Ausländerbehörde-approved health insurance plans - Germany

I'm retired and trying to get a resident visa in Berlin. Besides income, the most important thing seems to be health insurance. How do I find out which German health insurance plans are acceptable to the Auslanderbehorde? I don't want to sign up for something they won't approve.

I'm also trying to find out this too.
I have a good quote from AXA expat plan, but I don't want to sign up to be told by the Ausländerbehörde that it's not acceptable. Maybe I'll go and ask them what the requirements are.

I think they'll accept anything, as long as the insurance is accepted in Germany. This is a good plan though.

dblaisde + sharp: since I deal with these issues professionally, I have noticed recently that more and more Ausländerämter do not accept those international health insurances for visa and resident permits anymore which do not offer also a long term care insurance (Pflegepflichtversicherung). Most providers of international health insurances can not offer this but I know of one who has a cooperation with Allianz and can thus offer the Allianz Pflegepflichtversicherung together with the health insurance. On top of that the insurance I am talking about hands out policy documents both in English and German, the latter being important for the German 'crats who even if the work with and for foreigners don't care much about basic knowledge in English language or refuse English documents without translation.

As a retired person, dblaisde, you will most likely also have to proof that your pension is taken care of sufficiently. Nowadays it looks like all ExPats with an age >45years and without an employment contract (i.e. also selfemployed/freelancer) need to show proof for suffiencent pension claims and planning. At least Ausländeramt Frankfurt is pushing that now, but heard the same from others.

In order to make sure you'll get an insurance that will be accepted, employ the services of specialized independent brokers...

Cheerio

I just went through all of this and got a self-employment visa to set up a German office for my American company. Here is a little run down on what happened, that you might find useful

First of all, most of these discussions treat the visa requirements as one size fits all - they are not. A great deal of personal discretion seems to be applied to each individual case. Initially I was going to use the DKV insurance plan, but then when I went to the office to get the application (in September '08), one of the reps there told me that the visa office was starting to refuse this kind of insurance (even though it is a german plan that can be used for up to five years - i think). then I met someone else at random who told me that she had a friend who worked for that company and he told me it would work for sure. I didn't want to deal with an ambiguous situation, so I got the UltraCare Comprehensive policy from Interglobal PMI that provides up to 1.5MM€ of coverage (www.interglobalpmi.com). When I submitted my visa application/business plan, I also gave them the benefits document from the policy (which they scrutinized for twice as long as all of the other 50pp combined).

After submitting my application in early November, I got a 4 month temporary visa (fiction??) and they told me it would take 2-3 months to approve my visa. Finally at the beginning of February I got a letter telling me I had an appointment for the next week and that I should bring, my US Passport, proof of insurance, and 50EUR. So it took 3.5 months. Knowing they were obsessed with the health insurance, and having a PhD in beauracracy from my time spent in France, I called the insurance company and asked them to send me proof that my insurance policy was good and i had paid and was still paying the premiums. They sent me what I asked for

When I went in, I gave the woman gave the woman the passport and the proof of insurance. After she had examined them she told me (in English and German mixed as I can speak some German, but her English was better) that everything was fine, my business plan was approved, but there was a problem with my insurance.

"what's the problem?"
- you need "unlimited insurance"
"What's that?"
- your insurance expires after one year, it needs to last for as long as you stay here
"This policy is for one year, and after one year I renew it for another year as long as I like"
- But it is a travel insurance!
"No it's not, you can see from that document that I pay every month"
- you pay this much every month?
"Yes you can see, and here is the total amount, that is more than you would pay for a travel insurance"
- OK, that's fine, you can have the visa.

I had a lawyer working with me on this and she told me that they routinely reject applications in which they applicant has a one year travel insurance. But she couldn't tell me why sometimes they accepted insurances such as DKV and sometimes they rejected it. Maybe it has something to do with the German law that says if you make over a certain amount (something like 40,000€) you can have a private insurance, but if you make less you must use the German state insurance.

Anyway, there are a lot of online resources and people you can email to help get answers to these questions. A lot of the information on online forums is sketchy at best. Even what I've told you here, although it worked for me, may not work in your case.

Here are some links that may be helpful:

Download pdf documents on visa requirements for all sorts of visas:
http://www.berlin-partner.de/index.php?id=756&L=1

Step by step how to for getting residence in Germany (for many diff nationalities):
http://www.howtogermany.com/pages/residence.html

IMHO AXA is quite expensive for what you get. It should pay to look around a bit

I read a blog (link posted on Toytown in the visa forum), that stated that travel insurance was allowed. I wonder if it would make a difference if you stated that you only planned to live here for a year.

Kerbouchard: the problems here are twofold
1) since the law has changed per January 1st of this year, what was working in the past is not necessarrily still true today. Currently we experience more and more local immigration authorities (Ausländeramt) starting to reject the DKV plan you mention (which, technically is indeed only a travel health insurance, it does say so on the policy documents) and a similar plan from HanseMerkur both of which are entirely fine for limited time from our professional perspective. Both AXA PPP and BUPA have already informed their German resident clients that their insurance does not fulfill all the new German law requirements and that in their opinion every GErman resident should get himself a German public or private health insurance and use the AXA PPP or BUPA or similar plans as a private add-on insurance in order to get better service/treatment
2) the other problem is that each and every local immigration authority treats these issues differently, you can even see differences in one AMT from case office to case officer. So, just as you say, it is worth trying and sometimes if you are good in explaining things and if the case officer does not have a bad day, you'll still get through, but as said above, we see more and more cases of plain rejection of such plans which are not set up like the average German plan.

What the AUSLÄNDERAMT does require a health insurance to fulfill are the following paramters:

I) the insurance contract must be without timelimit
That would technically rule out both the plan from DKV and HanseMerkur since they are limited to max 60 month and no age higher than 65 years. Yet they have been accepted in the past and in my opinion it does not make sense to require someone to have unlimited health insurance coverage as long as he/she only has limited permit to live in Germany. Not sure how this rule would stand in a dispute at the European Supreme Court (EUGH)
II) the insurance must not have too high a deductible. Makes sense, but the question is: what is too high? According to § 193 VVG (which basically rules the new obligation to have a health insurance since Jan 2009) says that deductible/excess option should not be higher than 5.000.- EUR/year. So this should be like a benchmark, but not sure if any local immigration authority sees that alike.
III) it must not have limits as to the coverage in case of needing medical care. Now, in my opinion, a plan that offfers 1.5 million EUR max coverage should be entirely sufficient, but then again technically speaking it is a limit and thus could be rejected.
IV) the policy/plan must be calculated like a life insurance - now what does that mean? The phrase should acutally be rahter "like a German life insurance" because such an insurance is normally computed as to charge an average premium for every month of the duration without changes in the costs. All international plans I know charge a different (increasing) premium with every year of higher age. Thus, with an international health insurance you can start with much lower premiums when younger and end up with higher premiums in comparison when you are older. Once again I am not sure if this regulation would stand in a dispute at the EUGH as, I think, it violates European laws.

What really puzzles me is that since January their is a major discrepancy between what the "Versicherungspflicht" demands from any German (resident), which is simply an unlimited coverage for in- and outpatient (not dental, mind you) with no excess/deductible higher then 5.000.- EUR. That is enough to fulfill the obligation to have health insurance in Germany according to new laws. Why under these circumstances the immigration authorities may demand higher coverage is beyond my understanding. But thats what happens and someone applying for Visa or permits will have to face this problem - which can be best avoided by signing up with a private German health insurance (if you are not eligible for public health insurance, that is).

My general advice right now is this:

- for all Expats from EU memberstates with no limitations to moving and working within Europe (that exclueds a couple of Easstern EU memberstates): you should be able to continue working with your "old" plans, whether they are from AXA PPP, BUPA, MediCare or whatever. As long as in case you'll face major costs from a treatment or surgery these insurance will pay the costs, you should be save enough against demands from German authorities to have different German plans. Eventually someone will probably take this to the courts and win...
- for all Expats from outside the EU: if you require a VISA and other permits (work, residence) you should be aware that many local immigration authorities (Ausländeramt) do not accept anymore for a longer duration health insurance plans that are not constructed like the average German health insurance. While you can still try to get through, just as Kerbouchard demonstrated above, you have to know that your first application might be rejected for insufficient health insurance coverage - in which case you simply switch plans and take on a real German plan instead. But if you are in a hurry or if your application is in danger anyway because you do not entirely fulfill other obligation and thus you do not want to rock the boat, I would rather recommend signing up with a real German plan right from the beginning.

An independent broker who is specialized on caterin to Expats (several of them are advertising here on Toytown) should be able to work this out for you and guide you through the whole process.

Cheerio

P.S.: appears it is about time to re-write my health insurance WIKI again. Give me a couple of weeks and I will. Promise.

Great post. Is it possible to get German health insurance before I arrive in Germany, or must I undergo a physical examination of some sort, i.e. blood test, x-rays, etc.?

vontrappster: since life in Germany is so wonderullly complicated to this regards (and maybe some others, too), there is no easy answer but here is a selection:
1) if you find that you are eligible for public health insurance, no prior med-check and all that is required
2) many people succeed to arrive with some form of travel health insurance to cover them for the first couple of weeks (usually as an intermideate solution acceptable to immigration authorities) for which no check-uo is required. There are also some special Expat insurances (provided they are still legally fully acceptable which I simply don't know as much as it irks me as a professional, thats how FUBAR the situation is right now) which you can sign on within the first 30 days upon arrival without check-ups. Max duration for these insurances: 60 month
3) if you are only eligible for fully comprehensive private health insurance, then yes, you'll need a medical and dental check-up in order to get the insurance approved

Cheerio

This is great information. Thank you very much! From what I've read on the health insurance wiki, it sounds like all freelance English teachers will need to buy private insurance, correct? Thanks again for this great info.

vontrappster: that depends if a teacher has proof of prior insurance with any EU memberstates public health insurance for at least 24 month out of the last 5 years. If he/she has, he/she can become a voluntary member of the public health system. Which can make sense or not, depending on the invidiual situation and preference of the person.
Otherwise indeed only private health insurance is available to them. Plus: they have to pay the full public pension contributions from their income (about 19,x %) which comes always as a bad surprise to many who don't know. There are ways around this, but only few and they also come with some costs...

Cheerio

I'm so bloody confused reading all this. Irish private health insurance uses "risk equalisation" which means (similar I believe to Germany) that insurance companies cannot increase premiums based on age as a person gets older. Now, if I was to take out VHI Global Health Insurance (€829 for a year) would it help that it behaves like a life insurance policy in Germany? I understand that nobody has a definitive answer until someone challenges this in court.

My intention is to move to Berlin (I own my own place there) and study german at a private language school for 1 year before looking for work. Can I get any discount on any german insurance because I will not have a job in Germany?

NO this insurance most definetly does not fulfill German legal requirements by now. For instance it does not offer the compulsory PFLEGEPFLICHTVERSICHERUNG, i.e. the long term nursing care insurance. On the other hand, you as an EU citizen have no Visa issues and all, so you are not in such a bad situaton as people from outside the EU

No, not a chance with private health insurances

Cheerio

Thanks for taking the time to answer Starshollow. Any idea how much the Plegegepflichversicherung would cost as an add on? Is there an online system to get a quote from a private german health insurer for the absloute cheapest insurance to be legal in Germany?

Thanks so much!