Master prompt
Krankenversicherung + medical requirements for German residence permit
Mandatory statutory or private Krankenversicherung at residence-permit application. TB testing requirements for long-stay categories. Child vaccination evidence. Validity windows.
GermanyKrankenversicherungHealth insuranceTB testingMedicalSGB V
Advise [CLIENT_NAME] on Krankenversicherung (health insurance) and medical requirements for [PERMIT_CATEGORY] application. Health insurance is a hard prerequisite under §5 AufenthG — without it, no residence permit can issue.
§1 — LEGAL BASIS
• §5(1) AufenthG — applicant must demonstrate adequate health insurance covering the period of residence
• §5 SGB V — statutory health insurance (gesetzliche Krankenversicherung — GKV)
• §193(3) VVG — mandatory minimum private health insurance equivalent
• §257 SGB V — Krankenversicherungspflicht (compulsory insurance)
• §62-64 AufenthG — duty to disclose any communicable disease relevant to public health
Without proof of full coverage, the Ausländerbehörde will refuse the permit issuance at Termin — no exceptions.
§2 — STATUTORY (GESETZLICHE KRANKENVERSICHERUNG — GKV) vs PRIVATE (PRIVATE KRANKENVERSICHERUNG — PKV)
STATUTORY (GKV):
• Default for employees earning ≤ Versicherungspflichtgrenze (EUR 69,300 gross/year 2024) // 2026-05 — verify current Jahresarbeitsentgeltgrenze
• Compulsory for most Blue Card holders, students, spouses (Familienversicherung)
• Major Kassen: TK (Techniker Krankenkasse), AOK, Barmer, DAK, KKH
• Premium: typically 14.6% of gross salary (employer-employee split) + Zusatzbeitrag (0.7-1.8%)
• Coverage: comprehensive; doctor visits, hospital, prescriptions, dental (basic)
• Family included: spouse + minor children free under Familienversicherung if spouse not earning above EUR 505/month mini-job
PRIVATE (PKV):
• Option for high earners (above Versicherungspflichtgrenze)
• Compulsory choice for self-employed / freelancers (unless opted into GKV)
• Premium: depends on age, health, scope; typically EUR 300-800/month for full coverage
• Lower premium initially but rises sharply with age
• Family members: separate policies; not free
• Switch back to GKV after age 55: nearly impossible — counsel carefully
EXPAT-SPECIFIC INSURERS (PKV variants for newly arrived):
• Mawista Student / Expat
• Care Concept
• Hanse Merkur Expat
• DR-WALTER Expat
• Premium: EUR 35-100/month for student / EUR 80-200/month adult expat
• Validity: typically up to 5 years; after that must switch to GKV or full PKV
§3 — INSURANCE TYPE BY PERMIT CATEGORY
For STUDIUM (§16b):
• Under age 30: compulsory GKV at student rate (~EUR 120-130/month) — TK or AOK student rate
• Over age 30: must take expat PKV (Mawista Student / Care Concept) — GKV not available
• Confirm with [CLIENT_NAME]'s age [AGE_AT_APPLICATION]
For Blue Card EU (§18g) / Fachkraft (§18a/b):
• If salary ≤ Versicherungspflichtgrenze (EUR 69,300): GKV compulsory
• If salary > threshold: choice GKV vs PKV
• Most employees default to TK (Techniker Krankenkasse) — competitive premium + good service
For SELF-EMPLOYMENT (§21):
• Choice of GKV (voluntary) or PKV
• GKV voluntary rate: ~14.6% of declared income + Zusatzbeitrag
• PKV: age-based premium; typical EUR 400-700/month
For FAMILY REUNIFICATION (§28 / §30):
• Familienversicherung free under spouse's GKV if spouse is in GKV
• Otherwise: dependant on own policy
For [INSURANCE_TYPE]: confirm appropriateness against [PERMIT_CATEGORY].
§4 — REQUIRED DOCUMENTATION AT AUSLÄNDERBEHÖRDE TERMIN
A. Mitgliedsbescheinigung from GKV (or equivalent from PKV):
• Insured person (name, DOB)
• Insurance period (start date — typically date of arrival / employment start)
• Scope: confirmation of full coverage (Vollversicherung) — NOT travel insurance
• Issuer's stamp + signature
• Date of issue: WITHIN 30 DAYS of Termin (validity window)
B. For expat PKV (Mawista / Care Concept):
• Insurance certificate showing:
— Type "Versicherungsschutz im Krankheitsfall gemäß §5 AufenthG"
— Coverage period
— Insured person
— Repatriation coverage if requested by Ausländerbehörde
• Many expat policies offered specifically as "AufenthG-konform" — verify
• Must demonstrate equivalent scope to GKV (some Ausländerbehörden reject thin expat coverage)
C. For Familienversicherung:
• Family member's Mitgliedsbescheinigung listing the dependent
D. Premium-payment evidence:
• Bank standing order / Lastschriftmandat OR
• First-month payment receipt
§5 — TB TESTING REQUIREMENTS
Yes — India (high incidence per WHO): relevant.
Germany TB testing rules under §62 AufenthG + Infektionsschutzgesetz (IfSG) §36:
• Long-stay applicants from TB high-incidence countries: TB screening typically required for Studium and skilled-worker categories
• WHO TB high-incidence list includes: India, Pakistan, Nepal, Bangladesh, Sri Lanka, Indonesia, Vietnam, Philippines, several African countries
WHO and WHAT:
• Chest X-ray + tuberculin / IGRA (Interferon Gamma Release Assay) blood test
• Conducted by: local Gesundheitsamt (public health office) OR approved physician
• Free at Gesundheitsamt for visa-application purposes; private clinic EUR 80-150
• Result: typically within 1-7 days
• Documentation: ärztliche Bescheinigung confirming negative TB or completed treatment
TB screening required for:
• Studium (§16b) — typically demanded by university enrolment AND Ausländerbehörde
• Refugees / asylum seekers
• Long-stay employment > 1 year in healthcare / food / education sectors
Not typically required for:
• Most Blue Card / Fachkraft positions (employer screening covers it)
• Short-stay tourists / business
Per [BUNDESLAND] practice: confirm with [DESTINATION_USE].
§6 — VACCINATION DOCUMENTATION
For accompanying children ([INSURED_PERSONS] indicates children):
• Standard German childhood vaccinations expected per Robert Koch-Institut (RKI) STIKO recommendations
• Indian Universal Immunisation Programme + IAP vaccinations: largely overlap
• Bring:
— Indian Mother-Child Health Card (राष्ट्रीय बाल स्वास्थ्य कार्यक्रम / RBSK)
— School / clinic vaccination records
— Translated to German (sworn translation)
• Missing vaccinations: catch up via German Kinderarzt; some kitas / schools require proof of MMR + DTaP
For school enrolment (children ages 6+):
• Many German Bundesländer mandate Masern-Impfung (measles vaccination) under Masernschutzgesetz
• Two MMR doses required for kita/school admission
• If missing: catch up before school start
§7 — CRITICAL ILLNESSES + DISCLOSURE
Under §62 AufenthG + §73 IfSG, applicant must disclose:
• Active tuberculosis (untreated)
• Active leprosy
• Active syphilis
• Active HIV (more nuanced — does NOT bar entry; treatment access ensured)
• Communicable disease relevant to public health
Concealment risk: §95(1) AufenthG — imprisonment up to 3 years OR fine for misrepresentation.
Honest disclosure routes:
• If applicant has had treated TB: bring physician's letter confirming complete treatment + cure
• If HIV+ on antiretrovirals: confirmation of treatment access in Germany; does not bar permit
• If awaiting result: delay Termin until clear
§8 — TIMELINE BEFORE TERMIN
T-60 days: Confirm insurance type + activate policy
T-30 days: Request fresh Mitgliedsbescheinigung from Krankenkasse (validity window 30 days)
T-30 days: For Yes — India (high incidence per WHO) = Yes: schedule TB X-ray + IGRA
T-14 days: Verify all family members' coverage
T-7 days: Print fresh documents, all in original
T-1 day: Re-confirm Termin
§9 — RED FLAGS
□ Travel insurance presented as Krankenversicherung — REJECTED (not full coverage)
□ Mitgliedsbescheinigung older than 30 days — likely rejected
□ Expat insurance scope below GKV equivalent — possible rejection at Bavarian / strict Ausländerbehörden
□ Spouse / child not covered — Familienversicherung application required first
□ Gap between current insurance and new permit period — fill via short-term expat PKV
□ TB testing skipped for high-incidence-origin student application — likely additional request post-Termin
§10 — COST SUMMARY FOR [CLIENT_NAME]
Initial outlay typical:
• GKV student under 30: EUR 120-130/month
• GKV employee at threshold salary: EUR 350-600/month (employee share ~7.3% + Zusatz)
• Expat PKV student over 30: EUR 35-80/month
• Expat PKV adult: EUR 80-200/month
• TB test: free at Gesundheitsamt; EUR 80-150 private
• Krankenversicherung first month + 30-day fresh Bescheinigung: included
End with: "DRAFT — for Rechtsanwalt für Migrationsrecht (immigration lawyer) review. Verify against current Ausländerbehörde guidance before submission. Specifically confirm: (a) Krankenversicherung Mitgliedsbescheinigung issue date within 30 days of Termin, (b) TB testing acceptance window per [BUNDESLAND], (c) child vaccination compliance with Masernschutzgesetz if children attending kita/school."Unlock the vault to see the full prompt