Officialization 3: Health Insurance

Officialization TOC

Health Insurance


In Germany, health insurance is compulsory, and most people have a national health insurance policy. Before being able to enroll in my school, I need to provide proof of health insurance.

My department gave me free coverage with a private travel-like insurance, which allows me to waive the national insurance. The problem is that the private insurance doesn’t cover pre-existing conditions (which I have). I am also concerned that I may have a very hard time finding a doctor (especially an English speaking one) this way, to be able to switch doctors if I need to, and I would like to be covered in case something bad happens (who knows).

Furthermore, there’s a trick involving signing up/waiving national health insurance. I was told that:

  • if I sign up for it I am stuck with it for the whole two years that I am a student,
  • if I sign up for it, it will cover me in Italy as well because it is a European insurance,
  • if I waive it, I am stuck without it and won’t be able to revert back into it (at least until I am no longer a student, although I am not sure if I ever can),
  • if I waive it, I may have to get private insurance later (after the one the school gave me runs out), and at that point, they may not take me with pre-existing conditions.

So, if insurance is compulsory, but no one takes me and I end up without insurance, I think I can’t enroll in the Uni, which means that I can’t get a student visa, which means Germany kicks me out… I think? I still don’t quite understand this part.

Anyway, I decided to go with what my department recommended in this case, which is supposed to be the national health insurance, offered through the company AOK. I still don’t 100% know if this is the right thing, or if I’m losing a ton of money, but you know, I decided it was ok. This way, everything is official, no one can kick me out later, and all my health problems should be covered.

EDIT: The national insurance in Italy is only ~€200 Euro per year. In order to receive a residency permit in Italy you need to show that you are covered through your stay. The insurance in Germany is ~€1080 euro per year. If you get the German insurance you cannot get rid of it if you want to stay enrolled in Saarland, and you must stay enrolled in Saarland to receive your master’s degree at the end of the two years (the LCT program auto-enrolls you for the second year, even though you aren’t here and you don’t pay the ~230 euro enrollment fee per semester). So this means that if you go with the German national insurance, be prepared to be committed for ~€2160 euro. In retrospect, I would recommend finding a supplementary private insurance in Germany, if you need it, instead of going through the national one, and then just getting the local insurance for your second year. That would save you a big chunk of change.

EDIT: It turns out that once you turn 30, Germany won’t let you keep your student insurance anymore, and automatically kicks you out of it (but you can get normal insurance instead if you want). This actually worked in my favor in the end, because it meant I could legally remain enrolled, even without the German insurance, if I am not living in Germany, saving me a ton of money over the second year.

What I needed for the appointment:

  • Passport with the Shengen Visa
  • Zulassungsbescheid (Notification of admission to the Uni)
  • Mug shot, i.e. passport photo


  • €90/month (ouch!)

I also need to come back to the AOK office after I have a bank account (to pay them), and my student card and city registration from the Bürgeramt (to prove to them that I wasn’t lying about everything I said before). I think at that point I can get my health insurance number or health insurance card or… whatever it is.

As an aside, in the United States, with insurance, I paid 100-150 USD for a doctors visit which I have every six months, plus ~10-15 USD for meds each month. From what I understand, in Germany without insurance, the costs may be similar here for a visit and meds. (But I got the insurance because I didn’t want to risk being turned away or have something not be covered.)

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