Living abroad – what applies to health insurance?

To study in Rome, work in London and to retire in southern Spain – thousands of Germans are regularly drawn abroad for longer or even permanently. Many students also use the opportunity of a semester abroad and many pensioners have moved their retirement home abroad. But what impact does the (temporary) move have on health insurance? What do you have to consider when staying abroad for a longer period of time? And can you keep health insurance in Germany even if you live abroad?

EU makes moving abroad easier

With the freedom of establishment and freedom to provide services in the European Union (EU), moving to another European country has become uncomplicated. Germans can live and work in any EU country. Seniors also receive pension payments abroad. And in the event of illness, treatment abroad is made easier by the social security systems coordinated in Europe.

study abroad

Germany has concluded a so-called social security agreement with all member states of the EU and the European Economic Area and, independently of this, also with some other European states. If you want to study abroad, you have two options: a guest semester for a limited period of time or a full degree at a foreign university. Linked to the question of the type of study abroad is the question of whether the previous health insurance cover is still sufficient.

For Germans who are studying at a European university via an exchange program and are still enrolled at their home university, the insurance cover remains in place. In the event of illness, you can receive medical treatment with the  European health insurance card (EHIC) in all EU countries and also in Switzerland, Norway, Iceland, Liechtenstein and Great Britain. The EHIC does not have to be applied for separately if you have statutory health insurance in Germany – it is already printed on the back of the health card.

Students who are only enrolled at a foreign university should find out from their health insurance provider before they leave whether they are insured abroad.

If you are planning a semester abroad or studying in a country with which there is no social security agreement (e.g. the USA, China or Australia), private health insurance must be taken out within the framework of the requirements of the respective country.

Working abroad

Many Germans would like to emigrate with a view to better opportunities on the job market or higher wages. But can you keep your health insurance in Germany when you emigrate?

First of all, it can be said that there are three types of job emigrants: those who move their place of residence and work abroad permanently, those who only move to another country for a limited period of time for professional reasons, and those who work abroad but live in Germany. Whether the health insurance protection remains in Germany depends above all on how long the professional assignment abroad lasts.

Anyone who is sent abroad for a limited period or for a project generally retains their insurance cover. The same applies to dependents with family insurance. On the other hand, anyone who takes up a job with a company abroad usually has health insurance there – regardless of whether they also live in this country. Of course, if you live and work abroad, this regulation also applies.

For example, anyone who commutes between their workplace in Belgium and their place of residence in Germany is treated like someone who lives and works entirely in Belgium. The following applies to him: he must take out health insurance in Belgium.

retirement abroad

Spend the evening of life in the sun and by the sea – thousands of German pensioners fulfill this dream every year, for example by emigrating to southern Europe and setting up a permanent residence there. If you move within or outside the EU as a pensioner with compulsory insurance, receive a German pension and have no further income in your new home country, you will continue to be covered by statutory health insurance – even if you do not live in Germany. Such a move abroad does not change the contributions either.

Do I have to deregister from health insurance?

If you live abroad permanently, you should deregister from German health insurance. A de-registration certificate from the residents’ registration office is usually sufficient. As already described, there is an exception if you spend your retirement abroad.

Deregistering from health insurance can also be an advantage, for example, if you are planning a longer trip and take out separate international health insurance for it.

Health insurance abroad: what else do you have to consider?

It is important to know that even in countries where the European Health Insurance Card is valid, only those medical services are covered that are required by law in the respective country. In some cases, there may be additional services that are not covered by your local health insurance and that have to be paid for privately – depending on the country, directly and in cash. Supplemental private insurance can be an option to cover such eventualities.

If there is an illness that requires permanent medical treatment, the treatment options abroad should be clarified in advance with the responsible authorities there and the doctor treating you.

Basically, if you want to move your place of residence abroad, be it permanently or for a study, it is advisable to seek advice from your health insurance company in good time.

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