An asterisk (*) denotes mandatory fields.

I would like to become a member as from

My dates of birth

My employer

Other status

My previous health insurer

Insured since

Membership terminated on

My photo for the health card (eGK)

Accepted filetypes: jpg, png.
Max. filesize: 8MB.

Social security number

Fill in your german Social security number here.
You’ll find it on your salary printout.
e.g: 50 010190 R 012


You can download the application for exempted children / partners on the page "Antrag herunterladen".

Other pt.2

You can download the application for your husband or partner on the page "Antrag herunterladen".

Privacy policy

To lawfully fulfill its duties, the health insurer needs to have all data specified above; these are collected in accordance with the provisions of the German social security code and stored on data carriers. Your data is subject to data protection and will be treated confidentially. Your application will be effective upon receipt by the health insurer. Termination is not possible before the end of the notice period.