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Online application form for Techniker Krankenkasse (TK)
"
*
" indicates required fields
1
Personal information
2
Work / Study details
3
Previous insurance / Family details
date
today
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provider
TK
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ref
expats
progedo-berlin
progedo-hamburg
progedo-frankfurt
sympatme
relonee
moveto-berlin
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partner
Start
I would like to insure myself as
*
Employee
Student
When do you want your TK coverage to start?
*
DD dot MM dot YYYY
This is / must be the date you start working (as is your work contract) or the start date of your studies. The date can be in the past.
Personal information
Name
*
First
Last
Date of birth
*
DD dot MM dot YYYY
Is your date of birth correct?
Gender
*
Male
Female
Diverse
Address
Is your employer: Airbus OR Kuehne+Nagel
*
Yes
No
If you have
no address
in Germany and your employer
is Airbus
, please answer the next question with yes and enter the following address. Your post from TK will then be sent to PROGEDO Hamburg.
Address Line 1:
Simon-von-Utrecht-Str. 1
Address Line 2:
c/o PROGEDO Hamburg
ZIP:
20359
City:
Hamburg
Do you have a german address?
*
Yes
No
We will send your health insurance confirmation to your employer.
Is your name on the mailbox?
*
Yes
No
Please enter in the line "Address Line 2" the name which is written on the mailbox and insert a "c/o" in front of the name.
Example: "c/o Name" or "c/o Company Name"
Do you currently live in a boarding house?
*
Yes
No
Example for VISION Apartments
Address Line 1:
Otto-Braun-Str. 67
Address Line 2:
c/o VISION Apartments
ZIP:
10178
City:
Berlin
Address
*
Street + Housenumber
Additional information (c/o)
City
ZIP / Postal Code
Privacy
You have the possibility to save your entries at any time and continue later. In this case we will store your data for up to 30 days. I have read the
privacy policy
and hereby agree that the personal information I have provided voluntarily may be raised, processed and used in order to provide the specified request. I agree that my confirmation of insurance will be sent to the address of my employer if I do not yet have an address in Germany. The confirmation can be sent to me and my assigned relocation company by email.
Broker information
*
I have read the
broker information
according to § 15 Insurance Mediation Ordinance.
I have read the broker Information.
Updates
I would like be signed up for TK-WelcomeGuide and I would like to be informed regularly by email about relevant insurance topics by Expats.de. We use the provider MailChimp to send our updates.
I have read the
privacy policy
and hereby agree that the personal information I have provided voluntarily may be raised, processed and used in order to provide the specified request.I can unsubscribe from this update service at any time.
I would like to be informed.
Employee
Is this your first time being employed in Germany?
*
Yes
No
Who is your new employer?
*
as written in the employment contract (exact company name)
What is the address of your employer?
*
Street + Housenumber
City
ZIP / Postal Code
What is the first day of your work contract?
*
DD dot MM dot YYYY
Is this the same date you want to start your TK coverage?
*
Yes
No
Why is there a difference between the dates?
*
As a rule, the start date of the insurance should coincide with the first day of your work. A possible reason can be the start of work abroad (in home office due to Corona). Please enter the reason here.
Are you a partner in and/or managing director of the company you're employed by?
*
In 99% of cases the answer is no, we just have to check...
Yes
No
How many per cent of the nominal capital?
*
e.g. 55,5
What is your monthly income (before taxes)?
*
Please include any bonus payments pro rata.
it does not exceed 520 EUR - mini-job
it is between 520 - 5.775,00 EUR
it exceeeds 5.775,00 EUR
Student
Please upload your current registration letter, stating the academic semester.
If you don't have it right now we'll follow up with you.
Drop files here or
Select files
Max. file size: 16 MB.
What university/college are you studying at in Germany?
*
e.g. TU Berlin
What is your subject area?
*
e.g. Mathematics - this doesn't need to be super specific
What is your current academic semester?
*
it's 1 if you haven't started yet
Please enter a number from
1
to
20
.
What date did you begin studying
*
DD dot MM dot YYYY
Do you study for a Masters Degree?
*
Yes
No
Have you studied in any other countries besides Germany?
*
Yes
No
How many semesters did you study abroad?
If you didn't have semesters take: years studied / 2.
Do you get or have applied for benefits from the Federal Employment Agency [Agentur für Arbeit]?
*
Yes
No
German pension number / Social security number
Do you have a German pension number?
*
The pension insurance number has 12 characters and a letter in the ninth place. For example: 04 150872 P 08 0
Yes
No
What is your German pension number?
*
If you do not yet have a number, it will be sent to you by the TK approx. 10 days after the insurance confirmation.
These next 3 questions are required instead of your pension number.
What was your family name / last name at birth?
*
What is the place/city and country of your birth?
*
e.g. Madrid, Spain
What is your nationality?
*
Select
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Faroe Islands
Fiji
Finland
France
French Guiana
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Greenland
Grenada
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Niue
North Korea
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Details of previous insurance
Were you last insured abroad OR did you last live abroad?
*
in 99% all expats can answer these question with yes. If you can answer one of these question with yes -> yes.
Yes
No
Which country?
*
Select
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darrussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
What's your last health insurance provider?
*
e.g. "Name of your Insurance provider"
Location (city/country)?
*
I am insured there since
*
DD dot MM dot YYYY
I am insured there/private until the beginning of my work/study in Germany?
*
Yes
No
I am insured there/private until
*
DD dot MM dot YYYY
If you are already in Germany before the start of the statutory health insurance, please take out a visa travel insurance for this period.
You can do this here.
What kind of insurance?
Compulsory insurance
Private insurance
Depedants insurance
Compulsory health/pension insurance
Have you been exempted from compulsory health insurance coverage in Germany?
*
Yes, if you applied for it you would have done that proactively and know about it.
Yes
No
Please upload a copy of your confirmation of exemption from compulsory health insurance coverage.
If you don't have it right now we'll follow up with you.
Drop files here or
Select files
Max. file size: 16 MB.
Have you been exempted from compulsory pension insurance coverage in Germany?
*
In 99% of cases the answer is no, this only applies for a few really specific professions.
Yes
No
Please upload a copy of your confirmation of exemption from compulsory pension insurance coverage.
If you don't have it right now we'll follow up with you.
Drop files here or
Select files
Max. file size: 16 MB.
Do you currently receive or have you applied for a state pension?
*
In 99% of cases the answer is no, this only applies for a few really specific professions.
Yes
No
Do you currently receive a non-state pension and related benefits (e.g. company pension).
*
In 99% of cases the answer is no, this only applies for a few really specific professions.
Yes
No
Family details
Would you like to have your dependents covered by non-contributory dependants insurance?
*
e.g. children or partner who isn't working
Yes
No
TK will send you a letter with a one-time password. You can use this to conveniently fill out the application for family insurance online.
You will receive more information in your confirmation email when you submit this application.
Are you married or are you living in a civil partnership pursuant to the LPartG [German Civil Partnership Act] and your spouse/civil partner is not insured with a statutory health insurance fund?
*
e.g. children or partner who isn't working
Yes
No
Are you exempt from social long-term care insurance?
*
Yes
No
Please upload a copy of your confirmation of exemption from social long-term care insurance.
If you don't have it right now we'll follow up with you.
Drop files here or
Select files
Max. file size: 16 MB.
Do you have any children?
*
Children, who live in the same household. Your contributions to long-term care insurance are lower if you have children. Please submit the relevant proof in the next step, e.g. a copy of the birth certificate.
Yes
No
Please upload a copy of the birth certificate here.
If you don't have it right now we'll follow up with you.
Drop files here or
Select files
Max. file size: 16 MB.
Contact details
We will pass it on to TK in case of any queries.
Email
*
Enter Email
Confirm Email
Phone
*
HR contact person
Signature
Signature
*
Voluntary information
How did your hear about us?
Search Engine (Google, etc.)
Social Media (LinkedIn, Facebook, etc.)
Newspaper, Blog
Recommendation
(virtual) Event
Other
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