Requirements for health insurance at the State Office for Immigration (LEA) in Berlin

The Berlin State Office for Immigration has specific requirements regarding health insurance , which is necessary to obtain a residence permit from the Berlin Immigration Office (official “Information Sheet on the Required Health Insurance Coverage for the Issuance/Extension of Residence Permits”). This information sheet is frequently requested, which is why we are publishing it here in its original text. The wording of the information sheet is as follows:

“The Residence Act (AufenthG) provides for the following residence permits in Section 4 Paragraph 1 Sentence 2:

Visa, residence permit, settlement permit, EU long-term residence permit, EU Blue Card, ICT Card, and Mobile ICT Card. According to Section 5 Paragraph 1 Number 1 of the German Residence Act (AufenthG), the granting of a residence permit generally requires proof of sufficient means of subsistence. According to Section 2 Paragraph 3 of the German Residence Act (AufenthG), proof of sufficient means of subsistence also includes adequate health insurance coverage.

Persons who are compulsorily insured pursuant to Section 5 of the German Social Code (SGB) V, voluntarily insured pursuant to Section 9 SGB V, or co-insured as family members pursuant to Section 10 SGB V, thereby demonstrate sufficient health insurance coverage. They only need to provide proof of their corresponding membership in the statutory health insurance system.

Furthermore, for all individuals not covered by German statutory health insurance, it is always necessary to verify whether their existing insurance provides sufficient health insurance coverage. Such coverage is considered sufficient if it corresponds in type and scope to that of statutory health insurance. This means, in particular, that it must not include extensive exclusions of benefits, must not generally require the insured to pay a deductible exceeding €300 per year in the event of illness, must not limit the reimbursable costs in the event of illness, and must not contain any expiry or termination clauses related to a specific age, cessation of employment, change of residence purpose, or loss of legal residency status. A higher deductible may be permitted under Section 152 Paragraph 1 of the German Insurance Supervision Act (VAG) following an individual assessment. Such insurance coverage may also be provided by an insurer based abroad.

Sufficient insurance coverage can always be assumed if the Federal Financial Supervisory Authority (BaFin) has confirmed to the insurance company that, based on the respective insurance contract, it fulfills the legal requirements regarding health insurance pursuant to Section 257 Paragraph 2a of the German Social Code, Book V (SGB V), and the health insurance company certifies this. Confirmation from BaFin is not given if the insurance coverage is limited in time and does not renew automatically, and if no surpluses are accumulated for the formation of reserves for old age, i.e., if the health insurance company has not calculated the product in the manner of a life insurance policy.

As part of the obligation to cooperate pursuant to Section 82 Paragraph 1 of the Residence Act, applicants must submit written proof from their health insurance company that it fulfills the legal requirements pursuant to Section 257 Paragraph 2a of the German Social Code, Book V, on the basis of the existing insurance contract.

In addition, when extending residence permits, all persons not covered by statutory health insurance must submit a certificate from their health insurance provider confirming that their insurance coverage has been continuous and has not been terminated in the interim. This proof is necessary to prevent health insurance from being terminated for cost-saving reasons and only reinstated upon renewal of the residence permit, leaving the individual without health insurance coverage in the interim.

If continuous health insurance coverage cannot be proven, it is reasonable to assume that the applicant's livelihood is not sufficiently secured in this respect, and grounds for refusal exist. The granting or extension of the residence permit can then be refused.

Should you have any questions regarding health insurance at the State Office for Immigration, our lawyers will be happy to advise you.