Long-term health insurance in Germany — which proofs the authority expects, step by step
Sources: § 5 AufenthG (insurance proof for the residence permit) · § 4 SGB IV (posted workers / Entsendung) · § 18d AufenthG (researchers) · Care Expatriate AVB · HanseMerkur Versicherungsgruppe Hamburg · Care Concept AG
Foreigners moving to Germany for 6 months to 5 years need a long-term Incoming policy recognised by the Ausländerbehörde under § 5 AufenthG. This applies to intra-company transferees, posted workers, researchers under § 18d AufenthG, freelancers, accompanying family members and most non-EU expats whose employer does not yet enrol them in German statutory cover (GKV).
The recognised standard is Care Expatriate from €58/month (ages 13–40). Premiums scale by 10-year age tier (30–39, 40–49, 50–59, 60–64, 65–74); the official price table is shown below. Cover runs from 1 to 60 months — long enough for the typical first Aufenthaltstitel cycle and most renewal windows.
Below: which expat profiles need long-term private Incoming cover (vs voluntary GKV), the four documents the Ausländerbehörde checks at the Aufenthaltstitel appointment, the full Care Expatriate price table by age tier, the bridge route via Care Economy for arrival gaps, and the clean handover to GKV when an expat joins a regular German payroll.
Long-Stay Coverage
Care Expatriate by HanseMerkur Versicherungsgruppe / Advigon
Residence Documents
Proof for visa or immigration authority documents
Fast Confirmation
PDF confirmation available after successful application
Over 10,000 policies issued · Since 2009
Aufenthaltstitel appointment booked? Pick the recognised long-term Incoming tariff.
Four mistakes that delay the Aufenthaltstitel appointment
Quick answer: "Why was my Aufenthaltstitel delayed?" — most long-term expats stumble on one of four points: bought a 90-day Schengen travel policy instead of long-term Incoming cover, applied for voluntary GKV without realising underwriting takes weeks, relied on a home-country employer policy that does not meet § 5 AufenthG, or arrived on a tourist policy that expires before the appointment date. Care Expatriate removes all four by default.
Avoid the mistakes that can delay your application
Visitor insurance may be too short
For multi-month or multi-year stays, Care Expatriate can be a better fit than short visitor coverage.
Statutory or private?
Freelancers, self-employed people and some incoming long-stay cases may need private incoming coverage instead of German statutory insurance.
Residence proof requested?
Care Expatriate can provide PDF confirmation after successful application for visa or immigration documents.
Renewal stress later
A longer coverage term can reduce repeated renewal pressure during projects, residence processes or long stays.
What happens if your long-term insurance gap is detected
One wrong insurance choice can cost you money, time and your application deadline
A medical incident can become expensive fast — but the wrong certificate can also delay your visa, enrollment, residence permit or work start.
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€500–€1,500
Emergency doctor visit
One urgent doctor or emergency-room visit can already create a painful bill — before tests, medication or follow-up treatment are added.
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€2,000–€10,000+
Hospital treatment
If observation, surgery, overnight stay or specialist treatment is needed, costs can quickly move from hundreds to thousands of euros.
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€30,000 minimum
Schengen proof must be clear
Your certificate should clearly show the required coverage amount, Schengen validity, travel dates and repatriation benefits.
- Wrong or incomplete proof can delay your visa, enrollment or authority process.
- Cheap home-country policies may miss the exact coverage, dates or repatriation wording required.
- The cheapest policy can become expensive if it is the wrong proof for your situation.
Before you apply, check: coverage amount, validity dates, destination area and repatriation cover.
Aufenthaltstitel appointments are fixed — secure the Incoming certificate first
Why act before the embassy appointment
Schengen visa insurance is not just a formality. Your proof should clearly show the required coverage, dates, validity area and repatriation benefits.
Appointments can be limited
If the proof is missing or unsuitable, preparing corrected documents can cost valuable time.
PDF certificate after application
Care Visa Protect provides the certificate by email after successful online application.
€30,000 minimum coverage
Schengen insurance should show at least €30,000 coverage plus medical repatriation for the Schengen Area.
From €0.85/day
Care Visa Protect starts from €0.85/day, with a minimum premium of €8.50 per trip.
From booking to Ausländerbehörde-ready certificate — in 3 steps
10 minutes online. PDF certificate (English/German) for HR, university administration and the Ausländerbehörde. Cover starts on the day you choose — typically the planned arrival date or the Aufenthaltstitel start date.
Schengen-ready in 3 steps
Proof of insurance for Schengen visa applications, including the €30,000 minimum-coverage requirement.
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Pick the right plan
Care Visa Protect for short Schengen stays · Care Economy for the Opportunity Card or longer visitor stays.
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Apply online
Enter passport, travel dates and destination. For Care Visa Protect, purchase before entry when required.
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Submit your proof
Receive the PDF certificate after successful online application and submit it with your visa or authority documents.
What long-term expats say about Care Expatriate for the Aufenthaltstitel
“My biggest worry was that the embassy wouldn't accept the insurance.
The proof was accepted immediately — no questions asked.
That saved me a lot of stress.”
Georges
Cameroon
“I needed proof of insurance urgently for my visa appointment.
The confirmation arrived within minutes by email.
Everything worked first time at the embassy.”
Olga
Russia
“Found the best solution and best service for health insurance for foreign visitors and guests in Germany.
Fast, simple and affordable.
Highly recommended!”
Michael
Germany
“The online sign-up was done in just a few minutes.
When I actually had to see a doctor, the billing went smoothly.
I was really covered — not just on paper.”
Yunhee
Australia
Now choose your plan
Recommended tariffs for long-term expats in Germany
Care Expatriate
from only €58.00 / month (coverage up to 5 years)
For foreign nationals with longer stays: expats, self-employed professionals, freelancers, employees on assignment without German statutory insurance, retirees & seniors up to age 74
- Proof of insurance for visas & immigration authorities quickly available (PDF)
- Coverage up to 5 years – less renewal stress
- Doctor, hospital, prescription medication & dental treatment coverage
- For longer stays in Germany, Austria, the EU/Schengen Area, Liechtenstein or Switzerland
- Suitable for expats, self-employed professionals, freelancers, employees on assignment without German statutory insurance, retirees & seniors
- More planning security for residence permits, projects or jobs
- 24/7 assistance + digital insurance card
- Age-based rates: from €58/month ages 13–40 · from €68 ages 41–60 · from €246 ages 61–74
- Coverage term: 3 months to 5 years · entry age 0–74
- Reputable insurance carrier
Why Care Expatriate?
For foreign nationals with longer stays who need solid health insurance and proof of coverage for authorities — suitable for expats, freelancers, self-employed professionals, employees on assignment without German statutory insurance, retirees & seniors up to age 74.
Why a 5-year coverage term?
More planning security: less renewal stress and a lower risk of a coverage gap if your stay lasts longer.
- 🏛️ HanseMerkur Insurance Group Hamburg – Advigon Insurance AG
- 📄 Instant proof of insurance for visas & immigration authorities (PDF)
- 🔒 Doctor, clinic, dental treatment & repatriation coverage
- 🏷️ From €58 / month · coverage up to 5 years
→ Complete the application, receive your instant PDF, submit your proof
Care Economy
from only €30.00 / 30 days (coverage up to 2 years)
For guests, tourists, family visits, job seekers & the German Opportunity Card
- Proof of insurance for visas & immigration authorities within minutes
- Affordable coverage from €1.00 per day
- Doctor, hospital & dental emergency coverage
- Suitable for Schengen visas, the Opportunity Card & family visits
- Flexible coverage from 1 day up to 2 years
- Coverage in Germany, the EU & the Schengen Area
- 24/7 assistance + digital insurance card
- Age-based rates: from €1.00/day up to age 64 · from €2.95/day for ages 65–74
- Coverage term: 1 day to 2 years · entry age 0–74
- Reputable insurance carrier
Why Care Economy?
For anyone who needs fast, affordable proof of health insurance — ideal for guests, visitors, tourists, family visits or job seekers, with doctor/clinic coverage subject to the policy terms and benefits.
Why a 2-year coverage term?
More flexibility when plans are uncertain: if your visa, trip or stay is extended, you avoid last-minute renewal stress and reduce the risk of a coverage gap.
- 🏛️ HanseMerkur Insurance Group Hamburg – Advigon Insurance AG
- 📄 Instant proof of insurance for visas & immigration authorities (PDF)
- 🔒 Doctor, clinic, dental emergency & repatriation coverage
- 🏷️ From €30 / 30 days · up to 2 years possible
→ Complete the application, receive your instant PDF, submit your proof
Joining a regular German payroll once your residence permit is granted? DAK-Gesundheit (employee GKV) at 17.8% of gross — split equally with your employer (8.9% each). Care Expatriate covers the gap until the GKV start date.
Working as a Freiberufler (§ 18 EStG) or running a Gewerbe? Freelancer cover from €58/month or self-employed (Gewerbe) cover from €58/month. For broader guidance see the expat health-insurance overview.
Care Expatriate — all long-term rates by age & tier
Quick answer: Care Expatriate starts at €58/month (ages 13–40). Premiums scale by 10-year age tier; the full official table below shows the exact rate for every age bracket up to 74. Up to 60 months in a single contract — recognised under § 5 AufenthG for the long-term Aufenthaltstitel.
| Care Expatriateworldwide without USA, Canada and Mexico |
Basic
|
BestsellerComfort
|
Premium
|
|||
|---|---|---|---|---|---|---|
|
Deductible / yr
150,–
|
Deductible / yr
150,–
|
Deductible / yr
500,–
|
Deductible / yr
0,–
|
Deductible / yr
500,–
|
Deductible / yr
1.000,–
|
|
| Entry age:0–12 (€ / month) | 64,– | 104,– | 81,– | 191,– | 149,– | 117,– |
| Entry age:13–40 (€ / month) | 58,– | 84,– | 63,– | 181,– | 141,– | 109,– |
| Entry age:41–60 (€ / month) | 68,– | 103,– | 77,– | 256,– | 201,– | 156,– |
| Entry age:61–74 (€ / month) | 246,– | 322,– | 248,– | 432,– | 336,– | 263,– |
All prices per month/person in euros. Deductible applies per insurance year. As of 2026.
Care Economy — bridge tariff for arrival & ≤2-year stays
Quick answer: Aufenthaltstitel still being processed and you need fast cover for the arrival window or a posting of ≤2 years? Care Economy from €30 per 30 days bridges the gap and is accepted by the Ausländerbehörde for the initial residence permit.
| Care Economy Duration |
Bestsellerup to 64
|
up to 64
|
Bestseller65+
|
65+
|
|---|---|---|---|---|
| no deductible | with deductible | no deductible | with deductible | |
| up to 90 days | €1.18/day | €1.00/day | €3.48/day | €2.95/day |
| 91–180 days | €1.59/day | €1.35/day | €4.37/day | €3.70/day |
| 181–365 days | €2.30/day | €1.95/day | €5.84/day | €4.95/day |
| 366–730 days | €2.83/day | €2.40/day | €9.32/day | €7.90/day |
All prices per day/person in euros. Minimum premium €10 per person and term. Deductible is the share you pay yourself. Entry age 0–74. As of 2026.
How long should the health insurance run?
Quick answer: Usually for as long as the stay is planned to last — and not shorter. The premium is set by the entry age at the start of the contract and stays in that age band for the whole term. Anyone who extends later typically signs a new contract at the age they are by then.
| Term | Premium/month | Total | Renewals needed | Pre-existing-condition gap |
|---|---|---|---|---|
| 12 months | €58 | €696 | 4 | possible (2×) |
| 24 months | €58 | €1,392 | 2 | possible (1×) |
| 60 months | €58 | €3,480 | 0 | none |
Is a 41st birthday coming up?
In the 13–40 age band the Basic premium is €58/month; in the 41–60 band it is €68/month (example values). The difference is around €10 a month — roughly €600 over 60 months. What counts is the age at the start of the contract, not the age during the term. Concretely: someone who chooses a 60-month term at 40 pays the 13–40 band for five years, rather than the 41–60 band from their 41st birthday onwards.
When the renewal falls due
A policy with a twelve-month term typically expires at close to the point the residence permit (Aufenthaltstitel) also needs extending. Both then fall in the same weeks: new contract, new proof of cover, new appointment at the foreigners' authority (Ausländerbehörde) — often under time pressure. A longer term decouples the two dates. There is also the practical effort: every renewal means passport details, proof of address and personal information again — usually gathered by relatives in Germany while the insured person is still abroad.
What is different at renewal
Conditions that first arise during a running contract are, as a rule, covered within that contract. In a contract taken out later they typically count as a pre-existing condition — and pre-existing conditions are usually excluded in incoming tariffs. The older the insured person, the more likely it is that a diagnosis falls between two contracts, and that diagnosis then usually counts as pre-existing in the follow-up contract. A continuous term avoids that gap.
A gap can also open up between two contracts — days without cover, which may become visible when the residence permit is next extended. A continuous term avoids that.
A fixed term also means planning certainty for the family: the premium is set for the whole duration, with no annual recalculation.
For context: Care Expatriate can be taken out up to the age of 74.
Monthly or a single payment?
Quick answer: Both are possible, and the price is the same — there is no discount for paying in one go. The difference lies in the risk: if a direct debit goes unpaid, that can affect the insurance cover — and the residence permit rests on that cover. With a single payment the cover no longer depends on an ongoing bank debit. That matters above all where the premiums are paid by relatives in Germany: a job change, a change of bank or one tight month then has no bearing on the insured person's residence status.
Where the premium is transferred from abroad, one payment replaces up to sixty individual transfers — each with its own bank charges and exchange rate.
What happens on an early return?
If the stay ends earlier than planned, the contract can be cancelled in writing. The overpaid premium is, as a rule, refunded minus a €5 processing fee (source: Care Concept FAQ). So someone who pays 60 months in advance and returns after two years gets the premium for the unused months back — the financial risk of paying in one go is therefore €5, not the remaining balance.
And if the visa is not granted?
If the entry visa is not granted, or entry does not take place for other reasons, the application can be cancelled in writing before the insurance cover begins. Premiums already paid are, as a rule, refunded minus a €5 processing fee (source: Care Concept FAQ).
Frequently asked questions about long-term health insurance for foreigners in Germany
Frequently Asked Questions
What is long-term health insurance for foreigners in Germany?
Cover valid 1–60 months (5 years) recognised by the Ausländerbehörde. Care Expatriate (from €58/month) is the standard private route; GKV at ~17.8% of gross via employer is the standard statutory route. Both accepted under § 5 AufenthG.
Which insurance covers foreigners for 5 years in Germany?
Care Expatriate — 1–60 months per contract, renewable, GKV-equivalent under HanseMerkur. From €58/month (ages 13–40), €68 (13–40), €150+ (41–60), €246+ (61–74). Accepted for §§ 18a/18b/20/21 AufenthG permits and family reunification under § 36.
Is long-term Incoming insurance accepted by the German immigration office?
Yes — expats pay from €58/month (13–40) via Care Expatriate; SB 150 €, worldwide including home country. Care Expatriate is accepted by the Ausländerbehörde for all residence permit types requiring health insurance proof — instant PDF certificate, worldwide cover including home country up to 6 weeks/year, zero deductible on Premium tier.
How much does long-term health insurance cost for foreigners in Germany?
Care Expatriate: from €58/month (13–40), €68 (41–60), €246 (61–74). Voluntary GKV: ~€220–450/month depending on income. Employer GKV: ~8.9% of gross (employee share) — cheapest for employees, unavailable for freelancers/self-employed.
Can I extend long-term Incoming insurance beyond 5 years in Germany?
Yes — Care Expatriate can be renewed for another 1–60 months. After a total of 5–7 years and permanent residence (Niederlassungserlaubnis under § 9 AufenthG), foreigners typically transition to voluntary GKV or a permanent PKV tariff.
What long-term health insurance options exist for foreigners in Germany?
Foreigners staying longer than 90 days need insurance beyond travel policies. If not eligible for public insurance (GKV), private incoming insurance like Care Expatriate (from €58/month, up to 5 years) is the typical choice. The certificate is recognized by immigration authorities.
How much does long-term health insurance cost in Germany for expats?
Care Expatriate starts at €58/month (ages 13–40, Basic with €150 deductible). Premiums vary by age: 41–60 from €68/month, 61–74 from €246/month. The insurance certificate is available instantly via email.
Can I switch from private incoming insurance to public insurance (GKV)?
Only if you become employed with a salary below the JAEG threshold (€69,300/year in 2026). Freelancers and self-employed expats without prior GKV membership generally cannot access statutory insurance. Care Expatriate provides full coverage from €58/month — with instant proof for your residence permit.
Over 10,000 policies issued · Since 2009