Without proof of health insurance, a required document is missing when you enrol at a German university. What happens next depends on whether you are already covered through your family, need to register with a statutory health fund or have private insurance. This guide explains the routes, the deadlines and the costs.
Short answer: Proof of health insurance is part of the enrolment documents. At the University of Freiburg it is an explicit requirement for enrolment, while other universities set this out in their own regulations. Students at state or recognised universities are generally subject to compulsory insurance unless other cover takes priority. In 2026, health and long-term care contributions come to about 143 euros a month (as of January 2026, assumption: additional contribution of 2.9 percent).
The most important points
- Students at state or recognised universities are generally subject to compulsory statutory health insurance until the age limit, unless other cover takes priority (section 5(1) no. 9 and (7) Social Code Book V, SGB V).
- At the University of Freiburg, the proof is sent electronically from the health fund to the university.
- If you are privately insured, you need an exemption from compulsory insurance. The application must be filed within three months of the obligation starting (section 8(2) SGB V).
- The exemption only takes effect once other health cover is proven. Once granted, it cannot be revoked.
- Student contributions are calculated on a fixed assessment base of 855 euros a month (as of January 2026).
Which proof does the university require?
Requirements vary between universities. The University of Freiburg describes three typical cases, which can help you find your own route. The rules of your own university always take priority.
| Your situation | What is typically required | Basis |
|---|---|---|
| Family-insured or already insured with a statutory health fund | The health fund sends the electronic notification to the university | University of Freiburg |
| No German health insurance | Registration with a statutory health fund, which must then send the notification with reason code 10 (Meldegrund 10) | University of Freiburg |
| Privately insured, or holder of an EHIC from the EU, EEA, Switzerland or the UK | Exemption from compulsory insurance, certified by a statutory health fund that sends the notification | University of Freiburg, section 8 SGB V |
Without this certificate, the exemption does not take effect (section 8(2) SGB V). That is why the health fund’s confirmation should be in hand before you enrol.
What happens if the proof is missing?
Without proof, the basis for enrolment is missing. Under its own regulations, the university can only complete your enrolment once the proof is in place. Compulsory insurance is linked to your studies (section 5(1) no. 9 SGB V), and the proof simply confirms it. Arranging the registration with your health fund early avoids delays at the university.
Which deadlines apply?
- Exemption from compulsory insurance: the application must be filed with your health fund within three months of the obligation starting (section 8(2) SGB V).
- Effect of the exemption: it applies from the start of the obligation if no benefits have been claimed. Otherwise it applies from the month after the application (section 8(2) SGB V).
- Changing health fund: a binding period of twelve months applies. Termination takes effect at the end of the second calendar month after the notice (section 175(4) SGB V).
If the three-month deadline for the exemption is missed, an application under section 8 SGB V is no longer possible. For this reason, note the deadline in your calendar as soon as you receive your university’s confirmation. If you remain with a statutory health fund, you do not need an exemption, but you still need to make sure the university receives the notification.
What does student health insurance cost?
Students do not pay on the basis of a salary. The assessment base is the monthly BAföG need for students who do not live with their parents: 475 euros basic need plus 380 euros accommodation allowance, a total of 855 euros (section 236 SGB V). The reduced contribution rate is seven tenths of the general rate, so 10.22 percent (section 245 SGB V, as of 1 January 2026).
| Component | Amount per month | Calculation |
|---|---|---|
| Health insurance without additional contribution | 87.38 euros | 855 euros times 10.22 percent |
| Additional contribution of the fund (average) | 24.80 euros | 855 euros times 2.9 percent (assumption) |
| Long-term care insurance without childless surcharge | 30.78 euros | 855 euros times 3.6 percent |
| Total | 142.96 euros | Sum of the three items |
The actual additional contribution depends on your health fund, so the average above is only an estimate. The basis comes from the 2026 calculation values of the GKV-Spitzenverband (as of January 2026). Students with a child, or students up to the age of 23, do not pay the childless surcharge in long-term care insurance.
Frequently asked questions
Do I have to register with a health fund myself?
If you are neither family-insured nor compulsorily insured elsewhere, you choose a statutory health fund yourself. The fund then notifies the university. At the University of Freiburg, this notification is requested with reason code 10. The choice of fund is yours.
What if I am insured through my parents?
Family insurance and student insurance exclude each other. Children in training are family-insured up to the age of 25 if their total income does not exceed one seventh of the reference earnings. In 2026, this limit is 565 euros a month (as of January 2026, GKV-Spitzenverband). If you are insured on a subsidiary basis, you are not also compulsorily insured as a student (section 5(7) SGB V).
Can I get an exemption if I have private insurance?
Yes, on application, if you can prove other health cover. The deadline is three months, and afterwards the decision cannot be revoked (section 8 SGB V). For the effects on contributions and benefits, read the guide on public or private health insurance for international students.
Does this also apply to students from abroad?
Students with a European Health Insurance Card (EHIC) from EU, EEA, Swiss or UK states can, according to the University of Freiburg, apply for an exemption from compulsory insurance. The EHIC usually covers only medically necessary treatment. Check with your health fund or the university whether this is enough for your situation.
What happens when I change my health fund?
The new health fund sends a notification with reason code M11, so that the university’s confirmation works properly. The new fund’s notification replaces the termination with the old fund (section 175(4) SGB V).
What to do now
- Check whether you are family-insured or compulsorily insured elsewhere. Your parents’ health fund can confirm whether you are still covered.
- Ask your statutory health fund for the notification to the university. The University of Freiburg uses reason code 10 for this.
- Read the enrolment regulations or the website of your university to see which form of proof it accepts.
- If you are privately insured, file the exemption application within three months and keep the proof of your private insurance ready.
- For questions about your personal situation, a personal consultation can help. You can read how this works at Academycon on our working method page.
Related guides
- Health insurance for international students in Germany
- Student health insurance in Germany 2026: key figures
- Semester off and health insurance: what applies
- Health insurance for Erasmus exchange students in Germany
Sources: section 5 SGB V, compulsory insurance (retrieved October 2026, German text), section 8 SGB V, exemption from compulsory insurance (German text), section 245 SGB V, contribution rate for students (German text), GKV-Spitzenverband, fact sheet on calculation values (as of 1 January 2026, German), University of Freiburg, health insurance proof for enrolment (German, no date given).
Last updated: October 2026. This guide is general information, not individual advice.
