One of the most frequent questions we get asked is, “how do I get health insurance after the age of 55?” Well, the answer you’ve probably gotten before is, “you don’t.” Insurance companies have decided that 55 is the cut-off date for switching back to public insurance, so at this point, most applications are denied.
Regardless of whether you’re German or an expat, it might not be possible to switch to public insurance. Below, we’ll talk you through a few possible solutions.
Just keep in mind if you signed the opt-out agreement at any point for public health insurance, and you’re over the age of 55, you almost certainly won’t be able to switch back with these methods. If you really want to give it a try though, we’ll help you submit your application.
What are my options if I am not eligible for public insurance?
If you already know you’re not eligible for public insurance, then you might need to apply for private or expat health insurance. For private health insurance, you may need to do a medical examination and there is also a chance that could need a dental exam as well to determine your current health status which is what the premium plan is based on. For more serious health conditions, this might result in the denial of the application. You’ll also need to prove that you make over €69,300 per year (updated: 2024) as a full-time employee or 30k as a freelancer even if employed outside of Germany (updated: 2022). If you’re on a pension, the insurer may also decide to cover you on a lower income depending on your individual situation. If you’re older, the chance of being denied could be higher because of the increased potential health risks the insurer would have to take on, but there is no age limit.
As for expat insurance, you can apply if you have been in Germany for less than five years and are under the age of 75. This might not be the best option either if you need to renew your visa after the first year or are getting a visa without a limitation since expat insurance only works for a short period of time.
How to get public health insurance in Germany
Working full-time and applying to public insurance
One of the easiest ways to get public health insurance as an EU citizen is to get a full-time job that’s under the limit for opting out. For 2023, this is €66,600 per year. As long as you’re under this number and haven’t signed the opt-out agreement, you shouldn’t have any problems.
If you’re from the UK, you’ll need to file the E104 form along with a letter from your general practitioner.
If you’re not an EU citizen, you’ll need to sign up for private health insurance even if you make less than €66,600 per year.
These rules also apply to people who have retired.
What if I am a refugee?
Refugees are actually considered employed through the Job Center which gives them public health insurance while they are applying for asylum regardless of their age. This means that they were insured publicly at least one day within the last five years which is a requirement for public health insurance after the age of 55.
Are there workarounds to signup for public health insurance?
Yes, this age-old question. If you’re over the age of 55, haven’t signed the opt-out agreement, and are completely sure that you want public health insurance in Germany, we have a few neat tricks that might help you out!
If you want to be a dependent on a family insurance plan, you’ll need to earn less than a certain amount. For 2023, this is €485 per month. Additionally, you’ll need to be married to someone who is already on public insurance and can list you as their dependent (which would make for an interesting Tinder bio).
If you can’t find someone to marry who has public insurance, you can go to another European country, get their public insurance and come back. This would make you eligible for public insurance.
After you’re over 55, you’re generally not eligible for public insurance unless you were insured under public insurance for at least one day in the last five years within the EU and are part of mandatory public insurance (in this case for example being employed or receiving German pension). If you weren’t insured publicly, you can still get public insurance if you were freed from the obligation of having it for a maximum of 900 days (half of the last five years) because of harmful, so-called qualified reasons. For example, exemption due to exceeding the annual salary limits or self-employment is harmful.
If the person in question was not covered by public health insurance for at least 900 days in the last five years for other reasons (known as “harmless”), access to public health insurance remains open even after reaching the age of 55. This is the case, for example, if someone becomes active in Germany after a long stay abroad or if someone had been receiving social welfare benefits for years.
Frank turned 55 on the 19th of October 2016. On the 1st of September 2015, Frank started his own business. Right before this, he was on public health insurance. Because he began his own business, Frank switched to private health insurance.
The business was unfortunately not successful, so on the 1st of November 2019, he was offered a position as a full-time employee with a salary below the cut-off limit. Since he was on public insurance only four years ago, Frank would be able to switch to public health insurance even if he is over 55 as he is under the annual income limit and was insured under public insurance in the last 5 years.
For the past 9 years, Ellie has enjoyed a high income, so she has switched to private insurance. After giving birth to her daughter, she decided that it was best to only work part-time which puts her below the annual income limit. She is eligible at this moment to switch back to public insurance, but she decides to stay under her private insurance plan. This decision makes it impossible for Ellie to go back to public insurance in the future.
Getting public insurance after the age of 55 is incredibly complicated and depends entirely on your individual situation. If you need help with your application or are unsure if you qualify, please don’t hesitate to contact us, and we can help you fill out your application to see if you are eligible.
You can also find more information about the German healthcare system on our blog!