Posting to Germany: Which Health Insurance Is Required — and What Happens Without A1?

The A1 (Regulation (EC) 883/2004) proves that a posted worker remains socially insured in the home EU/EEA country for up to 24 months. It replaces German GKV registration and exempts the employer from paying 17.8% of gross to DAK-Gesundheit during the posting.

Without A1, § 3 SGB IV kicks in: the employer must register the worker with DAK-Gesundheit at 17.8% of gross from day one. The Zoll (Finanzkontrolle Schwarzarbeit) can fine both employer and employee up to €500,000.

Care Expatriate (from €58/month, 1–60 months) is the standard § 5 AufenthG-compliant tariff for postings without an A1. Non-EU postings need a bilateral totalization agreement (e. g. , USA, India, Turkey) or private Incoming cover.

Up to 24 months under EU Regulation 883/2004, extendable to 60 months by mutual agreement (Article 16). Beyond that, GKV registration with DAK-Gesundheit at 17.8% of gross becomes mandatory.

§ 5 AufenthG requires proof — Care Expatriate (from €58/month) provides the accepted PDF certificate. Yes if from a non-EU country. EU-posted workers use the A1 form plus European Health Insurance Card (EHIC).

Yes – either through your home country's system (with an A1 certificate) or through a German or private policy. Care Expatriate (from 58 €/month) is designed for posted workers and expats, with worldwide coverage for up to 5 years.

If you have a valid A1 certificate (EU/EEA), your home insurance applies. For gaps or additional coverage, Care Economy (from 30 €/30 days) provides flexible short-term protection.

If the 24-month limit is exceeded without an extension, you may become subject to German social insurance – meaning both you and your employer must pay German contributions. Apply for an extension (Article 16 Regulation 883/2004) well in advance.