Student health insurance

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In the Federal Republic of Germany there is compulsory insurance for students . This means that in order to study at a state university ( technical college , university ), every student must be able to prove that they have insurance. The following text deals with the statutory health insurance for students (KVdS), which includes the scope of benefits of the statutory health insurance with comparatively low contributions.

Basics

In the following, the Social Security Code is abbreviated as SGB.

Legal bases

Up to the age of 25, students are regularly insured free of charge through their parents . After that you are compulsorily insured yourself. The prerequisite for this is that you are enrolled ( matriculated ) at a German university . Due to an EU regulation, this also applies to German students who are enrolled at corresponding universities in the European economic area. This applies up to the age of 30 at the latest. The limitation to 14 semesters no longer applies as of January 1, 2020. An extension beyond the age of 30 is only possible under certain conditions, for example because of a disability or bringing up children. Then either statutory voluntary health insurance or private health insurance must be taken out, unless there is an obligation to be insured due to another regulation (e.g. as an employee).

Insurance period

A doctoral degree does not extend the health insurance of the students because it is no longer part of the scientific education

  • Completion of the 30th year of life
    • in principle up to the age of 30
    • actual completion at the end of the semester
    • Extension events can delay the end
  • Extension options
    • Type of training
    • family reasons
    • personal reasons
    • Acquisition of the entry requirements in a training facility of the second educational path (possible to a limited extent, see Joint Circular 06B Title 1.1.2 Type of training)

If one of these reasons exists, an extension by the time taken is possible. Proof of family and personal reasons must be provided by means of suitable documents.

Registration procedure for students

  • Before enrolling at the university / college
    • Opting for health insurance or applying for exemption from student health insurance
    • The health insurance company issues the insurance certificate for submission to the university / college
    • The health insurance company issues the insurance certificate for the BAföG office
  • Enrollment at the university / college can take place
    • The student submits the certificate of enrollment to the health insurance company
    • the health insurance company now carries out the health insurance - the registration is carried out

The insurance remains in place until you are de-registered.

Priority and subordinate insurance

  • Priority insurance
    • Workers, salaried employees and those employed for their vocational training, Section 5 Paragraph 1 No. 1 SGB V
    • Beneficiary according to SGB III, § 5 Abs. 1 Nr. 2 SGB V (unemployment benefit)
    • Farmers, working family members, old age dividers, Section 5 (1) No. 3 SGB V
    • Artists and publicists, § 5 Abs. 1 Nr. 4 SGB V
    • Persons in youth welfare institutions, Section 5 Paragraph 1 No. 5 SGB V
    • Rehabilitants, § 5 Abs. 1 Nr. 6 SGB V
    • Disabled people, § 5 Abs. 1 Nr. 7 and 8 SGB V
    • Insurance claim abroad if this results in a claim to benefits in kind in Germany, Section 5 (1) No. 9 SGB V
    • Pensioners in the health insurance of pensioners (KVdR), § 5 Abs. 1 Nr. 11 and 12 SGB V
    • Family insurance , § 10 SGB V
    • Membership-preserving facts, § 192 SGB V

The insurance of the students, § 5 Abs. 1 Nr. 9 SGB V, has priority over the insurance of the interns, § 5 Abs. 1 Nr. 10 SGB V.

  • Subordinated insurance
    • Family insurance if the student's spouse or child is not insured, Section 5 (7) SGB V
    • voluntary insurance, § 9 SGB V
    • Pension applicants, § 189 SGB V
    • Insurance abroad if there is no entitlement to benefits in kind in Germany, Section 5 (1) No. 9 SGB V
    • Compulsory fall insurance (since April 1, 2007), Section 5 Paragraph 1 No. 13 SGB V

Exclusions

Students and interns are not subject to compulsory insurance if they are self-employed as a full-time job, Section 5 (5) SGB V, i.e. if self-employment is the focus of working life. This group of people should not have unrestricted access to the inexpensive insurance coverage provided by the statutory health insurance, but should instead consciously opt for one of the two systems through voluntary health insurance or private insurance.

Characteristics for a full-time self-employed activity can be:

  • the notification or approval of a trade
  • the employment of employees in the company (currently disputed)
  • the duration of the self-employed activity
  • the income from self-employment
  • Another exclusion is the exemption from insurance according to Section 6 (3) sentence 1 SGB V:
    • Annual earnings overrun
    • Civil servants, judges, regular soldiers, professional soldiers and other employees who are entitled to benefits, free medical care or free medical care
    • Clergymen who also have other claims
    • Teachers at private schools with civil servant-like claims
    • Pensioners with entitlement to subsidies
    • Persons who are protected in the event of illness under the EC sickness insurance system (EC officials and their family members)
    • Persons who have been exempted from compulsory health insurance upon application (Section 8 SGB V)

Early termination of a private insurance contract

Students and interns who are insured with a private health insurance company can prematurely terminate their insurance contract in accordance with Section 5, Paragraph 9, SGB V.

If the contract is terminated within three months (VVG, status 2009, §205 (2)) after the obligation to take out insurance, the contract will be terminated retrospectively. The insurance company has to reimburse the contributions. The occurrence of compulsory insurance must be reported to the insurance company by means of a certificate from the responsible health insurance company.

If the notification of compulsory insurance is neglected, the contract does not end until the end of the month in which the compulsory insurance was reported.

Exemption from compulsory insurance

Students and interns can be exempted from compulsory insurance in accordance with Section 8 Paragraph 1 No. 5 and Paragraph 2 SGB V. Proof of the existence of other coverage in the event of illness is required.

The exemption must be requested from the health insurance company within three months of the start of compulsory insurance. This option is only available until the end of the first three months of compulsory insurance as a student. Exemption from compulsory insurance is also possible after the end of family insurance. Family insurance is a priority insurance and pushes compulsory insurance into the background. Compulsory insurance only begins after the end of family insurance.

The application must be submitted to the health insurance company that would have been responsible if the insurance became mandatory. If the application deadline of three months is missed, the exemption is no longer possible for the duration of the study or internship. If the application is approved, the exemption is valid for the entire insurable period and is irrevocable.

In the summer of 2012, the KV-Spitzenverband found that the exemption did not continue to apply to further studies that had been started more than a month after completing the first degree.

membership

For statutory long-term care insurance, the rules of health insurance apply accordingly; the principle of “long-term care follows health insurance” applies.

Beginning of membership

At universities, the summer semester begins in April and the winter semester in October. At universities of applied sciences, the summer semester begins in March and the winter semester in September.

The student's compulsory insurance begins at the beginning of the semester. If you enroll after the beginning of the semester, the insurance begins on the day of enrollment (Section 186 (7) SGB V). For interns, compulsory insurance begins on the day they take up employment (Section 186 (8) SGB V).

Exception: If exclusions or priority insurance cease to exist, the compulsory insurance of students or interns begins on the day after the cessation.

End of membership

In the case of students, membership ends with de-registration (Section 190 (9) SGB V new version). The membership of students ends at the latest at the end of the semester during which the 30th year of life is reached, as long as there are no renewals according to § 5 Abs. 1 Nr. 9 and 190 Abs. 9 SGB V n. V. The legal opinion of the central associations of the health insurance companies presented in a circular dated March 21, 2006, which denies the application of Section 190 (9) SGB V in the event of termination of membership in the KVdS due to the subject semester or age limit being exceeded, was approved by the Social Court of Berlin rejected with judgment of January 17, 2013 (Az. S 72 KR 502/11). After the end of the KVdS insurance, you can temporarily choose insurance as an exam candidate for half a year, which is between the KVdS and the voluntary insurance in the contribution.

The membership of interns ends on the day they give up the activity (Section 190 (1) No. 10 SGB V).

Receipt of membership

Membership continues while receiving maternity allowance, child-raising allowance and parental leave (Section 192 (1) No. 2 SGB V). Membership is also retained when doing military or community service or voluntary service (Section 193 (2) SGB V).

Cash register

Students and interns have the right to choose according to Section 173 SGB V:

  • Local health insurance fund of the place of residence ( AOK )
  • any substitute fund whose responsibility, according to the statutes, extends to the place of residence of the insured person
  • the company or guild health insurance fund , if the articles of association so provide and the health insurance district includes the insured's place of residence
  • the Deutsche Rentenversicherung Knappschaft-Bahn-See
  • the health insurance company with which there was last a membership or insurance according to § 10 SGB V, the agricultural health insurance company, if such insurance last existed there
  • the health insurance company with which the spouse is insured

Students can also choose the local health insurance company or a substitute insurance company at the place where the university is based.

The interns can also choose the local, replacement, guild and company health insurance fund for the place of employment. The intern can also choose the company's guild and company health insurance fund.

Compulsory or exemption from insurance for interns

Internship is stipulated in study or examination regulations

Intern is enrolled at a university (interim intern) Freedom of insurance as an employee in all branches of social security. Compulsory insurance as a student. Entitlement to free family insurance exists only as long as the income limits applicable there are not exceeded.
The intern is not enrolled at a university (pre- or post-internship) - with wages Compulsory insurance as an employee. The regulations on exemption from insurance for marginal part-time employment do not apply.
The intern is not enrolled at a university (pre- or post-internship) - without pay Compulsory insurance as an intern in health and long-term care insurance. Compulsory insurance in the pension and unemployment insurance as employed for vocational training.

Internships are not stipulated in study or examination regulations

Intern is enrolled at a university (interim intern) Freedom of insurance as an employee in all branches of social security. The prerequisite is that the student is still considered a student according to his appearance (20-hour theory). There is no insurance if the income does not exceed a certain limit (see mini job ).
The intern is not enrolled at a university (pre- or post-internship) - with wages Compulsory insurance as an employee.

However, the regulations on exemption from insurance for marginal part-time employment apply (see mini job ).

The intern is not enrolled at a university (pre- or post-internship) - without pay No compulsory insurance as an employee or for vocational training possible.

No compulsory insurance as an intern in health and long-term care insurance is possible.

Calculation of contributions for students

The contribution amount for students is determined by multiplying the income base and contribution rate.

  • The income base is a fixed amount that is independent of the student's actual income. He is directed according to Section 236 (1) of the Social Code Book V in conjunction with Section 13 (1), no.2 and (2) BAföG according to the requirement rate for students who no longer live with their parents.
  • The contribution rate is the sum of the contribution rate for students and interns, the additional contribution rate and the contribution rate for long-term care insurance:
    • The contribution rate for students and interns is 70% of the general contribution rate for statutory health insurance of 14.6% (Section 245 Paragraph 1 in conjunction with Section 241 SGB V). It is the same for all health insurance companies and is 10.22%.
    • The additional contribution rate is determined by each health insurance company (Section 242 (1) SGB V). It is also payable in full by students.
    • The contribution rate for long-term care insurance is 2.55%; a surcharge of 0.25% is levied for childless students aged 23 and over.
Valid from Income base KV PV Childless PV supplement Sums (KV / PV with surcharge) BAföG grant (KV / PV)
08/01/2019 € 744.00 10.22% 3.05% 0.25% 76.04 € / 24.55 € 84.00 € / 25.00 €
01/01/2017 € 649.00 10.22% 2.55% 0.25% € 66.33 / € 18.17 71.00 € / 15.00 €
09/01/2016 / 10/01/2016 € 649.00 10.22% 2.35% 0.25% € 66.33 / € 16.87 71.00 € / 15.00 €
01/01/2015 € 597.00 10.22% 2.35% 0.25% € 61.01 / € 15.52 € 62.00 / € 11.00
01/01/2013 € 597.00 10.85% 2.05% 0.25% € 64.77 / € 13.73 € 62.00 / € 11.00
03/01/2011 / 04/01/2011 € 597.00 10.85% 1.95% 0.25% € 64.77 / € 13.13 € 62.00 / € 11.00
01/01/2011 € 512.00 10.85% 1.95% 0.25% € 55.55 / € 11.26 € 62.00 / € 11.00
10/01/2010 € 512.00 10.43% 1.95% 0.25% € 53.40 / € 11.26 € 62.00 / € 11.00
07/01/2009 € 512.00 10.43% 1.95% 0.25% € 53.40 / € 11.26 € 50.00 / € 9.00
01/01/2009 € 512.00 10.85% 1.95% 0.25% € 55.55 / € 11.26 € 50.00 / € 9.00
10/01/2008 € 512.00 10.7% 1.95% 0.25% € 54.78 / € 11.26 € 50.00 / € 9.00
07/01/2008 € 466.00 10.6% 1.95% 0.25% € 49.40 / € 10.25 € 47.00 / € 8.00
10/01/2007 € 466.00 10.6% 1.7% 0.25% € 49.40 / € 9.09 € 47.00 / € 8.00
10/01/2005 € 466.00 10.2% 1.7% 0.25% € 47.53 / € 9.09 € 47.00 / € 8.00
07/01/2005 € 466.00 10.3% 1.7% 0.25% € 48.00 / € 9.09 € 47.00 / € 8.00
01/01/2005 € 466.00 10.0% 1.7% 0.25% € 46.60 / € 9.09 € 47.00 / € 8.00
  • In addition, according to Section 236 (2) of the Social Code Book V, contributions on the pension comparable income (pension payments) as well as income earned in addition to the pension or pension payments are due. However, only if they exceed the above-mentioned contribution rates for students.

Calculation of contributions for interns

Pre- and post-interns with wages

If the wage is less than one seventh of the total income , the employer pays the contributions alone. In addition, contributions are generally to be paid equally.

Parity payment:

  • general contribution rate of the health insurance
  • care insurance

No equal contribution payment:

  • Additional contribution for childless people to long-term care insurance (since January 1, 2005)
  • Special contribution (since July 1, 2005)

Pre- and post-interns without pay

For contributions to health and long-term care insurance, see also contribution calculation for students . The employer has to bear the contributions for the pension and unemployment insurance alone (§ 162 No. 1 SGB VI and § 342 SGB III).

Web links

Individual evidence

  1. ↑ https://www.haufe.de/personal/entgelt/meldeverfahren-zur-krankenversicherung-der-studenten_78_423308.html MDK reform law
  2. ^ Judgment of the Federal Social Court of March 23, 1993 - 12 RK 45/92 - USK 9318
  3. ↑ landesrecht.hamburg.de
  4. ↑ Record of the results of the meeting of the specialist conference contributions on June 27, 2012 in Berlin. GKV-Sitzenverband, accessed on August 1, 2019 .
  5. ↑ KV exemption does not apply to other courses. In: www.focus.de. August 7, 2012, accessed August 1, 2019 .
  6. ↑ Health and long-term care insurance for students, interns without pay, those employed in vocational training without pay and trainees in second education. (PDF) (No longer available online.) Central health insurance associations, archived from the original on August 10, 2014 ; accessed on September 27, 2016 . Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / www.vdek.com
  7. ↑ SG Berlin · Judgment of January 17, 2013, Az.S 72 KR 502/11. Retrieved September 27, 2016 .
  8. ↑ In general, this premium is due for all insured persons born from January 1, 1940, who have reached the age of 23 and are childless.
  9. ↑ Maximum monthly allowance according to §§ 13a Abs. 1 Nr. 2 and Abs. 2 Nr. 2 BAföG.
  10. ^ Announcement of the BMG of February 20, 2008
  11. ^ Announcement of the BMG of February 28, 2007
  12. ^ Announcement of the BMG of March 16, 2005