AOK Nordost

FAQ around the membership process

Here, we answer your questions about changing health insurance providers and insurance with AOK Nordost.

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1. What requirements do I have to fulfil to change to AOK Nordost?
AOK Nordost is a regional open health insurance provider for Berlin, Brandenburg and Mecklenburg-Western Pomerania.

General admission requirements:

You live in Berlin, Brandenburg or Mecklenburg-Western Pomerania or

You work or study in Berlin, Brandenburg or Mecklenburg-Western Pomerania or

Your spouse or registered life partner is insured with the AOK Nordost or

The AOK Nordost was your last statutory health insurance provider
2. How do I terminate my previous health insurance fund to AOK Nordost?
To switch to another health insurance provider, it is sufficient if you fill out the online declaration to become a member of AOK Nordost within 14 days of commencement of your

employment or training

studies

receipt of unemployment benefits or Bürgergeld.

If you are changing insurers from a current insurance plan, you must observe a changeover period. You can find out more about this in the answer to “What is the changeover period?”

A change of health insurance fund without a changeover period is possible in the event of a change of status or an insurance gap. You can find more information on this in the answer to “Can I also change my health insurance fund without a changeover period?”.

It is our pleasure to insure you.
3. How can my co-insured family members switch?
Family members who are co-insured with a member of the health insurance provider and who wish to change health insurance providers with that member do not have to make their own choice. We will then inform your previous health insurance provider about the termination of your family insurance with them.
4. What is the changeover period?
The following applies to all persons with statutory health insurance: When you change health insurance funds from a current insurance plan, you are generally bound to your new health insurance fund for 12 months. After that, the notice period/changeover period is two months to the end of the month.

Please take this into account when specifying the date on which you want to start you new AOK NORDWEST membership.

Example 1

You have been insured with your previous health insurance provider for more than 12 months without interruption and declare your wish to change to AOK Nordost on 10 July. Your membership will therefore end on 30 September and from 1 October, you will then be an AOK Nordost member.

Example 2

You have been insured with your previous provider since 1 April of the previous year. Your membership can therefore at the earliest end on 31 March of the current year. In order to become a member of AOK Nordost from 1 April, we must receive your declaration by 31 January at the latest, in order to comply with the notice period/switching period.

Tip: Please also note the information on the special right of termination and the possibility of switching to AOK Nordost without compliance with a notice/changeover period.
5. Does a special right of termination apply to my case?
If your health insurance fund charges an additional contribution for the first time or increases the existing additional contribution, you have a special right of termination. In this case, the commitment period of 12 months shall not apply. The declaration must be received by AOK Nordost by the end of the month for which the new additional contribution is due. Your membership declaration will take effect two months later at the end of the calendar month.

Example

You have been insured with your previous health insurance fund since 1 April of the current year, and they inform you that they will be charging an additional contribution from 1 January of the next year. In this case, you can make use of your special right of termination, even though you have not yet been insured with this health insurance fund for 12 months. If you terminate your membership by 31 January at the latest, you can become an AOK Nordost member from 1 April.

By the way: Your health insurance fund must notify you about an additional contribution as well as your special right of termination at the latest one month before the first due date.
6. Is it possible to change health insurance companies without giving notice?
A change of health insurance fund without a notice/changeover period is possible in the event of a change of status or an insurance gap (interruption of membership of min. 1 day and max. 1 month).

Examples for a change of status

You switch from employer A to employer B

You switch from employer A to the employment agency (or vice versa).

You switch from employment or from receiving unemployment benefit to receiving a pension.

Example for an insurance gap

Your employment A ends on 12 October and your employment B starts on 15 October.

If you have any further questions regarding other constellations, please contact us personally.
7. How does the immediate change of health insurance work?
You choose a new health insurance fund within two weeks of becoming subject to compulsory insurance. Please inform your employer, the employment agency (if applicable) or another reporting body within the above-mentioned period about your declaration of membership.
8. If I am participating in an optional rate, what should I bear in mind when terminating my contract?
If you have opted for an optional rate with your previous health insurance fund, you are bound to this fund for between 1 and 3 years (from the start of participation), depending on the type of rate. You can only switch to AOK Nordost after the respective commitment period has expired.

A change of status overrides the above-mentioned commitment period and allows you to switch to AOK Nordost immediately.

If your health insurance fund charges or increases an additional contribution, you have a special right of termination. This would only be excluded if you were a participant in a so-called optional sickness benefit plan.
9. What should I bear in mind when taking out student insurance?
As a student, you are usually covered free of charge by family insurance until your 25th birthday, unless you are already subject to compulsory insurance by exceeding the defined income limit. After your family insurance cover ends, you are free to choose your health insurance fund and switch to AOK Nordost.

As a student, you are entitled to student health insurance until you reach the age of 30. After that, you can take out voluntary insurance as a student.

Tip: Student insurance can be extended, for example, through voluntary military service or federal voluntary service.
10. Is health insurance compulsory for students?
When you start studying, you can apply to be exempted from compulsory health insurance if you were not subject to compulsory insurance immediately before and can prove that you are otherwise entitled to insurance cover in the event of illness - for example, by taking out private insurance.

The basis for the regulations on exemption from compulsory health insurance is set out in Section 8 of the 5th Volume of the German Social Code (SGB V). This exemption applies for the duration of your studies.

However, this decision should be duly considered, as it entails some disadvantages:

The exemption cannot be revoked for the entire duration of the study programme, unless you interrupt your studies in order to take up a new study programme at a later point in time.

The consequence of the exemption is that it will then not be possible to take out free family insurance with a statutory health insurance fund during your studies (e.g. via your spouse in the case of marriage).

As a rule, a student’s entitlement to benefit via their parents will end when they reach the age of 25. This means that the costs of private health insurance will also increase when the entitlement to benefit ends.

As a rule, a return to statutory insurance after graduation is only possible by means of compulsory insurance. This is because it is not possible to join a voluntary insurance scheme due to the lack of a pre-insurance period.
11. What do I have to bear in mind as a trainee?
If you receive a trainee salary as a trainee, you are no longer covered by non-contributory family insurance from that point on and can freely choose your health insurance within 14 calendar days of the start of your vocational training.

Your contribution will be calculated based on your trainee salary.

Important: If you do not earn more than 325 euros gross per month, your employer will pay your contributions in full.
12. Can I also insure family members with AOK?
Of course you can. Within the scope of your online application for membership, we will ask you whether you have family members and if you would like to insure them as well. If your answer is “Yes”, we will send you the application for family insurance. Please complete the application form and return the signed original document to us by post.
13. Are there age limits for children covered by family insurance?
In the case of statutory health insurance, children can be covered by family insurance if one of the following criteria applies:

Up to the member’s 18th birthday.

Up to the member’s 23rd birthday, provided they are not in gainful employment.

Up to the member’s 25th birthday, if they are attending a school-based training, studying or doing an unpaid voluntary social year, voluntary ecological year (Youth Voluntary Service Act) or Federal Voluntary Service (Federal Voluntary Service Act).

beyond the age of 25, if you are in school education or studying. The additional prerequisite is that this school-based training or study programme was interrupted or postponed by voluntary military service or other statutory voluntary service. Family insurance is extended by a maximum of the period of service - i.e. a maximum of 12 months pursuant to the new law. Disabled children are included under the family insurance policy, as long as they are unable to support themselves due to their disability.

Note: The disability must have occurred at a time when the child was already covered by family insurance.
14. In what cases is family insurance not possible?
Family insurance is not possible if one of the following criteria applies:

if the spouse, registered life partner or children do not have their domicile or habitual residence in Germany;

if the spouse, life partner or children are themselves compulsorily or voluntarily insured, exempt from insurance or exempt from compulsory insurance;

if the family member is self-employed on a full-time basis;

if the family member has a total income exceeding EUR 470 per month. For persons employed on a marginal basis, the income limit is 450 euros per month.

Spouses are not covered by family insurance for the duration of the protection periods under the Maternity Protection Act as well as during parental leave if they were last not covered by statutory health insurance. They then remain insured on a private basis.

Family insurance of children is excluded,

if one spouse/registered life partner is covered by statutory health insurance, while the other spouse/registered life partner related to the child is not covered by statutory health insurance,

the child’s monthly salary exceeds 5.775 Euro (gross) and

the child regularly earns more than the spouse/registered life partner insured in a statutory health insurance.
15. Will I receive a membership certificate and what do I have to do with it?
You will receive a certificate from AOK Nordost before you start your membership.

So that your employer or your reporting body (e.g. job centre, Federal Employment Office, institutions of higher education) is also notified about your switch to the AOK Nordost health insurance fund and so that these can in turn carry out the required registration process for you, AOK will also send a membership certificate directly to these bodies. Nevertheless, we recommend that you also hand in your membership certificate to your employer or registration office.

If you were insured with your previous health insurance fund (e.g. self-employed, freelancer) on a voluntary basis, you must also send your membership certificate to your previous health insurance fund by the end of the notice period.

In the case of insured persons on parental leave, who receive parental allowance or child-raising benefits, and where there is no employer or other reporting body, AOK Nordost will send the membership certificate to the previous health insurance fund within the notice period.

However, no membership certificates need to be sent for pensioners, as in this case, the pension insurance institution will receive an automatic notification.

Important: If your previous insurance relationship changes between the date of your application and the start of your insurance with AOK, e.g. due to a change of employer or unemployment, please inform us so that we can update your certificate of membership; you may then be able to switch to AOK Nordost earlier. Please also notify us promptly, if your reporting body should change during this period. Your change to us can only take effect if we also inform the new reporting body in good time. This also applies if the previous reporting body is no longer responsible for your case ( e.g. at the end of the employment relationship) and you still have to take out voluntary insurance with your previous health insurance fund until you start your membership with us.
16. Having problems filling out the online membership declaration?
Our service team will be happy to help you. Simply you can reach us free of charge from the German landline and mobile network at the telephone number: 0800 2650800

From abroad you can reach us at: 0049 331 2772-1111 (at the rate of the foreign telephone provider)

Alternatively, you can schedule a consultation | AOK Nordost and we will enter your membership declaration together with one of our staff.
17. Where can I get information on sickness benefits?
You can find information on sickness benefit here.
18. Why does the AOK need my tax identification number (tax ID for short)?
The Act on the Improved Tax Consideration of Pension Expenses (Citizens’ Relief Act) seeks to relieve the tax burden of citizens by increasing the tax deductibility of health and long-term care insurance contributions paid.

For this purpose, the social insurance agency will directly transmit the health and long-term care insurance contributions paid and/or reimbursements from optional rates and/or bonus programmes to the Central Incentive Authority for Old-Age Provision (ZfA). In order for us, as your partner in matters of health and long-term care insurance, to be able to transmit the amount of the health and long-term care insurance contributions paid by you to the Central Incentive Authority for Old-Age Provision (ZfA), we need to know your tax identification number (tax ID).
19. What are the conditions for switching from private insurance to statutory insurance?
If you are a member of a private health insurance fund, you can switch to statutory health insurance when you take up a non-self-employed main job with a remuneration is below the compulsory insurance threshold. Privately insured employees under the age of 55 can apply to switch to a statutory health insurance fund if their income permanently falls below the compulsory insurance limit.
20. How is insurance provided after returning from abroad?
In principle, everyone is insured with the health insurance fund with which they were last insured. If you were last insured with a statutory health insurance fund before your stay abroad, you can again take out a membership with health insurance fund. If you were last insured with a private health insurance fund before your stay abroad, you can take out private health insurance from the time of your return. If you did not have health insurance in Germany before, your new job in Germany will determine the type of health insurance.