Become a member online | AOK NordWest

1 Personal details
2 Further details
3 Insurance details
Check and send

This process step becomes active as soon as you have selected the "I would like to insure myself as ..." field.

Yes, I would like to become a member

Insure as... *

Desired start of insurance (please choose one option) *

Desired start of insurance (please choose one option) At the earliest possible date

Desired start of insurance (please choose one option) At the specified date

Start date of insurance cover

For further information, please refer to question 3 “What notice period must be observed?” under Questions and Answers

My data

Salutation *

Title

First name *

Last name *

Date of birth *

Due to legal requirements, only persons over the age of 15 are permitted to change health insurance companies.

Nationality *

Place of birth *

Country of birth *

I have my german pension insurance number at hand *

I have my german pension insurance number at hand Yes

I have my german pension insurance number at hand No

You will find your pension insurance number (Rentenversicherungsnummer) example "12 123456 M 123" on your social security card, salary statement or pension approval certificate.

German Pension insurance number *

Name at birth *

Address

Country *

Postcode *

City *

Street *

No. *

Additional address information

Address data not found?

You can now enter your address manually.

Contact

Telephone/mobile phone number

It is not mandatory to mention your telephone or mobile phone number. However, this information will help us reach you quickly in case of any queries.

Email address *

Your email address is required for authentication. Once we receive your application, an email with a confirmation link is sent to the address provided by you.

* Mandatory field

Details of study programme

Name of the university *

Start of semester *

Please indicate when the (current) semester for which you are enrolled starts.

I have recognised reasons for extending my study period

I have recognised reasons for extending my study period Yes

I have recognised reasons for extending my study period No

The statutory compulsory insurance of a student terminates at the end of the semester in which the student reaches the age of 30. In exceptional cases, it is possible to extend the compulsory insurance.

Reason for extension *

Please upload a corresponding proof in step 3 of this application.

Your university is automatically informed about your insurance through the automatic notification procedure.

Details of benefits due

I receive assistance under BAföG (The German Federal Training Assistance Act) or have applied for it *

I receive assistance under BAföG (The German Federal Training Assistance Act) or have applied for it Yes

I receive assistance under BAföG (The German Federal Training Assistance Act) or have applied for it No

I am exempt from compulsory health insurance *

I am exempt from compulsory health insurance Yes

I am exempt from compulsory health insurance No

Before beginning their studies, students who are insured by a private health insurance can request to be exempted from the statutory compulsory health insurance. This is valid for the entire period of study and cannot be revoked.

I am entitled to aid/medical care *

I am entitled to aid/medical care Yes

I am entitled to aid/medical care No

If you have entitlement to aid/medical care, we require appropriate proof of this.

I am studying abroad in Germany and have health insurance in another EU/EEA country. *

I am studying abroad in Germany and have health insurance in another EU/EEA country. Yes

I am studying abroad in Germany and have health insurance in another EU/EEA country. No

If you are studying in Germany temporarily and are a resident of a certain EU/EEA country, your foreign health insurance will continue to exist. However, the German legislation will apply as soon as you take up employment during your studies. We would be pleased to schedule a personal consultation to check the conditions under which a switch to statutory health insurance is possible.

Details of the student’s part-time job

I am employed or self-employed *

I am employed or self-employed Yes

I am employed or self-employed No

Type of employment *

Type of employment Part-time job/internship

Type of employment Self-employment

Amount of monthly income (€)

Weekly working time (h)

Employment from *

Employment expected up to

If the employment is not fixed-term, please indicate an expected end date for it. For example, the date of the regular end of the study programme.

Details of the employer

Are you starting a new job in germany? *

Are you starting a new job in germany? Yes

Are you starting a new job in germany? No

Name of your new employer at the time you start insurance with AOK:

Name of the employer *

From when? *

Country *

Postcode *

City *

Street *

No. *

Additional address information

Address data not found?

You can now enter your address manually.

company number *

Your employer's company number is 8 digits and you can find this number on your employer's social security statement or on your contribution statement.

Beschäftigungsbeginn_Betriebsnummer *

Is your place of work in Germany? *

Is your place of work in Germany? Yes

Is your place of work in Germany? No

I have another occupation *

I have another occupation Yes

I have another occupation No

If the remuneration of further employment is more than 450,00€ per month, please indicate Yes.

This training is my first employment in Germany *

This training is my first employment in Germany Yes

This training is my first employment in Germany No

Details of self-employment

Start of self-employment *

I am a shareholder/managing director *

I am a shareholder/managing director Yes

I am a shareholder/managing director No

If you are a shareholder or managing director, please send the AOK your shareholder agreement or proof of your managing director's salary as evidence.

I am an entrepreneur *

I am an entrepreneur Yes

I am an entrepreneur No

Details of income

Amount of annual income (€) *

To be able to insure you appropriately, we require information on the amount in euros of your annual income from self-employment/freelance work. You can find this information in your current notice of income tax assessment. Please send a copy of this notice to your AOK.

From the employment agency I receive *

From the employment agency I receive Start-up grant

From the employment agency I receive Start-up money

From the employment agency I receive No grants

Do you have any other income? *

Do you have any other income? Yes

Do you have any other income? No

I receive…(Multiple answers possible) *

Income from business operations

Income from rental and leasing

Rental and investment income (e.g. interest)

Additional one-off payments (e.g. Christmas bonus)

Remuneration/salary

Pay from marginal employment

other income

Other income

Note: If you have little or no income, please indicate how you support yourself (e.g., parental support, support from partner, etc.) under other income

Details of sickness benefit

I would like to insure myself with entitlement to sickness benefit from the 7th week *

I would like to insure myself with entitlement to sickness benefit from the 7th week Yes

I would like to insure myself with entitlement to sickness benefit from the 7th week No

As a self-employed person or freelancer, you pay a reduced contribution rate and are not entitled to sickness benefit. If you want to insure yourself against loss of income, you can choose the statutory sickness benefit starting from the 7th week and pay the general contribution rate. You can find more information on sickness benefit at www.aok.de.

I would like an optional sickness benefit tariff from the AOK. Please send me documents. *

I would like an optional sickness benefit tariff from the AOK. Please send me documents. Yes

I would like an optional sickness benefit tariff from the AOK. Please send me documents. No

If you choose a health insurance with entitlement to statutory sickness benefit, you can take out a sickness benefit optional tariff from AOK as an individual supplement. You can find information on optional tariffs at www.aok.de.

Further details

I receive a gross monthly income of over EUR 5.550 Euro *

I receive a gross monthly income of over EUR 5.550 Euro Yes

I receive a gross monthly income of over EUR 5.550 Euro No

If your monthly income is above EUR 5.550 (gross), we will insure you as a voluntary member. The gross amount of EUR 5.550 per month – EUR 66.600 Euro per year – is the statutory threshold for this. If you earn less than EUR 5.550 (gross) per month, you become a member covered by compulsory insurance.

I receive unemployment benefit (ALG) *

I receive unemployment benefit (ALG) Yes

I receive unemployment benefit (ALG) No

In the following, please enter the details that apply at the time you start insurance with AOK NORDWEST. You will find this information on your notice of approval.

Registered office of the service provider *

Name of the service provider *

Customer number *

Start of benefit receipt *

I receive Bürgergeld (unemployment benefit) *

I receive Bürgergeld (unemployment benefit) Yes

I receive Bürgergeld (unemployment benefit) No

In the following, please enter the details that apply at the time you start insurance with AOK NORDWEST. You will find this information on your notice of approval.

I also receive Bürgergeld (unemployment benefit) *

I also receive Bürgergeld (unemployment benefit) Yes

I also receive Bürgergeld (unemployment benefit) No

Please enter the details below that are applicable at the time you started your insurance with AOK NORDWEST. You will find this information on your notification of approval. (Arbeitslosengeld II)

Registered office of the service provider *

Name of the service provider *

Customer number

Start of benefit receipt *

I have applied for a statutory pension from the Deutsche Rentenversicherung (German Pension Insurance) but have not received an approval yet *

I have applied for a statutory pension from the Deutsche Rentenversicherung (German Pension Insurance) but have not received an approval yet Yes

I have applied for a statutory pension from the Deutsche Rentenversicherung (German Pension Insurance) but have not received an approval yet No

I receive a pension from the Deutsche Rentenversicherung *

I receive a pension from the Deutsche Rentenversicherung Yes

I receive a pension from the Deutsche Rentenversicherung No

Start of pension drawdown *

I receive pension payments from abroad *

I receive pension payments from abroad Yes

I receive pension payments from abroad No

I receive care allowance (e.g., company pension, pension – also abroad) *

I receive care allowance (e.g., company pension, pension – also abroad) Yes

I receive care allowance (e.g., company pension, pension – also abroad) No

Steueridentifikationsnummer

Ihre Steueridentifikationsnummer (Steuer-ID) finden Sie beispielsweise auf Ihrem letzten Steuerbescheid oder auf Ihrer letzten Lohnsteuerkarte. Die Steuer-ID (Beispiel: 12345678901) wird benötigt, damit die AOK die Daten über die von Ihnen geleisteten Beiträge zur Krankenversicherung direkt an das zuständige Finanzamt übermitteln kann. Krankenversicherungsbeiträge werden steuerbegünstigend angerechnet.

SEPA Mandate

The contributions are transferred by my employer *

The contributions are transferred by my employer Yes

The contributions are transferred by my employer No

The contributions are to be collected via direct debit *

The contributions are to be collected via direct debit Yes

The contributions are to be collected via direct debit No

If you would like to participate in direct debit, you will receive the SEPA Direct Debit Mandate form from AOK by post in the next few days. Alternatively, you can transfer your entire semester fee in advance to AOK itself. You will receive further details by post.

Tax identification number

You will find your tax identification number (tax ID) on your last notice of tax assessment or on your last income tax card, for instance. The tax ID (example: 12345678901) is required so that the details of the health insurance contributions you have paid can be directly transferred to the competent tax office by AOK. Health insurance contributions are tax-deductible.

Should the debit be made from your own account? *

Should the debit be made from your own account? Yes

Should the debit be made from your own account? No

We now need your account details

You can download the application for participation in the direct debit procedure (SEPA mandate) after completing this online application. Please sign it and send it to the AOK.

We now need the details of the account holder

You can download the application for participation in the direct debit procedure (SEPA mandate) after completing this online application. Please sign it and send it to the AOK.

First name *

Last name *

Country *

Postcode *

City *

Street *

No. *

Additional Adress Information

Address data not found?

You can now enter your address manually.

Name of the credit institution *

Valid from?

If you would like your health and nursing care insurance contributions to be debited at a later date than from the start of the insurance, please enter a date here.

IBAN *

BIC *

Details of the statutory nursing care insurance

I am the mother/father of one or more children *

I am the mother/father of one or more children Yes

I am the mother/father of one or more children No

We need to know whether you have children (even adopted or foster children) to be able to correctly calculate your contributions to nursing care insurance. As proof, we need a parental benefit certificate or birth certificate for instance.

* Mandatory field

Insurance details

I was insured for the last 12 months *

I was insured for the last 12 months insured

I was insured for the last 12 months Not insured

In the last five years, I have been a *

In the last five years, I have been a insured

In the last five years, I have been a not insured

Previous insurance *

Previous insurance Compulsorily insured (employed persons, trainees, pensioners, unemployed)

Previous insurance Voluntarily insured (self-employed, annual salary > 66.600 €)

Previous insurance Family insurance (as spouse or child)

Previous insurance No statutory health insurance (privately insured, abroad, no insurance)

Name of your current health insurance company *

Name of the health insurance company *

Reason for no statutory health insurance *

Country of Previous Residence *

Reason for switching from private to statutory insurance *

What was the reason for the change? *

Name of your last statutory health insurance fund in Germany *

This is my first job in Germany *

This is my first job in Germany Ja

This is my first job in Germany Nein

I am returning to Germany *

I am returning to Germany Ja

I am returning to Germany Nein

Versichertennummer *

Note: You will find your insurance number on your current electronic health card (chip card).

Details of family insurance

I have a partner or children who need family insurance *

I have a partner or children who need family insurance Yes

I have a partner or children who need family insurance No

If you have a partner or children who are to be insured as a family, the application for free family insurance will be sent to you separately.

Details of necessary certificates

I need a certificate for the BAföG office

File upload (optional)

You have the option of uploading the following documents directly. However, you are also welcome to send the documents by post to:

_x000D_ _x000D_

AOK NORDWEST
._x000D_ 58079 Hagen

Photo for the electronic health card

Approval notice ALG

Approval notice Bürgergeld

Identification document

Parental benefit certificate/birth certificate

Certificate of enrolment/admission

Proof of reason for extension

Proof of entitlement to aid/medical care

Rentenbescheid

Pension notice foreign pension

Notice for aid/medical care

Nachweis zur privaten Krankenversicherung

Nachweis des Auslandsaufenthalts bzw. der ausländischen Versicherung

Details of data protection

Data protection notice

Data is collected and processed for the fulfilment of our health insurance related tasks according to § 284 Para. 1 Sentence 1 No. 1 of SGB V and of our nursing care insurance related tasks according to § 94 Para. 1 No. 1 of SGB XI for the purpose of determining the health and nursing care insurance relationship according to § 5 of SGB V and § 20 of SGB XI. Your information is required according to § 206 of SGB V and § 50 Para. 3 of SGB XI. Your membership cannot be processed in the event of lack of cooperation. Third parties or service providers commissioned by us may be the recipients of your data within the scope of legal obligations and powers of notification. General information on data processing and your rights can be found at www.aok.de/nw/datenschutzrechte. If you have any questions, please contact AOK NORDWEST – Die Gesundheitskasse, Kopenhagener Str. 1, 44269 Dortmund, kontakt@nw.aok.de or our Data Protection Officer at datenschutz@nw.aok.de.

Declaration of the person wishing to switch

Consent to data retransmission

I commission the sales partner to arrange membership of AOK NORDWEST. I declare my consent to AOK NORDWEST transmitting to the sales partner for billing purposes my identification data and the information as to whether and, if applicable, from when my membership with AOK NORDWEST has come into effect. This consent is voluntary and I can revoke it within 14 days with my "distribution partner".

Yes, I agree.

Details of data use

Consent to data use

I consent to AOK NORDWEST processing and using my data in order to inform and advise me in the future about the services and products of AOK NORDWEST in a targeted manner by email, including within the scope of customer surveys. I can revoke this consent at any time with effect for the future - a call to the service number 0800 265 5000 is sufficient. You can only make this declaration of consent if you have reached the age of 15.

Yes, I agree.

Declaration of the Distributor

I confirm the accuracy of the personal details entered for the person wishing to switch. *

* Mandatory field

Thank you for switching to AOK NORDWEST!

Please check whether you meet at least one of the requirements for switching to AOK NORDWEST.

You live in Westphalia-Lippe or Schleswig-Holstein
You work or study in Westphalia-Lippe or Schleswig-Holstein
Your spouse or life partner (according to the Act on Registered Life Partnerships – LPartG) is insured with AOK NORDWEST
AOK NORDWEST was your last statutory health insurance company

No, none of the above