Could I stay on "travel" health insurance for 5 years?

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By the way, I really appreciate everyone taking the time to advise me!  You guys rock. Also I get a good impression from Keith Tanner; he's been very helpful. Just trying to seek all available info to make an informed decision!


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On 13.4.2019, 20:56:44, SteveHarris said:

What about this?  Cigna Global, purchased in conjunction with Pflegepflichtversicherung.
Says it meets "German standard" and is approved by BaFin, but is cheaper than German insurance.

Is there a catch?

I am glad that you are with my esteemed colleague Keith Tanner, who is a real professional with tons of experience. As an independent insurance broker he/we are beholden to offer you the best possible advice, i.e. to care for your best interest in the role of a fiduciary in contrast to insurance agents. If you do not know the difference in the German system, check the video on our website that explains this here:


Now, let's break down the meandering discussion here (where I am lucky enough to come in late when much more accurate information is available than was initially) :


1. it is important to check initially if you belong to KSK, i.e. if your occupation is considered to be more art than business. because if you do, going with KSK is a "Pflichtversicherung", i.e. it is not your's to choose if you go with public health insurance and with KSK or not, you simply have to.


2. German private health insurances are rather hesitant to accept a newby  self-employed/freelancer because of the credit risk. You do not have a credit history in Germany yet nor a secure source of income (from the point of view of the German insurance companies). Since they are not allowed to terminate a contract with you even if you fail to pay your dues, they will often enough not consider an application from you. 


3. Solid alternatives with private health insurance in Germany are the following

   i ) The group health insurance plan thru  the Association of Self-Employed Expats in Germany (ASEIG - with the HALLESCHE, a leading German private health insurance company. You can be insured with this group plan for up to 5 years. During that time (after min 2 years membership) you can also switch without further medical check-ups or tests into any normal health insurance plan from Hallesche. And because this plan qualifies/complies in full under both § 193 Abs 3 VVG (which stipulates what kind of private health insurances are compliant in Germany) and § 257 Abs 4 SGB V (which stipulates what kind of health insurance qualifies for full taxfree employer co-contribution and thus sets an even higher legal standard), you can also without risk of back-charges switch to any other German fully comprehensive health insurance later.

ii) The Expat-insurance plan from OTTONOVA apparently also complies under Sec. 193 VVG and Sec 257 SGB V according to my latest info.

iii) GLOBALITY (formerly from DKV Germany) is, last time I checked, the only international health insurance which has it in writing from the German regulatory body BaFin that they comply with Section 193 VVG.  Therefore you can also use this without having to fear back-charges later from other German private health insurance companies.They also offer a - so not fully guaranteed - option to change later into a normal health insurance plan with DKV (which is not a health insurance provider I would put on top of any recommendation list in Germany right now, though) .


All these three options are limited to max 5 years duration, but also offer the obligatory long-term nursing care insurance (German: Pflegepflichtversicherung).

Any other international health insurance would have to give it to you in writing (!) that they comply with § 193 Abs 3 VVG before you can consider them as really compliant choice under German laws. If an international insurance cannot offer such a guarantee in writing, it is not fully compliant. Period. You can still use it at your own risk as long as your local Ausländeramt plays along. But you could well face back-charges and other problems later. You would not believe how often we as professional advisors to Expats see that a few years down the road the need comes up to obtain now "real" health insurance but by then it is impossible due to negative development of one's health. Not a nice situation to find yourself and one that only offers really expansive solutions by then.

And regarding your question why CIGNA is cheaper than German insurances: because it is calculated like a riks-insurance and not like a life-insurance is one of the main reasons. The latter is required under German law, though. What does that mean: CIGNA will get more expensive every year in an ever steeper curve upwards the older you get. because the older you get, the higher your health-cost-risk grows. German insurances are obligated to calculate your health-cost-risk for your entire (statistical) life-span at the beginning and divide these costs over time evenly (more or less) to calculate your contributions. Hence they have to be more expensive for younger people..but are significantly lower in premium costs when getting older. Plus there are some serious differences in coverage, too. 


Special Expat health insurances like MAWISTA, CARE CONCEPT, BDAE, are legally speaking only travel-health insurance. They can only be used by someone here on a Visa (i.e. temporary stay) or otherwise clearly limited temporary stay, for instance like a study-program or research-project in academia. If they intended stay does not come with a fixed deadline, i.e. if it is not open-ended, one should not use this kind of insurance. It is sncll being sold otherwise, I know that. But the devil takes the hindmost and that is usually the client who later finds out he faces back-charges due to the use of a not strictly compliant health insurance.


Yes, health insurance does not come cheap in Germany. And it is required legally, too. The rules and regulae s are somewhat opaque, to say the least. but I outlined your options as best as possible above.


In the end the basic calculation for the insurance companies on the costs to cover someone's health are all based on the same statistics worked out by actuaries. Some changes in pricing can come from differences in administrative costs or negative trends of client-selection in an insurance plan over time. But if a health insurance is much, much cheaper than another, it HAS TO COME from much lower coverage or different obligation to actually pay for your health risks in the future.

If you buy cheap, you'll get cheap...and not inexpensive.




I am a professional independent insurance broker, financial adviser, and authorised advertiser. Contact me.

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