Letter from your Krankenkasse: what health insurance letters mean

Who writes to you?

Most people in Germany are insured with a statutory health insurer (gesetzliche Krankenkasse). The Krankenkasse pays for doctors, hospital and many medicines, and it collects contributions (Beiträge). If you are employed, your employer usually pays the contributions together with your salary; if you are self-employed, a student, voluntarily insured or have no income, you may pay yourself.

Every letter contains your insurance number (Krankenversichertennummer or Versichertennummer). Quote it whenever you reply.

Common types of letters

• Fragebogen zur Familienversicherung: a questionnaire to check whether family members (spouse, children) can stay insured free of charge. The insurer asks about their income.
• Request for a photo (Lichtbild) for your electronic health card (elektronische Gesundheitskarte, eGK).
• Mitgliedsbescheinigung: a membership certificate — for example for your employer, university or the Ausländerbehörde.
• Beitragsbescheid: a decision about the contributions you pay yourself, often based on your income. You may be asked to send proof of income (Einkommensnachweis), such as a tax assessment.
• Information about a higher Zusatzbeitrag (additional contribution). When your insurer raises it, you generally have a special right to switch to another insurer (Sonderkündigungsrecht) — the letter must tell you about this.
• Beitragsrückstand / Mahnung: you owe contributions. Arrears can lead to surcharges and, in some cases, limited benefits until you pay.
• Letters about sick pay (Krankengeld) if you have been unable to work for a long period.
• Information about the electronic patient record (elektronische Patientenakte, ePA). You can object (widersprechen) if you do not want one.

Deadlines and decisions

Questionnaires and requests usually give a date by which you should reply. If you need more time, ask for it before the date. A Bescheid (decision) — for example about contributions or sick pay — comes with a Rechtsbehelfsbelehrung. As a general rule, you can file a Widerspruch within one month after you received it. Check your letter for the exact deadline.

If you have contribution arrears

Do not wait. Contact your Krankenkasse, explain your situation and ask for instalments (Ratenzahlung) or a deferral (Stundung). If your income has dropped, send proof — your contribution may be recalculated. Debt counselling services can help if you have several debts.

Key German words

What to do

1. Find out what the letter asks forInformation, a document, a photo, a payment — and by which date.
2. Collect the documentsFor example payslips, a tax assessment, a student certificate or a photo.
3. Reply on timeUse the insurer's online portal or app, or reply by post with your insurance number. Keep copies.
4. Ask for more time if neededWrite before the deadline and say when you can send the documents.
5. Check decisionsIf you disagree with a Bescheid, file a Widerspruch within the period stated in the letter.

Useful German phrases

• Meine Versichertennummer lautet …My insurance number is …
• Anbei sende ich Ihnen den ausgefüllten Fragebogen.Please find enclosed the completed questionnaire.
• Ich benötige eine Mitgliedsbescheinigung.I need a membership certificate.
• Bitte gewähren Sie mir eine Fristverlängerung bis zum …Please grant me an extension until …
• Ich bitte um Ratenzahlung für den Beitragsrückstand.I request instalments for the contribution arrears.

Where to get free or low-cost help

• Unabhängige Patientenberatung Deutschland (UPD)Independent, free advice for patients and insured people on health insurance and patient rights.
• Migrationsberatung für erwachsene Zuwanderer (MBE)Free, confidential counselling for immigrants aged 27 and over, offered by welfare organisations with federal funding. Counsellors help you understand letters, fill in forms and contact authorities. Find an office near you with the BAMF-NAvI search.
• Schuldnerberatung (debt counselling)Recognised debt counselling services run by municipalities and welfare organisations are usually free. They help you check claims, talk to creditors and plan repayments.

Official sources

• Federal Ministry of Health (bundesgesundheitsministerium.de) — statutory health insurance
• Unabhängige Patientenberatung Deutschland — free advice