# International health insurance for expats leaving Germany > Once you move your residence out of Germany, you usually lose your German health cover, and travel medical insurance does not fill the gap: it is built for trips, not for living abroad. An international expat plan replaces health insurance in your new country. Just as important is how you get back in if you return. Quelle/Source: https://www.nammert.com/en/insurance-broker-expat-health-insurance.php Updated: 2026-11-07 ## Is my travel medical insurance enough if I move abroad? No. Travel medical insurance covers temporary trips, on an annual policy usually six to eight weeks per trip, and normally requires a residence in Germany. Long stay plans run for up to a few years, often only if your habitual residence stays in Germany. If you live abroad permanently, you need international health insurance designed for a residence outside Germany. ## At a glance - **Mandatory?:** Not in Germany, but many destination countries require it for a residence permit - **Travel vs expat:** travel cover for trips, expat plan for a residence abroad - **Back into private cover:** an Anwartschaft locks in your current health status - **Back into public cover:** often closed from age 55 (section 6 (3a) SGB V) - **Premium:** depends on age, country, deductible and US cover ## Travel, long stay, expat: three products for three situations Travel medical insurance tops up your German health insurance while you are on holiday. Most policies require a German residence and limit how long each trip may last. Once you move abroad, that basis is gone. Long stay plans for sabbaticals, work and travel or assignments run for up to a few years, and some insurers only offer them while your habitual residence stays in Germany. An expat plan is full health insurance for life abroad: no fixed end date, with check ups, maternity and chronic conditions as the plan terms allow. ## What happens to German statutory health insurance If you leave Germany for good and live outside the EU and EEA, your membership with the statutory fund (gesetzliche Krankenkasse) usually ends. Inside the EU, the scheme of your new country normally takes over if you work there. Get written confirmation from your fund before you deregister, and never cancel without new cover in place. Coming back: if your last cover was statutory and you have no other insurance, you become compulsorily insured again under section 5 (1) no. 13 SGB V. Age is the hurdle. From your 55th birthday, section 6 (3a) SGB V can exclude you if you had no statutory cover in the previous five years. A statutory Anwartschaftsversicherung, a dormant membership, can keep that door open. ## Privately insured: small or large Anwartschaft German private health insurance often covers stays outside Europe only for limited periods. Instead of cancelling, you can put the policy on hold. The small Anwartschaft records your health status on the day you sign, so you can return later without a new health check. The large one also keeps building ageing reserves and costs considerably more. If you return without one and your last cover was private, you are entitled to the basic tariff (Basistarif), but not to your old plan. An Anwartschaft pays nothing abroad: it only secures your way back. ## When the destination country asks for proof Many countries require proof of health cover for a residence permit. Spain, for example, requires private health insurance from an insurer authorised in Spain, with no co payments and no waiting periods, for the non lucrative residence visa and the digital nomad visa. Travel insurance is not accepted. Whether an international plan meets the authority's rules depends on the certificate the insurer issues, not on the brochure. Ask the consulate what exactly it expects before you buy. ## What is covered - Outpatient and inpatient treatment in your country of residence and worldwide within the chosen area - Prescription drugs, therapies and medical aids as per plan - Treatment in Germany during visits or by choice, depending on the plan - Medically necessary evacuation or transfer to a suitable hospital - Check ups and vaccinations on higher plans - Maternity after a waiting period - Dental treatment, dentures as a separate module - Direct billing with hospitals through a 24 hour assistance line ## What is not covered - Pre existing conditions not declared on the application - Maternity and dentures during waiting periods - Treatment in the USA if the area of cover excludes it - A right to return to German health or long term care insurance - Sick pay and long term care benefits unless insured separately - War and stays in countries excluded from cover ## Who needs it - Anyone giving up their residence in Germany to live abroad - Retirees spending their retirement abroad for good - Freelancers and digital nomads without a German residence - Families moving abroad with children for several years - Anyone who needs proof of cover for a residence permit ## Who does not need it - Holidaymakers living in Germany, for whom travel medical insurance is enough - Employees covered by social security in their EU country who do not want benefits above that level ## What it costs An expat plan is full health insurance, so it costs many times more than travel cover. Age and whether the USA is included drive the premium most. **What drives the premium:** - Age at entry - Country of residence and area of cover, with or without the USA and Canada - Plan level, inpatient only or inpatient and outpatient - Annual deductible - Pre existing conditions and loadings - Dental and maternity modules _We do not quote ranges because country, age and deductible move the premium more than in any other private line. Your premium is fixed in the quote._ ## The policy levels on the market - **Hospital and emergencies:** Inpatient care and emergencies, you pay doctor visits yourself. Low premium, for young and healthy people with savings. - **Inpatient and outpatient:** Full cover for doctors, hospital and medicines, usually with a choice of deductible. The standard expat plan. - **Comprehensive:** Adds check ups, dental, maternity and treatment in Germany. For families and older people who want everything in one plan. ## How to recognise a good policy | Criterion | Minimum standard | Strong policy | Why it matters | | --- | --- | --- | --- | | Area of cover | country of residence and Europe | worldwide, USA as an option | Treatment in the USA is only covered if you included it beforehand. | | Term | limited to a few years | open ended, insurer cannot cancel | A plan that ends at 65 leaves you uninsured when you need it most. | | Pre existing conditions | excluded | insurable with a loading | An exclusion for high blood pressure often hits exactly the most expensive consequences. | | Treatment in Germany | emergencies during visits only | planned treatment as well, for a limited time | Many people prefer larger operations at home. | | Maternity | not covered | covered after a waiting period | A birth abroad can cost more than a year's premium. | | Deductible | high annual deductible | your choice, including none | A deductible lowers the premium but must be affordable in a bad year. | | Proof for authorities | standard confirmation | certificate matching the destination's rules | Without the right certificate there is no residence permit. | ## Insurers on the German market Many expat specialists are based outside Germany, such as Allianz Care in Ireland or Cigna in Belgium, and some plans are group contracts run by intermediaries like BDAE. German health insurers mainly offer long stay plans with a maximum term. The list shows companies authorised in Germany and is a market overview. - **Hallesche**: long term international health insurance with a maximum term - **HanseMerkur**: long term international health insurance for several years - **ERGO Reiseversicherung**: long stay plans for stays without moving your habitual residence - **Barmenia**: risk carrier behind international plans of the underwriting agency Care Concept - **ottonova**: plan for expats moving to Germany, not for people leaving 80 insurers supervised by BaFin, the German regulator, are licensed for this class of insurance. (Krankenversicherer, Krankheit, Kostenversicherung). Source: BaFin company database, 2026-09-18; EU insurers without a German office excluded. ## Typical claims and who pays - **Heart catheter in Miami** (easily five figures): Plans without the USA pay at most for emergencies on trips there. With the USA included, treatment is covered in full. - **Giving birth in Lisbon** (several thousand euros): Basic plans exclude maternity. Comprehensive plans pay for the birth once the waiting period is over. - **Insulin for known diabetes** (every month): Undeclared, nothing is paid. Declared, the condition is often covered with a loading, sometimes excluded. - **Hip surgery back in Germany** (five figures): Some plans pay only emergencies in Germany. Strong plans also cover planned surgery back home. - **Broken crown in Bangkok** (a few hundred euros): Almost all plans pay pain relief. Dentures need a separate module with waiting periods. - **Back at 58, fund says no** (full private premiums instead): No expat plan reopens German statutory insurance. Only a dormant membership taken out before you leave can do that. ## Myth or truth - „My travel medical insurance keeps working after I move abroad." ✘ False. Most policies require a German residence and limit each trip. Once you move, you are no longer travelling. - „With a small Anwartschaft I can return to my German private plan without a new health check." ✔ True. It locks in your health status from the day you sign. Only the large version keeps building ageing reserves. - „An Anwartschaft also pays my doctor's bills abroad." ✘ False. It is dormant and only secures your way back. You need separate health insurance while abroad. - „Returning to Germany after 55 can mean no way back into statutory insurance." ✔ True. Section 6 (3a) SGB V can exclude compulsory cover from 55 if you had no statutory cover in the previous five years. A dormant membership helps. - „Travel insurance is enough for Spain's non lucrative residence visa." ✘ False. Spain requires private health insurance from an insurer authorised in Spain, with no co payments and no waiting periods. ## Common mistakes - Moving abroad on travel insurance and finding out in hospital that it no longer applies - Cancelling German private health insurance instead of converting it into an Anwartschaft - Returning after 55 without a plan and finding the statutory fund closed - Leaving pre existing conditions off the application and losing cover when it counts - Choosing a plan whose certificate the destination's authorities do not accept - Forgetting to include the USA although family or work is there ## FAQ ### What is the difference between travel medical and expat insurance? Travel medical insurance tops up German health insurance for trips of limited length and usually requires a German residence. Expat insurance replaces it when you live abroad. ### Does my German statutory health insurance end when I move abroad? For a permanent move outside the EU and EEA, usually yes. Inside the EU you are normally insured in your new country if you work there. Get written confirmation from your fund before deregistering. ### Can I get back into German statutory health insurance? If your last cover was statutory, you become compulsorily insured again on return if you have no other cover. From age 55, section 6 (3a) SGB V can prevent this. A dormant membership with the fund keeps the door open. ### What is an Anwartschaft in German private health insurance? A dormant policy at a reduced premium. The small version locks in your health status, the large one also keeps your ageing reserves growing. It pays nothing abroad. ### Do I need private health insurance to live in Spain? For the non lucrative residence visa and the digital nomad visa, yes: private, from an insurer authorised in Spain, with no co payments and no waiting periods. If you work there under social security, the public system covers you. ### Can I get expat insurance with a pre existing condition? Often yes, with a loading or with that condition excluded. Declare everything on the application, otherwise the insurer can withdraw from the contract when you claim. ### Am I covered when visiting Germany? It depends on the plan. Some pay only emergencies during visits, others also cover planned treatment for a limited time each year. ### When should I take out expat insurance? Before you move, while you are healthy, starting the day after your German cover ends. A gap of a few days is enough to leave you paying for treatment yourself. ## Legal basis and sources - [Insurance Contract Act (VVG, German)](https://www.gesetze-im-internet.de/vvg_2008/) - [BaFin company database (licensed insurers)](https://portal.mvp.bafin.de/database/InstInfo/) ## Request quotes We obtain quotes and come back with a comparison, free of charge. You can write in English. https://www.nammert.com/en/insurance-broker-expat-health-insurance.php#anfrage --- Your broker: Norman Nammert, trading as NAMMERT. Insurance broker licensed under section 34d(1) of the German Trade Regulation Act. Broker register no. D-C08Q-TOSD4-37. NAMMERT Assekuradeur GmbH is a separate company. It does not arrange your contract. NAMMERT Assekuradeur GmbH, Karl-Marx-Straße 4, 15711 Königs Wusterhausen, +49 3375 29 12 77, info@nammert.com. Wikidata: Q141141479.