Can I still join public health insurance after 55?
If you're over the age of 55 and wondering whether it's still possible to join Germany’s public health insurance system (Gesetzliche Krankenversicherung, or GKV), the answer depends on your individual situation. In this article, we’ll walk you through two common scenarios: moving to Germany from abroad, and switching from private to public insurance while already living here.
1. Moving to Germany at 55 or older
If you're moving to Germany and are not currently insured here, your ability to access public health insurance depends on whether you’re coming to work as an employee or planning to be self-employed.
EMPLOYED
For those moving to take up employment with a German-based company, the rules are relatively straightforward. If you have not lived in Germany, the EU, or the EEA in the last five years, then your age will not prevent you from enrolling in the public health system. In this case, you are treated as a new entrant, and you can join GKV.
If, however, you did live in Germany or within the EU/EEA in the last five years, there are two conditions you must meet in order to access public health insurance:
You must have had at least one day of public health insurance coverage in those last five years, and
Your last insurance during that period must have been public, not private.
If these two criteria are met, you can still join GKV through your new job, even if you’re 55 or older.
SELF-EMPLOYED
For individuals coming to Germany to be self-employed, the requirements are actually no different with regards to age, so individuals aged 55 or over face the same general requirements. To be accepted for voluntary public health insurance, you must have been insured in a public system anywhere within the EU, EEA, Switzerland, or the UK for either:
the last 12 months continuously, or
at least 24 months combined within the last 5 years, and your public/state insurance did not end more than 3 months ago
If you don't meet these criteria, public insurance will generally not accept you — regardless of age — and you may need to consider private options.
2. Already in Germany and privately insured
If you're already living in Germany and have private health insurance, going back to public insurance after turning 55 is very difficult — and only allowed in special cases.
You can only switch back to public health insurance if you are employee in a German-based company, with salary under the private threshold (€73800/ gross a year) and you have been on public health insurance for at least half of the last 5 years.