AOK NordWest
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FAQ

Here we answer your questions on the subject of changing health insurance companies and insurance with AOK NordWest.

 

AOK NordWest is a regional open health insurance fund for Westphalia-Lippe and Schleswig-Holstein.

Basic requirements:

  • you live in Westphalia-Lippe or Schleswig-Holstein or
  • your place of employment/institution of higher education is in Westphalia-Lippe or Schleswig-Holstein or
  • your spouse or civil partner is insured with AOK NordWest or
  • AOK NordWest was your last statutory health insurance fund.

 

In order to change your health insurance fund, it is sufficient if the member submits the membership application to AOK NordWest online, within 14 days of the start of:

  •     their employment or training
  •     their study programme
  •     their receipt of unemployment benefit I or II

If you are changing insurers from a current insurance plan, you must observe a changeover period. You can find out more about this in the answer to “What is the changeover period?”

A change of health insurance fund without a changeover period is possible in the event of a change of status or an insurance gap. You can find more information on this in the answer to “Can I also change my health insurance fund without a changeover period?”.

It is our pleasure to insure you.

Family members who are co-insured with a health insurance fund member and who would like to change health insurance funds together with that member do not have to declare their willingness to change. We will simply inform your previous health insurance fund that the family insurance there will be terminated.

 

The following applies to all persons with statutory health insurance: When you change health insurance funds from a current insurance plan, you are generally bound to your new health insurance fund 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 NordWest membership.

Example 1:

You have been insured with your previous health insurance fund for more than 12 months without interruption and declare your wish to change to AOK NordWest on 10 July. Your membership will therefore end on 30 September and you will be a member of the AOK NordWest from 1 October.

Example 2:

You have been insured with your previous insurance fund since 1 April of the previous year. Your membership can therefore at the earliest end on 31 March of the current year. To become a member of the AOK NordWest from 1 April, your membership declaration must be received by us by 31 January at the latest in order to comply with the notice period/changeover period.

Tip: Please also note the information on the special right of termination and the possibility of switching to AOK NordWest without compliance with a notice/changeover period.
Exception: If two memberships immediately follow each other, you have the right to directly choose a health insurance fund upon commencement of the new membership (provided there is no longer an 18-month commitment period in force).

Example 3:

You have been insured with your previous fund for more than 18 months without interruption and take up a new employment relationship on 1 May. In this case, you can become a member  of AOK NordWest as soon as 1 May.

Change of health insurance fund without notice period:

In certain cases, you do not have to terminate your previous insurance to switch to AOK. If two memberships follow seamlessly, you may change your health insurance fund without giving notice. For instance, this applies if you take up employment that is subject to compulsory insurance after becoming unemployed, without an insurance gap. However, the prerequisite for changing health insurance funds is that the prescribed 18-month commitment period with your previous health insurance fund has been fulfilled. Another possibility is if you are employed subject to compulsory insurance, switch to a new employer and thus to a new employment relationship subject to compulsory insurance. If an insurance gap of at least one calendar day thus emerges between the two insurance relationships, you can even choose a new health insurance fund without fulfilling the 18-month commitment period and without giving notice to your previous health insurance fund.

If you were last covered free of charge within the scope of family insurance, your membership application to AOK NordWest is sufficient. In this case, we need your membership application in good time before you end your family insurance, i.e. for example before you take up employment. Further notice of termination is not necessary.

Tip: Please also note the information provided on the special right of termination.

If your health insurance fund charges an additional contribution for the first time or increases the existing additional contribution, you have a special right of termination. In this case, the commitment period of 12 months shall not apply. The membership declaration must be received by AOK NordWest 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 fund since 1 April of the current year, and they inform you that they will be charging an additional contribution from 1 January of the next year. In this case, you can make use of your special right of termination, even though you have not yet been insured with this health insurance fund for 12 months. If you terminate your membership by 31 January at the latest, you can become a member of the AOK NordWest from 1 April.

By the way: Your health insurance fund must notify you about an additional contribution as well as your special right of termination at the latest one month before the first due date.

 

A change of health insurance fund without a notice/changeover period is possible in the event of a change of status or an insurance gap (interruption of membership of min. 1 day and max. 1 month).    

Examples of a change of status:

You switch from employer A to employer B

You switch from employer A to the Employment Agency (or vice versa).

You switch from employment or from receiving unemployment benefit to receiving a pension.

Example of an insurance gap:

Your employment A ends on 12 October and your employment B starts on 15 October.

If you have any further questions regarding other constellations, please contact us personally.

 

You choose a new health insurance fund within two weeks of becoming subject to compulsory insurance. Please inform your employer, the employment agency (if applicable) or another reporting body within the above-mentioned period about your declaration of membership.

 

If you have opted for an optional rate with your previous health insurance fund, you are bound to this fund for between 1 and 3 years (from the start of participation), depending on the type of rate. You can only change to AOK NordWest after the relevant commitment period has expired.

A change of status overrides the above-mentioned commitment period and allows you to switch to AOK NordWest immediately.

If your health insurance fund 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.

When you start studying, you can apply to be exempted from compulsory health insurance if you were not subject to compulsory insurance immediately before and can prove that you are otherwise entitled to insurance 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 set out in Section 8 of the 5th Volume of the German Social Code (SGB V). This exemption applies for the duration of your studies.

However, this decision should be well considered, 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.

The consequence of the exemption is that it will then not be possible to take out free family insurance with a statutory health insurance fund during your studies (e.g. via your spouse in the case of marriage).

As a rule, a student’s entitlement to benefit via their parents will end when they  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, a return to statutory insurance after graduation is only possible by means 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.

 

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 will be calculated based on your trainee salary.

Important: If you do not earn more than 325 euros gross per month, your employer will pay your contributions in full.

Of course you can. Within the scope of your online application for membership, we will ask you whether you have family members and if you would like to insure them as well. If your answer is “Yes”, we will send you the application for family insurance. Please complete the application form and return the signed original document to us by post.

With statutory health insurance, children can be covered by family insurance if the children meet the following criteria:

  • up to  the age of 18.
  • up to the age of  23, provided they are not in gainful employment.
  • up to the age of 25, if they are attending a school-based training, studying or doing an unpaid voluntary social year, voluntary ecological year (Youth Voluntary Service Act) or Federal Voluntary Service (Federal Voluntary Service Act).
  • beyond the age of 25, if they are attending a school-based training or studying. The additional prerequisite is that this school-based training or study programme was interrupted or postponed by voluntary military service or other statutory voluntary service. Family insurance is extended by a maximum of the period of service - i.e. a maximum of 12 months pursuant to the new law.
  • disabled children are included in family insurance for 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.

 

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 Germany.
  • if the spouse, civil partner or children are subject to compulsory or voluntarily insurance themselves, are 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 monthly income exceeding 470 euros. For persons employed on a marginal basis, the income limit is 450 euros 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 one spouse/civil partner is covered by statutory health insurance while the other spouse/civil partner related to the child is not covered by statutory health insurance,
  • their monthly salary exceeds 5,362.50 euros (gross), and
  • they regularly earn more than the legally insured spouse/civil partner.

Before the start of your membership, you will receive a welcome letter from AOK NordWest.

So that your employer or your reporting body (e.g. job centre, Federal Employment Office, institutions of higher education) is also notified about your switch to the AOK NordWest health insurance fund and so that these can in turn carry out the required registration process for you,  AOK will also send a membership certificate directly to these bodies. Nevertheless, we recommend that you, too, inform your employer or your registration office of your choice of health insurance fund.

If you were insured with your previous health insurance fund (e.g. self-employed, freelancer) on a voluntary basis, you must also send proof of your membership to your previous health insurance fund by the end of the notice period.

In the case of insured persons on parental leave, who receive parental allowance or child-raising benefits, and where there is no employer or other reporting body, AOK NordWest will send the membership certificate to the previous health insurance fund 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 your application date and the start of your AOK membership, e.g. due to a change of employer or unemployment, please inform us so that we can update your welcome letter, possibly you will be able to switch to AOK NordWest sooner. Please also notify us promptly, if your reporting body should change during this period. Your change to us can only take effect if we also inform the new reporting body 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 fund until you start your membership with us.

Our service team will be happy to help you. Simply contact us on the toll-free phone number 0800 265 5119 or send us an email to mitglied_werden@nw.aok.de.

Alternatively, you can arrange a consultation and we will enter your membership declaration together with one of our staff.

 

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, the social insurance agency will directly transmit the health and long-term care insurance contributions paid and/or reimbursements from optional rates and/or bonus programmes to the 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).

 

If you are a member of a private health insurance fund, you can switch to statutory health insurance when you take up a non-self-employed main job with a remuneration is below the compulsory insurance threshold. Privately insured employees under the age of 55 can apply to switch to a statutory health insurance fund if their income permanently falls below the compulsory insurance limit.

In principle, everyone is insured with the health insurance fund with which they were last insured. If you were last insured with a statutory health insurance fund before your stay abroad, you can again take out a membership with health insurance fund. If you were last insured with a private health insurance fund 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.

 

Your question was not answered here? Then simply contact us and we will be happy to help you personally.