If you are coming from the United States to study in Germany, you will quickly come across the European Health Insurance Card (EHIC, Europäische Krankenversicherungskarte). It only helps in certain countries. This guide explains which cover is relevant for students from the US, when German student health insurance (studentische Krankenversicherung, KVdS) applies, and which documents your university and visa office will ask for.
Short answer: According to the health insurance funds, the EHIC applies to students from the EU and EEA and, in some cases, under social security agreements. The United States is not on that list. If you are enrolled at a state or state-recognised university and have no other cover, you are generally subject to compulsory student health insurance. Last updated: October 2026.
The most important points at a glance
- The EHIC does not replace German cover for US students, because the United States does not appear among the countries named by the health insurance funds.
- Students enrolled at a state or state-recognised university are compulsorily insured under section 5 (1) no. 9 of the Social Code Book V (SGB V), up to age 30. The rule depends on enrolment, not on nationality.
- Calculation example for 2026 (assumption: contribution base of 855 euros, additional contribution of 2.9 percent): about 112 euros per month, without long-term care insurance.
- An exemption is only possible with another entitlement to cover in case of illness and must be applied for within three months.
- For the student visa, German diplomatic missions ask for proof of health insurance and proof of funds. Each mission sets its own requirements.
Why the EHIC does not help students from the US
The EHIC is the reverse side of the German health insurance card. According to the health insurance funds, it applies to students from the EU and EEA, including Switzerland. For some countries outside the EU there are social security agreements with their own procedures, for example Turkey or Tunisia. The United States is not on this list. You can read more about stays abroad in our guide Student Health Insurance Abroad: Erasmus, USA and Work and Travel.
This does not mean you are left without cover. It means you have to secure yourself through a different route. The overview below shows the options.
Which cover is an option for US students?
| Option | When it applies | What to check |
|---|---|---|
| EHIC | Not for the USA, according to the health insurance funds | No replacement for German cover during your studies |
| Student health insurance (KVdS) | When you enrol at a state or state-recognised university, up to age 30 | Clarify contribution and start date with the health insurance fund |
| Exemption from compulsory cover (section 8 SGB V) | Only with another entitlement to cover in case of illness | Apply within three months of the start of compulsory cover |
| Travel or international health insurance from the US | For the journey and the transition until German cover starts | Travel insurance may be excluded for long-term stays |
When does German student health insurance apply?
Under section 5 (1) no. 9 SGB V, students at state or state-recognised universities are compulsorily insured up to age 30. Under section 190 (9) SGB V, membership ends at the end of the semester in which you are de-registered, or when you turn 30 before the end of that semester.
Contributions are based on the BAföG needs rate for students who do not live with their parents. For 2026, the German Statutory Health Insurance Association (GKV-Spitzenverband) sets a contribution base of 855 euros per month. An illustrative calculation with stated assumptions gives the following:
- Health insurance without additional contribution: 855 × 10.22 percent = 87.38 euros
- Average additional contribution (assumption: 2.9 percent): 855 × 2.9 percent = 24.80 euros
- Total (without long-term care insurance): 112.18 euros per month
The source for these figures is the GKV-Spitzenverband fact sheet on contribution parameters, status 1 January 2026. Your actual additional contribution depends on your health insurance fund. Our guide on student health insurance in Germany explains the contribution in more detail.
Can I apply for an exemption?
An exemption under section 8 SGB V is possible only under strict conditions. It requires another entitlement to cover in case of illness. Whether your US policy meets this condition is decided by the health insurance fund in each individual case.
The application must be submitted to the health insurance fund within three months of the start of compulsory cover. The exemption takes effect from the start of compulsory cover if no benefits have been claimed yet, otherwise from the month after the application. The exemption is also not revocable. Check carefully in advance whether it suits you.
What does the visa office require?
An information sheet from a German diplomatic mission lists, as an example for a student visa, proof of sufficient health insurance cover and proof of funds. The information sheet from the Embassy in San José, status August 2025, names both documents. It only applies to that mission. The requirements for your country are set by the mission responsible for you.
For a residence permit for study, the Residence Act refers to admission to a full-time degree programme at a state or state-recognised university (section 16b AufenthG). Health insurance and the blocked account therefore belong among the points you should clarify early. Details on the blocked account are in our guide on health insurance and blocked accounts for students from Nepal.
What to do if you are already insured in the US
For the journey and the first days you need travel or international health insurance. After that, you should quickly have cover in Germany. Only cancel your US policy once German cover is really in place, so that there is no gap. The international offices of the universities and the health insurance funds can advise you.
Frequently asked questions
Does my US health insurance apply in Germany automatically?
No. An insurance policy from the United States does not automatically replace the duty to be insured. Under section 193 (3) of the Insurance Contract Act (VVG), anyone with a residence in Germany must be insured with an insurer authorised in Germany. Whether your policy is sufficient for an exemption is decided by the health insurance fund.
Do I have to arrange the university certificate myself?
When you enrol, your university asks for proof of health insurance cover. The confirmation is usually sent electronically by the health insurance fund you have chosen. Your university’s student administration can explain the details.
How long am I bound to one health insurance fund?
Compulsorily insured persons are bound to the chosen fund for at least twelve months (section 175 (4) SGB V). After that, termination is possible with effect from the end of the second calendar month following notice. Choose your fund with the whole period of study in mind.
What happens when I am de-registered?
Membership ends at the end of the semester in which you are de-registered (section 190 (9) SGB V). After that you need new cover, for example through employment or another policy. Plan this transition early, as described in our guide on health insurance for students in the EU.
How to proceed now
- Ask your university which health insurance proof it requires for enrolment and in which form.
- Check whether an exemption is an option for you. The three-month deadline runs from the start of compulsory cover.
- Ask your German diplomatic mission for the current list of visa documents, including health insurance and the blocked account.
- Keep travel or international health insurance until German cover is in place.
Related guides
- Health Insurance for International Students in Germany
- Student Health Insurance in Germany 2026: Key Figures
- Public or Private Health Insurance for International Students
- Private Health Insurance Abroad During Your Studies
Sources: Section 5 SGB V, compulsory insurance (current version, in German); Section 190 SGB V, end of membership (current version, in German); GKV-Spitzenverband, contribution parameters 2026 (status 1 January 2026, in German); Health insurance fund information on the EHIC for students (no date, in German); Information sheet on student visas, German Embassy San José (status August 2025, in German).
Last updated: October 2026. This guide is general information, not individual advice.
