AOK PLUS

FAQ around the membership process

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

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1. What requirements do I have to fulfil to change to AOK PLUS?
AOK PLUS is a regional open health insurance provider for Saxony and Thuringia.

Basic requirements:

You live in Saxony and Thuringia or

You work or study in Saxony or Thuringia or

Your spouse or civil partner (according to the Registered Civil Partnership Act (LPartG) is insured with AOK PLUS or

AOK PLUS was your last statutory health insurance provider
2. How do I switch from my previous health insurance provider to AOK PLUS?
In order to change your health insurance provider, it is sufficient to create the membership declaration for AOK PLUS online within 14 days of the start of

employment or training

studies

receipt of Unemployment Benefit or Bürgergeld. We will then inform your previous health insurance provider that your membership or family insurance there will be terminated. 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. You can find the questionnaire for admission to the family insurance scheme here.
4. What is the changeover period?
The following applies to all persons with statutory health insurance: If you change health insurance providers from a current insurance plan, you are generally bound to this health insurance provider 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 PLUS 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 PLUS on 10 July. Your membership will therefore end on 30 September and from 1 October, you will then be an AOK PLUS 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 PLUS from 1 April, we must receive your declaration by 31 January at the latest, in order to comply with the notice period/switching period.As to when a change without a change period is possible, this is described in question 6.
5. Does a special right of termination apply to my case?
If your health insurance provider charges an additional contribution for the first time or increases the existing additional contribution, you have a special right of termination. The commitment period of 12 months then does not apply. The declaration must be received by AOK PLUS 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 provider since 1 April of this year, which informs you that it will levy an additional contribution from 1 January of the following year. Here, you can make use of your special right of termination, even though you have not yet been insured with this health insurance provider for 12 months. If you terminate your membership by 31 January at the latest, you can become an AOK PLUS member from 1 April.
6. Is it possible to change health insurance companies without giving notice?
Under certain conditions, it is also possible to switch to AOK PLUS immediately. An immediate right to choose a health insurance provider means that a person entitled to choose may select a new health insurance provider without notice and without regard to the duration of membership with the previous health insurance provider.

Case 1:

Membership of a statutory health insurance provider is interrupted for at least one day (a so-called “gap case”).

Example of a “gap case”:

Employment subject to compulsory insurance is pursued until 15.10. of the calendar year. A new employment relationship subject to compulsory insurance begins on 17.10. of the calendar year. For 16.10. of the calendar year, there is family insurance via the spouse. With your new employment subject to compulsory insurance on 17.10., you can immediately become a member of AOK PLUS. You must have submitted your declaration to us within 14 days after 17.10.

Case 2:

Your existing insurance ends by law and a new insurable event follows immediately thereafter.

Example of the immediate right to choose:

An employee terminates his employment subject to compulsory insurance on 15.10. of the calendar year. On 16.10. of the calendar year, he starts a new employment relationship subject to compulsory insurance. He has an immediate right to choose his health insurance provider. All commitment periods, including from existing elective tariffs, will cease to apply. You must have submitted your declaration to AOK PLUS within 14 days after 16.10. An immediate right to choose a health insurance provider is also possible if a voluntary insurance policy ends as per the law and is immediately followed by a new membership. And so it does not depend on a person’s insurance status. It is only the end of membership as per the law that is decisive.
7. How does the immediate change of health insurance work?
You choose a new health insurance provider within two weeks of becoming compulsorily insured by completing a declaration with AOK PLUS. It is no longer necessary to terminate the contract with the previous insurance provider. You must immediately submit the certificate of membership with AOK PLUS to the office obligated to notify you, e.g. your employer.
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 provider, you are bound to this provider for between 1 and 3 years (from the start of participation), depending on the type of rate. You can only switch to AOK PLUS after the respective commitment period has expired.A change of status (e.g. change of employer, start of studies, receipt of unemployment benefit or pension) suspends the above-mentioned commitment period and enables an immediate change to AOK PLUS. If your health insurance provider 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 by non-contributory family insurance until you reach the age of 25, unless you are already subject to compulsory insurance yourself by exceeding the defined income limit. After your family insurance ends, you can freely choose your health insurance within the first 14 days and switch to AOK PLUS. 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 or existing family insurance can be extended, for example, through voluntary military service or federal voluntary service. Feel free to enquire.
10. Is health insurance compulsory for students?
At the beginning of your studies, you can apply to be exempted from compulsory health insurance if you were not compulsorily insured immediately before, and can prove that you are otherwise entitled to 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 laid down in Section 8 of the German Social Code (SGB V). This exemption applies for the duration of your studies. However, this decision should be considered carefully, as it entails some disadvantages:

The exemption cannot be revoked for the entire duration of the studies, unless the studies are interrupted, in order to take up new studies at a later point in time.

The exemption bears the consequence that there is no possibility of free family insurance with statutory health insurance during your studies (e.g. via the spouse in the case of marriage).

For students, the entitlement to support via your parents usually ends when you 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, returning to statutory insurance after graduation is only possible in the form 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 is calculated according to your vocational trainee salary.

Important: If you do not earn more than €325 gross per month, your employer will pay your contributions in full.
12. Can I also insure family members with AOK PLUS?
Of course you can. At the end of your online application for membership, we will ask you if you have any family members you would like to insure. If your answer is “Yes”, we will send you the application for family insurance. Please complete this and return the original document to us by post using the enclosed postage-paid envelope. Do not forget to sign the application.You can also find further information on family insurance under the “Family insurance” section of AOK PLUS – Die Gesundheitskasse
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 person’s 18th birthday, the income of the beneficiary does not exceed the above-mentioned limits.

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

Up to the person’s 25th birthday, if they are in school or vocational training, are studying or are doing a voluntary social year, a voluntary ecological year or are part of the Federal Volunteer Service. If a course of study is completed at a state or state-recognised higher education institution, the insurance cover continues until the end of the semester, and no later than until they reach the age of 25.

are beyond the age of 25, if you are in school education or studying. An additional prerequisite is that this vocational training or study was interrupted or delayed by voluntary military service, voluntary service under the Federal or Youth Voluntary Service Act, comparable recognised voluntary service or work as a development worker. Family insurance is extended by the period of service – for a maximum of 12 months.

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, civil partner or children do not have their domicile or habitual residence in the country

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 €535 per month. For persons employed on a marginal basis, the income limit is €556 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 for children is excluded – if the spouse/life partner of the parent with statutory health insurance is related to the child and is not insured under the statutory health insurance scheme,

his or her salary regularly exceeds €6,150 (gross) per month and

at the same time, he or she regularly earns more than the spouse/registered life partner with 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 PLUS before you start your membership.You will inform your employer about your choice of AOK PLUS. Your employer then registers you with AOK PLUS and receives confirmation from here.If you were voluntarily insured with your previous health insurance provider (e.g. self-employed, freelancer), AOK PLUS will inform your previous health insurance provider via the electronic registration procedure. In the case of insured persons on parental leave, receiving parental allowance or child-raising benefit, for whom there is no employer or other body obliged to report, an electronic report is generated by AOK PLUS and sent to the previous health insurance provider 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 PLUS, 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 PLUS earlier.

Please also notify us promptly, if your reporting body should change during this period. Your switch to us can only come about if you inform us 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 provider 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. You can reach us on the free phone number
0800 105 900 0 or send us an email to online.me@plus.aok.de.
Alternatively, you can arrange a consultation 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) is intended to relieve the burden on citizens by increasing the tax deductibility of health and long-term care insurance contributions. For this purpose, it was determined that the social insurance body transmits the health and long-term care insurance contributions paid and/or reimbursements from optional tariffs and/or bonus programmes directly to the following authority: 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 provider, you can switch to statutory health insurance when you take up a non-self-employed primary job with a remuneration that is below the compulsory insurance threshold. Privately insured employees under the age of 55 can apply to switch to a statutory health insurance provider if their income permanently falls below the compulsory insurance threshold.
20. How is insurance provided after returning from abroad?
In principle, everyone is insured with the health insurance provider with which they were last insured. If you were last insured with a statutory health insurance provider before your stay abroad, you can again take out a membership with health insurance provider. If you were last insured with a private health insurance provider 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.