Health Insurance When Switching Your Residence Permit in Germany
- New § 21 / § 16f permit: Care Expatriate from €58/month (HanseMerkur · up to 5 years · cancellable when GKV starts)
- New § 18a employed under JAEG: DAK ~17.8% of gross (mandatory statutory · § 5 Abs. 1 Nr. 1 SGB V · employer pays half)
- Switch-day bridge: Care Economy from €30/30 days (Schengen-conform · cancellable when new lane starts)
Three rules that prevent every lane gap during the permit switch:
- 1Map the new permit to the lane: § 18a employed under JAEG → DAK 17.8% of gross (open-ended) · § 21 / § 16f / § 36 (private side) → Care Expatriate from €58/month (up to 5 years).
- 2Bridge the switch day: Care Economy from €30 / 30 days (up to 2 years) Schengen-conform covers any days between the Ausländerbehörde appointment and the new lane (DAK or Care Expatriate) starting.
- 3Cancel the old lane only with confirmation: GKV cancellations need an employer or new-insurer confirmation. Care Expatriate is cancellable monthly the day the new GKV Mitgliedsbescheinigung is issued — no minimum-term penalty.
Permit switch booked? 30-second permit-switch tariff finder →
Inside: the one cancellation document the Ausländerbehörde always asks for · why a 2-week gap between permits costs more than 12 months of premium · the bridge tariff that resets to €30 on every new permit category
Sources: § 5 Abs. 1 Nr. 1 AufenthG (cover precondition) · § 16b / § 16f / § 18a / § 21 / § 36 AufenthG (permit categories) · § 5 Abs. 1 Nr. 1 SGB V (statutory employees) · § 6 Abs. 6 SGB V (JAEG €77,400 in 2025) · § 10 SGB V (Familienversicherung) · DAK-Gesundheit tariff sheet 2026 · HanseMerkur Care Expatriate / Care Economy AVB
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
Residence-permit switch ahead? Lock in the right lane before the Ausländerbehörde appointment — Care Expatriate for § 21 / § 16f, DAK for § 18a employed under JAEG, Care Economy as the universal switch-day bridge.
6 common residence-permit transitions — what changes for the health-insurance lane
Quick answer: "What do I need to watch out for on the health-insurance side when I switch my German residence permit?" — these six common transitions cover Study → Skilled Worker, Study → Job-search, Employed → Self-employed and back, Schengen → Long-term, and Family Reunification. Each row shows the recognised lane on the new permit category.
§ 16b Study (graduate)§ 18a Skilled Worker (employed)
GKV obligation triggers from the contract start date under § 5 Abs. 1 Nr. 1 SGB V. Cancel Care Student / Care College the day DAK Mitgliedsbescheinigung is issued. The employer registers the contract and pays half (~8.9% of gross).
§ 16b Study (graduate)§ 16f Job-search (18 months)
Care Student / Care College ends with the matriculation. The 18-month job-search permit needs a recognised long-term incoming contract — Care Expatriate from €58/month is the typical bridge until the work contract is signed.
§ 18a Skilled Worker (employed)§ 21 Self-employed
Cancel GKV with the employer's confirmation. The new § 21 permit needs a recognised long-term incoming or PKV contract — Care Expatriate from €58/month is accepted by the Ausländerbehörde for § 21 AufenthG, locked for up to 60 months at the entry-age premium.
§ 21 Self-employed§ 18a Skilled Worker (employed)
GKV obligation triggers from the contract start date under § 5 SGB V (under JAEG €77,400). Cancel Care Expatriate the day DAK takes over. Family members on private contracts join DAK Familienversicherung free of charge under § 10 SGB V.
Schengen / Tourist visa§ 18a or § 21 (long-term)
Travel / Schengen cover is not accepted as long-term residence-permit proof. Switch to Care Expatriate from €58/month before the Ausländerbehörde appointment; bridge any gap with Care Economy from €30/30 days (Schengen-conform).
Any permit§ 36 Family Reunification (incoming spouse / child)
Each joining family member needs an independent recognised certificate from day 1. Statutory sponsor → DAK Familienversicherung free for spouse / children under § 10 SGB V. Private / incoming sponsor → separate Care Expatriate contract per family member.
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 a wrong lane on the permit switch can cost
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.
🏥
€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.
🏨
€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.
🧳
Up to 5 years
Short visitor cover may be too weak
For long stays, freelance work or residence documents, short visitor insurance may be too short or not the right proof.
- 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.
Permit appointment in the next weeks? Lock in the new lane this week — the wrong proof at the appointment delays the permit by 4–8 weeks
Why act before your residence documents are due
Long-stay proof can become urgent during visa, residence permit, project or relocation steps. Short visitor cover may not be enough.
Long stay, different proof
Care Expatriate can fit longer incoming stays up to 5 years, depending on age and selected plan.
Residence documents need clarity
Your proof should match destination, coverage period and long-stay purpose.
Do not wait for renewal stress
Preparing longer coverage early can reduce repeated extension pressure.
Private or statutory?
Freelancers, self-employed people and employees on assignment without German statutory insurance may need a different route than employees.
From old permit to new lane — in 3 steps
10 minutes online for Care Expatriate (long-term) or Care Economy (switch-day bridge), the policy document is issued by email in German + English and is accepted by every Ausländerbehörde for the new permit appointment. For § 18a employed under the JAEG, DAK takes over under § 5 SGB V the day the employer registers the contract.
Long-term stay covered in 3 steps
Care Expatriate can cover longer incoming stays up to 5 years, depending on age and selected plan.
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Choose your plan
Care Expatriate for expats, freelancers, self-employed people, employees on assignment without German statutory insurance, or seniors up to entry age 74.
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Complete the application
Enter passport, destination, stay details and requested coverage period online. Additional questions may apply depending on the plan.
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Submit your proof
Receive PDF confirmation after successful application and submit it to the embassy, consulate or immigration authority if requested.
What expats say about Care Expatriate when switching their German residence permit
“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
The 3 recognised products for the German residence-permit switch
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
DAK-Gesundheit Employees
currently 17.8% of gross income
(employer pays half · plus long-term care insurance)
For foreign employees with a social-security-covered job in Germany
- Statutory health insurance for employees in Germany
- Employer pays half of the health insurance contribution
- Family coverage for spouse & children may be possible under statutory rules
- Doctor, dentist, hospital, pharmacy & prescription medication coverage
- Health insurance card for medical treatment in Germany
- EU/EEA coverage via the European Health Insurance Card
- Save €120 per year with DAK Garantietarif 120 possible
- Optional: DAK Fit & Travel with additional benefits up to age 39
- Mandatory long-term care insurance also applies
- Reputable statutory health insurance provider
Why DAK-Gesundheit?
For foreign employees in Germany who need statutory health insurance with a health insurance card, employer contribution and possible family coverage.
Why statutory health insurance as an employee?
More security in everyday working life in Germany: the employer pays half, family members may be covered free of charge under certain conditions, and medical treatment is handled easily through the health insurance card.
- 🏛️ DAK-Gesundheit
- 📄 Membership certificate for employers & authorities
- 🔒 Doctor, dentist, clinic, pharmacy & prescription medication
- 🏷️ Currently 17.8% of gross income · employer pays half
→ Complete the application, start your membership, receive your health insurance card
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
Need the residence-permit explainer? Why insurance is almost always required. Switching into employment? HR insurance-proof checklist. Self-employed vs employed? Lane comparison. Compare every expat lane in the foreigners hub.
Full price tables — Care Expatriate · DAK-Gesundheit · Care Economy
Quick answer: Three recognised products cover every permit-switch scenario: Care Expatriate from €58/month for the § 21 / § 16f / § 36 lane (entry-age premium locked for up to 60 months), statutory DAK at ~17.8% of gross under the JAEG for the § 18a employed lane (employer pays half), and Care Economy from €30/30 days as the switch-day bridge.
New § 21 / § 16f / § 36 permit — Care Expatriate
HanseMerkur incoming, ages 0–74, up to 5 years, accepted by the Ausländerbehörde for the private-side permit categories, certificate issued in German + English (4 tiers — Si / S / M / XL):
| 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.
New § 18a employed under JAEG — DAK-Gesundheit
Statutory under § 5 Abs. 1 Nr. 1 SGB V, ~17.8% of gross salary, employer pays half, free Familienversicherung for spouse and children (DAK button price: 17.8% of gross (open-ended)):
| DAK-Gesundheit for employees (statutory) | |
|---|---|
| General contribution rate |
14.6 % of gross
+ 3.2 % DAK supplement = 17.8 %
|
| Employer / employee share |
8.9 % each
Paid 50/50
|
| Compulsory long-term care |
approx. 3.6 % standard
4.2 % childless from age 23 · reductions depending on number of children
|
| Total (incl. care, childless) |
≈ 22.0 % of gross
Depending on long-term care variant
|
| Family co-insurance |
possible
Spouse & children covered under statutory conditions
|
| Sickness pay (Krankengeld) |
from day 43
70 % of gross, max 78 weeks
|
| Compulsory insurance limit (JAEG) |
€77,400 / year
= €6,450 / month (as of 2026)
|
2026 contribution rates: 14.6 % general + 3.2 % DAK supplement = 17.8 %; split 50/50 between employer and employee (8.9 % each). Compulsory long-term care approx. 3.6 % standard, 4.2 % childless from age 23, reductions depending on number of children. Family co-insurance possible under statutory conditions. As of 2026.
Switch-day bridge — Care Economy
Schengen-conform incoming, ages 0–74, 1 day to 2 years, cancellable the day the new lane (DAK or Care Expatriate) is in place:
| 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.
FAQ — Health insurance when switching the German residence permit
Frequently Asked Questions
What changes for health insurance when I switch my German residence permit?
The lane follows the new permit category. Switching to § 18a Skilled Worker (employed) under the JAEG (€77,400/year in 2025) triggers GKV obligation under § 5 Abs. 1 Nr. 1 SGB V — typically <a href="/en/insurance-plans/dak-gesundheit-angestellte/overview/" class="text-primary underline underline-offset-2">DAK-Gesundheit at ~17.8% of gross</a>, employer pays half. Switching to § 21 Self-employed or § 16f Job-search needs a recognised long-term incoming contract — typically <a href="/en/insurance-plans/care-expatriate/overview/" class="text-primary underline underline-offset-2">Care Expatriate from €58/month</a> (HanseMerkur, up to 5 years). Bridge the gap during the switch with <a href="/en/insurance-plans/care-economy/overview/" class="text-primary underline underline-offset-2">Care Economy from €30/30 days</a>.
Can I cancel Care Expatriate the day my new GKV (DAK) starts after the permit switch?
Yes. <a href="/en/insurance-plans/care-expatriate/overview/" class="text-primary underline underline-offset-2">Care Expatriate</a> is cancellable monthly with the new GKV Mitgliedsbescheinigung as proof — no minimum-term penalty after the GKV obligation triggers under § 5 Abs. 1 Nr. 1 SGB V. The reverse direction (cancel DAK, switch to Care Expatriate for § 21 self-employed) requires the employer's cancellation confirmation. The full self-employed vs employed comparison is in the <a href="/en/guide-health-insurance-germany/health-insurance-expats-germany/self-employed-or-angestellt-expat-what-changes-self-typically-health-insurance-germany/" class="text-primary underline underline-offset-2">lane comparison page</a>.
Is travel insurance enough during the residence-permit switch in Germany?
No — travel insurance is not accepted as long-term residence-permit proof, and the Ausländerbehörde checks the certificate validity covers the entire requested permit duration. The recognised bridge during a switch is <a href="/en/insurance-plans/care-economy/overview/" class="text-primary underline underline-offset-2">Care Economy from €30/30 days</a> (Schengen-conform, ages 0–74), and the recognised long-term proof is <a href="/en/insurance-plans/care-expatriate/overview/" class="text-primary underline underline-offset-2">Care Expatriate from €58/month</a>. See also the <a href="/en/guide-health-insurance-germany/health-insurance-expats-germany/expat-job-start-what-hr-and-employer-require-as-insurance-proof-germany/" class="text-primary underline underline-offset-2">HR insurance-proof checklist</a> if the new permit is § 18a Skilled Worker.