Antrag gesetzliche Krankenkasse - deine-krankenkasse.de

Desired health insurance provider

Current health insurance

Press on you -no prior insurance- if you are coming from abroad.

Salutation

Woman
Mister

Name

First

Last

Straße Familienmitglieder Geburtsort

Maiden name

Email address

Date of birth

Telephone

Street

House number

Zip code

Place of birth

Country of birth

Nationality

Join Date (Read Note!)

If you start a new job, you can specify the start date of your new employment. Otherwise, the statutory notice period of two full calendar months applies. Example: If the application is made in July, a health insurance change is possible at the earliest on 10/01/20XX.

Do you have children?

No
Yes

Do you want to insure family members as well?

No
Yes

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