Become a member that easy!

THANK YOU VERY MUCH FOR YOUR APPLICATION FOR MEMBERSHIP!

What's the next step?

Shortly you will receive a message from us. It also includes this template, which you can use to cancel your previous health insurance. If there are any open questions or ambiguities in your application, we will get back to you separately.

Personal information (*required fields)

Your preferred start date of insurance

Do you want to co-insure family members free of charge?

Please select your current profession:

Information on the employer/employment agency

How were you insured so far?

Personal information Edit

Salutation
Title
First Name
Surname
Street and house number
Postcode
Town
Birthday
Telephone number
Email

Your preferred start date of insurance Edit

Co-insure family members free of charge Edit

Please select your current profession: Edit

Information on the employer/employment agency Edit

Name
Street and house number
Post code
Town
Telephone number
company number
Start date of employment or receipt of benefits
Previous employment in Germany

Previous insurance Edit

Previous insurance type
Previous health insurance
Cancellation status

 

 

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