🩺 Health insurance without a fixed address
In brief
If you have no other cover, you are covered by statutory health insurance through the statutory fallback insurance (Auffangversicherung, § 5 Abs. 1 Nr. 13 SGB V) – regardless of whether you have a fixed home address. If you receive basic income support (Grundsicherungsgeld/Bürgergeld), you are usually already compulsorily insured through the Jobcenter anyway. For social assistance recipients without other cover, § 264 SGB V can additionally apply, under which the health insurance fund takes over treatment.
Step by step
- Check existing coverFind out whether you already have statutory health insurance, e.g. through receiving basic income support (Grundsicherungsgeld/Bürgergeld) (§ 5 Abs. 1 Nr. 2a SGB V).
- Claim the fallback insuranceIf that is not the case, the fallback insurance under § 5 Abs. 1 Nr. 13 SGB V applies by law with any health insurance fund – regardless of residence status.
- Apply for a contribution reductionFor outstanding contributions from the past, you can apply for a reduction under § 256a SGB V.
- Have § 264 SGB V checkedSocial assistance recipients without other insurance cover should have it checked whether the health insurance fund must take over treatment under § 264 SGB V.
- Act in case of acute symptomsIf you have acute symptoms and no proof of a card, inform the health insurance fund or Sozialamt; alternatively visit a street clinic.
Deadlines
- If you were not health-insured for years, you become liable for contributions retroactively on re-entry – since a transitional rule expired in 2013, there is no longer a full "amnesty", only a "reasonable reduction" at the fund's discretion.
- § 264 SGB V generally does not concern recipients of basic income support (Grundsicherungsgeld/Bürgergeld) (SGB II) – they are usually already compulsorily insured under § 5 Abs. 1 Nr. 2a SGB V anyway. It concerns mainly social assistance recipients (SGB XII) without other cover.
- In case of acute illness, do not rely on first clarifying your insurance status completely – emergency care is accessible regardless (see "Health care for homeless people").
In depth · legal basis, figures and practice – for advisers and professionals
The fallback insurance (§ 5 Abs. 1 Nr. 13 SGB V)
Since 2007, a general insurance obligation has in principle applied in Germany: anyone who has no other health insurance cover and was last covered by statutory health insurance (or has never had other cover) becomes a member of statutory health insurance by law. This fallback insurance is independent of having a fixed address.
Contribution debts (§ 256a SGB V)
Anyone who has not paid contributions for a longer period can face considerable contribution debts on re-entering the insurance. § 256a SGB V enables the health insurance fund to grant a reasonable reduction of these arrears. A temporary cut-off date rule that allowed a more extensive waiver in 2013 has since expired; since then, the reduction is at the discretion of the respective fund.
§ 264 SGB V: medical treatment for social assistance recipients
For recipients of benefits under SGB XII who are not otherwise health-insured, the competent health insurance fund takes over medical treatment under § 264 Abs. 2 SGB V; the costs are reimbursed by the social assistance provider. In practice, this provision mainly concerns people receiving social assistance without their own insurance cover, not the majority of SGB II recipients.
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