# Health insurance in Germany for a German citizen who has lived all her life in Canada?



## MeeshaB

Hi all! I've been trying to find an answer online but my question is too convoluted for search engines. I'm considering retiring to Germany, am a Canadian who has lived in Canada all her life, and I also have German citizenship. I am wondering if I would be able to get the European Health Insurance Card based just on my citizenship, or not. Also, I'm guessing I would need to pay into health insurance in one form or another, and am wondering what kind of costs I'm looking at. My initial online research on that suggested something prohibitive like 1500 Euros per month for my husband and I. Does anyone have thoughts on this? (I'm also considering moving to Spain so will ask the same question on the Spain thread.) Thank you!!


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## Bevdeforges

No, in Germany you are not entitled to the state health cover simply by virtue of citizenship. The European Health Insurance Card is only for Europeans traveling from their country of residence to another EU country and is only valid for "necessary" care and treatment in the country they are visiting.

In Germany, you have a choice between the government health system or private health insurance (depending on your status or level of income). This article explains what your options are: How To Germany - Health Insurance Options in Germany


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## Nononymous

From what little I know of it, you are not eligible for public coverage in Germany if you are over 55 and have never been in the public system before. So a person in this situation, retiring to Germany based on citizenship but never having lived there, is going to need private insurance, and presumably that is going to be extremely expensive at a more advanced age.


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## MeeshaB

Bevdeforges said:


> No, in Germany you are not entitled to the state health cover simply by virtue of citizenship. The European Health Insurance Card is only for Europeans traveling from their country of residence to another EU country and is only valid for "necessary" care and treatment in the country they are visiting.
> 
> In Germany, you have a choice between the government health system or private health insurance (depending on your status or level of income). This article explains what your options are: How To Germany - Health Insurance Options in Germany


Thank you! That is very helpful!


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## MeeshaB

Nononymous said:


> From what little I know of it, you are not eligible for public coverage in Germany if you are over 55 and have never been in the public system before. So a person in this situation, retiring to Germany based on citizenship but never having lived there, is going to need private insurance, and presumably that is going to be extremely expensive at a more advanced age.


Thank you for the info! I think it's all confirming that I won't be able to afford to live in my country of origin which I love and miss. 6 months at a time, visiting only, I guess!


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## Nononymous

Where do you get 6 months from? I believe it's 90 days or declare residency, even as an EU citizen, and residency requires health insurance. You could possibly stay longer with cheaper expat travel insurance if they accept it, though maybe not if you're a German citizen. Who knows?

In any case I would not give up based on the advice of some complete strangers on the internet. Have you spoken to an actual German insurance agent, or to any of the public Krankenkassen?


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## MeeshaB

Nononymous said:


> Where do you get 6 months from? I believe it's 90 days or declare residency, even as an EU citizen, and residency requires health insurance. You could possibly stay longer with cheaper expat travel insurance if they accept it, though maybe not if you're a German citizen. Who knows?
> 
> In any case I would not give up based on the advice of some complete strangers on the internet. Have you spoken to an actual German insurance agent, or to any of the public Krankenkassen?


That's a very good question as to where I got the 6 months from. (Probably I was remembering info from Mexico, and got mixed up!) I have not yet spoken to either insurance agents or to any of the Krankenkassen, as I'm early in my research. Also considering going and speaking with the Konsulat here in Vancouver, but will wait until the end of all the covid restrictions for that.


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## ALKB

MeeshaB said:


> That's a very good question as to where I got the 6 months from. (Probably I was remembering info from Mexico, and got mixed up!) I have not yet spoken to either insurance agents or to any of the Krankenkassen, as I'm early in my research. Also considering going and speaking with the Konsulat here in Vancouver, but will wait until the end of all the covid restrictions for that.


I am not completely sure but it might be something to ask a statutory insurance provider in Germany about. I think a key factor for new arrivals in Germany getting statutory insurance, is whether the last two years of insurance were in a country with which Germany has an agreement about health care. Any EU public system should be okay.

So if you don't mind moving and long term plans, you could move to an EU country with free or nearly free national health system for residents, spend a couple of years there and then move to Germany.

But absolutely ask a (or five) statutory insurance provider about this! (What if I move to Germany from an EU country?)


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## Tellus

MeeshaB said:


> Hi all! I've been trying to find an answer online but my question is too convoluted for search engines. I'm considering retiring to Germany, am a Canadian who has lived in Canada all her life, and I also have German citizenship. I am wondering if I would be able to get the European Health Insurance Card based just on my citizenship, or not. Also, I'm guessing I would need to pay into health insurance in one form or another, and am wondering what kind of costs I'm looking at. My initial online research on that suggested something prohibitive like 1500 Euros per month for my husband and I. Does anyone have thoughts on this? (I'm also considering moving to Spain so will ask the same question on the Spain thread.) Thank you!!


Hi, don't know how old and fit you are, retiring could be a wide spreaded topic, but one thing could be a minijob with more than 450€ income. As "sozialversicherungspflichtige Mitarbeiterin" f.i. in a supermarket you are in public social system.





Mindestlohn: Was ist bei Minijobs und Beschäftigungen im ... / 4 Umwandlung von ...
 

Ob durch die Verpflichtung zur Zahlung des Mindestlohns von 12 EUR[1] oder weil der zeitliche Umfang einer geringfügig entlohnten Beschäftigung nicht ausreicht, um die anfallende Arbeit im Betrieb abzudecken: Wenn die Verdienstgrenze nur knapp eingehalten werden kann, ist es durchaus ...




www.haufe.de


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## Nononymous

As I've considered jobs in Germany over the past few years, I was told that it's apparently impossible to enter the public system after age 55 if you haven't been in similar EU public insurance previously. So not sure if the minijob is a loophole.


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## ALKB

Nononymous said:


> As I've considered jobs in Germany over the past few years, I was told that it's apparently impossible to enter the public system after age 55 if you haven't been in similar EU public insurance previously. So not sure if the minijob is a loophole.


A job over 450 EUR (and below a much higher threshold) is required by law to have statutory insurance, so I am really confident that any kind of 'Sozialversicherungspflichtiger' job would be an in to statutory insurance. Very cheap, too, if it's not a lot over 450 EUR


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## Nononymous

Yes but isn't there a cutoff at age 55 after which you aren't eligible for public insurance? Or so I have read.


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## ALKB

Nononymous said:


> Yes but isn't there a cutoff at age 55 after which you aren't eligible for public insurance? Or so I have read.


I thought that's only if one had private insurance in Germany until then.

Definitely something to ask providers!

I do know of two people over 55 coming from Pakistan to join their British son in Germany (under EU freedom of movement rules) and as they had not previously been insured in a country that has a health care agreement with Germany, it was a bit tricky to get statutory insurance for them but they managed, without working, even. Wasn't as cheap as a part time job would make it, though.


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## Christiane A

MeeshaB said:


> Hi all! I've been trying to find an answer online but my question is too convoluted for search engines. I'm considering retiring to Germany, am a Canadian who has lived in Canada all her life, and I also have German citizenship. I am wondering if I would be able to get the European Health Insurance Card based just on my citizenship, or not. Also, I'm guessing I would need to pay into health insurance in one form or another, and am wondering what kind of costs I'm looking at. My initial online research on that suggested something prohibitive like 1500 Euros per month for my husband and I. Does anyone have thoughts on this? (I'm also considering moving to Spain so will ask the same question on the Spain thread.) Thank you!!


I am a German citizen from birth, left Germany at 22 to move to the US.
I am now 70 years old and would like to move back to Germany, because my only grandchildren live here.
I am currently visiting for 2 months to 
“Investigate” . I went to 2 insurance companies, and they both told me 
“I am too old” to be accepted by them into the gesetzliche Krankenkasse. Private Krankenversicherung is not affordable for me. In the US I have Medicare and 20% supplemental insurance, which I cannot use in Germany. 
What I basically found out so far is : YES, I can live here because I am a German citizen, but in reality I cannot, because I have no idea how to comply with German law, that you must have insurance after 3 months living here.
Perhaps anyone has any helpful advise/ experience re. the return to Germany after living most of your life abroad.


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## MeeshaB

Christiane A said:


> I am a German citizen from birth, left Germany at 22 to move to the US.
> I am now 70 years old and would like to move back to Germany, because my only grandchildren live here.
> I am currently visiting for 2 months to
> “Investigate” . I went to 2 insurance companies, and they both told me
> “I am too old” to be accepted by them into the gesetzliche Krankenkasse. Private Krankenversicherung is not affordable for me. In the US I have Medicare and 20% supplemental insurance, which I cannot use in Germany.
> What I basically found out so far is : YES, I can live here because I am a German citizen, but in reality I cannot, because I have no idea how to comply with German law, that you must have insurance after 3 months living here.
> Perhaps anyone has any helpful advise/ experience re. the return to Germany after living most of your life abroad.


I very much feel for you. I understand why they would want to protect their system from having to pay for health care for elderly people who didn't pay into the system, but on the other hand, it's tragic that German citizens are unable to return to their country to be with their relatives in older age. There certainly is less freedom to be a world citizen than I once fantasized (unless a person is wealthy).


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## Nononymous

Christiane A said:


> What I basically found out so far is : YES, I can live here because I am a German citizen, but in reality I cannot, because I have no idea how to comply with German law, that you must have insurance after 3 months living here.
> Perhaps anyone has any helpful advise/ experience re. the return to Germany after living most of your life abroad.


Thanks for confirming that I wasn't imagining things, and sorry to hear that moving back is financially prohibitive for anyone who can't access the public health insurance system.

For the local experts on this: in the unlikely event that we were to move over for a longer stay in the future, older than age 55, does the fact that we were in the public system several decades ago (for over a year) mean that we could enroll again?


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## Christiane A

MeeshaB said:


> I very much feel for you. I understand why they would want to protect their system from having to pay for health care for elderly people who didn't pay into the system, but on the other hand, it's tragic that German citizens are unable to return to their country to be with their relatives in older age. There certainly is less freedom to be a world citizen than I once fantasized (unless a person is wealthy).


Thanks, what the authorities here in Germany also told me is: “that I should have thought about my move back to Germany earlier in my life” !!!
Well, when I was younger how could I possibly have known ( and planned for )—that my daughter , who was raised in the US would ever move to Germany, and that my only grandchildren would be there.
Are they suggesting I should have paid health insurance in Germany for the last 20 or 30 years JUST IN CASE my daughter might move there when she is grown up ?
Something doesn’t make sense here !


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## kaju

Christiane A said:


> Thanks, what the authorities here in Germany also told me is: “that I should have thought about my move back to Germany earlier in my life” !!!
> Well, when I was younger how could I possibly have known ( and planned for )—that my daughter , who was raised in the US would ever move to Germany, and that my only grandchildren would be there.
> Are they suggesting I should have paid health insurance in Germany for the last 20 or 30 years JUST IN CASE my daughter might move there when she is grown up ?
> Something doesn’t make sense here !


Right now, I live in Austria.

Australia, where I come from, has reciprocal agreements with several countries for healthcare. I had always paid both the national 1.5% of taxable income for universal health care in Australia, and always also paid the highest level for private cover too, for my whole working life, for me and my family. But Germany and Australia don't have this reciprocal agreement yet, although one exists with the UK, Netherlands, Italy, Ireland, Belgium, Norway, etc. But if a German goes to Australia (as a permanent resident), they are automatically covered by the Australian public health system...

We decided a few years ago (me, Australian, and wife and disabled son, German and Australian dual-nationals) to live in Germany, to get the best specific long-term care for our son. But I was over 55. My wife had worked for a few years in Germany so she should be able to get public insurance there. My son too, as he has never worked and is severely disabled. But not me.

However, you can transfer into the German public health system if you have served at least a year in another EU country. So we came to Austria temporarily, and they let me join the state system here. If you can get residence here or in another EU country and get into their system (can do this in Ireland, France, Cyprus, Austria, UK and more I think) then after a year you should be able to move to Germany, and join their public system.

However, you would want to be sure first, and have a plan B.

The best thing would be to talk to a couple of good insurance advisors in Germany (Versicherungsberater). I'm not sure whether what you were told is correct anyway as I think there may be an obligation to allow public health care for German citizens. There are many public health funds in Germany and many don't want older people that on average will be a cost for them. So it may be worth asking the more friendly ones, such as Techniker Krankenkasse. Perhaps your daughter could ask her local TK branch whether SGB 5 (the German health insurance law) point 13 would apply to you: § 5 SGB 5 - Einzelnorm
A good insurance adviser will be able to advise you.

So we came to Austria for a while! Of course, we are not all that far from Germany (maybe 100km) and it is a pretty and friendly country. We have been in the Austrian public health system over a year now and plan to move to Germany in a few months and transfer to a German public fund then - we'll see how it goes.

Another thing a versicherungsberator might help with is information about the basistarif. This is basic but good cover that private companies don't advertise, and they can't deny it to anyone, although they will very often try. But it's about 900 euros a month! However, it may be possible that Germany`s welfare system would subsidise the basistarif cost substantially if your income is low enough. I don't know much about it, and again, I can only and highly recommend talking to a couple of insurance advisers.

My best suggestion is to get professional advice - don't rely on what people like me say! Perhaps your family in Germany could ask at a "good" place like Techniker Krankenkasse, but a good advisor can sometimes help public insurance companies to er, understand their obligations...I suspect they'd cost several hundred dollars for the full service and some may only be interested in selling private cover, but a few at least would be able to advise you.


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