Private health insurance and leaving Germany: what happens to your cover

When you leave Germany, public health insurance usually ends with your move. A German private policy continues if you move within the EU/EEA (§ 207 (3) VVG); if you move anywhere else, it usually ends unless you agree otherwise, and a temporary move can be bridged with a dormant policy (Anwartschaft) for about 5 to 10% of the premium (Allianz). Your ageing reserves can't be taken abroad (as of October 2026).

What happens to your health insurance when you leave Germany

Two things decide: which system you are in, and whether you move within the EU/EEA or elsewhere. The EU/EEA means the 27 EU countries plus Iceland, Liechtenstein and Norway. Switzerland and the UK are not covered by the EU/EEA rule in the private model terms – for private insurance they count as “elsewhere”.

“Moving” here means moving your habitual residence (gewöhnlicher Aufenthalt). A holiday or a short secondment without giving up your home in Germany is something else – then your policy and your tariff's travel cover apply.

Leaving Germany with private health insurance: a move within the EU/EEA

If you move to Spain, the Netherlands or another EU/EEA country, your German private policy simply continues. The insurer pays at most what it would pay for treatment in Germany (§ 207 (3) VVG). Whether that is a good idea depends on your new country:

• If you will work there as an employee, you will usually be insured in that country's system by law. Your German policy would then be a second, expensive cover – a dormant policy or a cancellation makes more sense.
• If you stay self-employed or retire there, keeping your German policy can be an option. Check whether doctors there accept reimbursement and how bills in a foreign currency are handled.
• If you want to cancel, the normal rules apply: at the end of an insurance year with three months' notice, and not before an agreed minimum term of up to two years (§ 13 MB/KK 2009, § 205 VVG).

Leaving Germany with private health insurance: Switzerland, the UK, the USA and elsewhere

Under the model terms the policy ends when you move your habitual residence to a country outside the EU/EEA – “unless it is continued on the basis of another agreement”, for which the insurer may charge an appropriate surcharge. For a merely temporary move you can demand that the policy is converted into a dormant policy (§ 15 (3) MB/KK 2009). Your own tariff may be more generous, for example with an international option.

The dormant policy (Anwartschaft): small or large?

A dormant policy (Anwartschaftsversicherung) pauses your cover while you are away and secures your rights for a return. You don't get benefits during that time.

When it is worth it: if a return to Germany is realistic and you would want to be privately insured again. The small version protects you against the biggest risk – new health questions after years abroad, with a possible surcharge, exclusion or rejection. The large version also keeps your entry age, which matters more the older you are. Insurers often expect you to reactivate within about two months of your return (Allianz). Dormant policies in general are explained in depth at KV-Statuswechsel.de (in German).

Ageing reserves and notice periods: what you can't take with you

Private premiums include a savings part, the ageing reserves (Alterungsrückstellungen), which are meant to keep premiums stable as you get older. They belong to the collective of insured people, not to you personally:

• They are only transferred if you switch to another German private insurer at the same time – and only the part that matches the basic tariff (§ 204 VVG).
• If you cancel because you emigrate, nothing is paid out or transferred abroad.
• A large dormant policy keeps building them; a small one doesn't.

That is why private insurance is a poor fit for short stays: you pay for reserves you may never use. More in private health insurance for short stays.

Leaving Germany with public health insurance

Public insurance is tied to your residence or job in Germany. When you move away for good, membership usually ends. What to do:

A dormant public membership exists, but only for certain groups – TK, for example, names staff of international organisations and development workers. Ask your fund whether you qualify.

Watch the days around the move: your German cover may end on your moving date, while your new insurance may only start with your first job or after registration abroad. A short-term travel policy can bridge that gap – check that it covers the destination and the exact dates. If you move within the EU/EEA, ask your new country's insurer which documents from Germany it needs, so your periods are recognised without delay.

Coming back to Germany: which system takes you back?

Whether you return to public or private insurance usually depends on your last insurance – not on your wishes:

• Last publicly insured (in Germany, the EU/EEA, Switzerland or the UK): you usually return to public insurance. For citizens of non-EU countries the fall-back public insurance applies only with a residence permit of more than twelve months that doesn't require proof of secured livelihood (§ 5 (11) SGB V).
• Last privately insured: you must take out private insurance again (§ 193 (3) VVG) – at your then age and with new health questions, unless you kept a dormant policy. If you apply more than one month after the obligation arises, a one-off premium surcharge applies (§ 193 (4) VVG).
• A job below the threshold before 55 or family insurance can bring you back into public insurance even after private cover. From 55 this route is usually closed (§ 6 (3a) SGB V).

The full return logic: health insurance when returning to Germany; in German at PKV-Ausland.de: zuletzt privat versichert.

Leaving Germany for popular destinations

The rules above apply everywhere; what differs is your new country. Whether and how you are insured there is decided by that country – check its official sources before you move. If you keep living in Germany and only commute to work in Switzerland, see the guide for cross-border commuters (in German).

Your timeline: from the decision to the moving day

Special cases: posting, partner in Germany, digital nomads

• Posted by your German employer: for a posting limited in advance, German social security rules can continue to apply – within the EU for an expected duration of up to 24 months with form A1 (§ 4 SGB IV, Art. 12 Regulation (EC) 883/2004). Your employer and your fund clarify this.
• Partner and children stay in Germany: family insurance in public insurance requires the family members to live in Germany – if you leave and they stay, their cover has to be checked separately.
• Working remotely while keeping your German home: if your habitual residence stays in Germany, your policy continues; for longer stays outside Europe check your tariff's travel cover (model terms: the first month outside Europe).

Five mistakes people make when leaving Germany

• Deregistering first and asking the insurer afterwards – the cheapest options may be gone.
• Assuming the private policy pays worldwide – under the model terms it doesn't after a move outside the EU/EEA.
• Cancelling a private policy for a two-year assignment and facing new health questions on return.
• Paying for a German policy and a compulsory local insurance at the same time.
• Losing the paperwork: proofs of insurance periods and the dormant policy contract are needed years later.

Worked example: a three-year assignment abroad

Priya, 38, is privately insured in Germany with a premium of €600 a month. Her employer sends her to Singapore for three years; she plans to return. She has three options:

For Priya the small dormant policy is the obvious minimum: for about €30–60 a month she protects her health status. Whether the large version pays off depends on how much a three-year higher entry age would add to her premium – her insurer can calculate that before she leaves.

EU citizens and non-EU citizens: what differs

• EU/EEA and Swiss citizens benefit from the EU coordination rules: public insurance periods in one member state count in the others (Art. 6 Regulation (EC) 883/2004). A return to public insurance is usually straightforward if you were last publicly insured somewhere in the EU/EEA.
• Citizens of other countries are covered by the German fall-back public insurance only with a settlement permit or a residence permit of more than twelve months that doesn't require proof of secured livelihood (§ 5 (11) SGB V). Insurance periods in countries such as the USA or India are disregarded.
• Everyone: whether a residence permit is granted or renewed – and which insurance it requires – is decided by the immigration authorities, not by an insurer. This page is not immigration advice.

Coming back late: the premium surcharge in numbers

If you were last privately insured and return to Germany, you must take out private insurance within one month; otherwise a one-off surcharge applies (§ 193 (4) VVG): one monthly premium for each further month without insurance, and from the sixth month one sixth of a premium per month. The PKV association's example: 14 months without insurance cost 5.5 monthly premiums – with a premium of €600 that is €3,300. A reactivated dormant policy avoids this.

Plans still open? How to keep your options

Many newcomers simply don't know yet whether they will stay two years or twenty. That is normal – and it is a reason to choose in a way that keeps doors open:

• First job in Germany above the threshold? Public insurance stays open to you for three months after you start (§ 9 (1) no. 3 SGB V). If you are unsure, starting in public insurance keeps the most options.
• Going private anyway? Ask before you sign whether the tariff can continue outside the EU/EEA, what a dormant policy costs and whether there is a minimum term. Get the answers in writing.
• EU citizen? Keep proof of every public insurance period in other member states – form E 104 or S041 can open voluntary public insurance later.
• Family on the horizon? Remember that public insurance covers a spouse without income and children free of charge – a strong argument while your plans are open.

The 60-second decider treats “not sure yet” as an answer of its own and adjusts its recommendation accordingly.

Your exit plan – before you sign a private policy

If you are still deciding between public and private, ask these questions now, not when the moving boxes are packed:

• How likely is it that I leave within five years – and to which region?
• Does the tariff offer international cover or a continuation outside the EU/EEA?
• What would a small and a large dormant policy cost – in euros, in writing?
• Is there a minimum contract term, and what is the notice period?
• Would I want to come back – and would I then prefer public or private insurance?

The 60-second decider includes your planned stay and gives you an exit plan with your result. Comparing the numbers first? Use the public vs private cost calculator.

Next steps

• Your personal recommendation: leaving-Germany planner – cancel, pause or keep.
• Staying only a few years? Why private rarely pays off for short stays.
• All arguments: public vs private health insurance in Germany.
• German terms explained: glossary.

Frequently asked questions

This article provides general information on health insurance in Germany (as of 12 October 2026). It does not replace individual advice. Which solution suits you depends on your personal situation, e.g. age, health, income, family and length of stay. Despite careful review we cannot guarantee completeness and accuracy; laws and tariffs change. It is not immigration advice: whether your insurance is sufficient for a visa or residence permit is decided by the German mission abroad or your immigration office. Publisher: German-PKV.de. German-PKV.de is not an insurance broker and does not provide insurance, legal or tax advice; individual advice is provided exclusively by specialised cooperation partners licensed under § 34d GewO.