marginal and low paying while attending university or a vocational school are considered to be employees, not students. This means that their employment is subject to statutory health insurance contributions. Students who are gainfully employed but devote their time and effort primarily to university/school are considered to be students, not employees. This means that their employment is not subject to statutory health insurance contributions.
Choice of health insurance funds
Students who are subject to mandatory statutory health insurance or are entitled to be insured in the statutory health insurance scheme on a voluntary basis can choose between the following public health insurance funds:
- the Allgemeine Ortskrankenkasse (AOK) health insurance fund for their place of employment or place of residence or the AOK responsible for the city in which their university is located,
- an approved alternative health insurance fund,
- the competent company health insurance fund, provided that they are employed at a company and that company has a company health insurance fund,
- any company or guild health insurance fund, if the statutes of that fund provide for this,
- the KNAPPSCHAFT health insurance fund,
- the last public health insurance fund with which they were insured or co-insured before they became subject to mandatory statutory health insurance or entitled to be insured in the statutory health insurance scheme on a voluntary basis,
- the health insurance fund with which their spouse or registered civil partner is insured.
Long-term care insurance
The following principles apply: When an individual enrols in a programme at a university and thus becomes subject to mandatory statutory health insurance, he or she also becomes subject to mandatory statutory long-term care insurance. When an individual is exempted from insurance in the statutory health insurance scheme, he or she is also exempted from insurance in the statutory long-term care insurance scheme. The principle that non-contributory co-insurance takes precedence over mandatory statutory insurance as a student applies to both statutory health insurance and statutory long‑term care insurance.
Proving your insurance status to your university
As a new student, you are required to prove your insurance status to your university before you enrol. What you must do is ask the competent health insurance fund (see below) to confirm your insurance status, i.e. state whether or not you are/will be insured in the German statutory health insurance scheme effective on or before the first day of the semester in which you are planning to commence your degree programme or, respectively, the day on which you enrol in that programme. Your health insurance fund will forward that confirmation directly to your university via an electronic notification system. If your university does not use that electronic system, your health insurance fund will issue you with a letter confirming your insurance status and you will have to forward that letter to your university.
The health insurance fund you will have to contact for that confirmation of your insurance status is the fund with which you are or will be insured when you commence your degree programme. If you requested an exemption from mandatory statutory health insurance, the health insurance fund that has granted you that exemption will be responsible for confirming your insurance status. If you will not be insured in the German statutory health insurance scheme when you commence your programme, please request the confirmation of your insurance status from the last health insurance fund with which you were insured or co-insured or, if you have never been insured in the German statutory health insurance scheme, from any one of the health insurance funds you could choose if you were subject to mandatory statutory health insurance.
This information sheet provides general information only. For more specific information (e.g. about contributions), please contact the competent health insurance fund.