Letter from your German health insurer — what now?

A letter from your German health insurer is usually less dramatic than one from Finanzamt or Jobcenter. But some require an answer, otherwise something important lapses. Here's an overview of what AOK, TK, Barmer & Co. send and what to watch out for.

What kind of letters does your insurer send?

The common ones:

• Mitgliedsbescheinigung (membership confirmation). Confirms you're insured. Usually sent automatically when you start, but you can request one anytime.
• Beitragsanpassung (contribution change). Your monthly contribution or additional fee (Zusatzbeitrag) changes (usually yearly on 1 January). Triggers a special termination right.
• Leistungsbescheid (benefit decision). Reply to an application you filed (e.g. sick pay, rehab, medical aids). Approved, denied, or partially granted.
• Request for documents. They need e.g. a sick note, income proof, marriage certificate — without it, benefits aren't paid.
• Optional tariff or bonus offer. Marketing — usually ignorable or worth taking depending on interest.
• Reminder. For voluntarily insured or self-employed — when the contribution wasn't paid.

What is typically worth checking

In every letter, check three things:

Contribution change — what to do?

If your insurer raises the Zusatzbeitrag, you will typically get a letter. Three options:

• Accept. Just do nothing. The new amount is debited automatically from date X.
• Use the special termination right. You can cancel within 2 months of the increase, even if you haven't completed the usual 18-month commitment. You can switch to a cheaper insurer.
• Cancel an optional tariff. If you have a Wahltarif (e.g. deductible) — you can often cancel that separately during the contribution change.

Compare Zusatzbeiträge at gkv-spitzenverband.de. A 0.5% difference at €3,000 gross/month means about €15 less per month — €180 a year.

How an objection typically works

Informal letter to your insurer:

Hiermit lege ich Widerspruch gegen den Bescheid vom [date], Mitgliedsnummer [...] ein. Begründung folgt.

Deadline: 1 month from delivery. By post, fax, or via your insurer's online portal (most have one). The detailed justification can follow in 2–4 weeks — e.g. with a doctor's statement or medical opinion.

If your insurer rejects the objection, the next step is the Sozialgericht (social court). Filing is free, a lawyer can be paid via legal aid.

When is switching insurers worth it?

German statutory health insurers are about 95% the same in benefits. The difference is mainly the Zusatzbeitrag (between 1.3% and 2.5% of gross income, depending on insurer) and some optional benefits (osteopathy, alternative medicine, travel health insurance).

Options to switch:

• After 12 months of membership, normal termination (2 months notice).
• After a contribution increase: 2 months special termination — even inside the 12-month commitment.
• On a job change: often an immediate switch is possible.