Health insurance coverage abroad is one of the most important issues that should be clarified prior to working internationally.
The coordination of social security systems applies within most european states (see Working abroad in an EU country).
Statutory health insurances in Germany provide benefits only within the EU and EEA countries and in some countries with which social security agreements (cf. contract states, or the individual contracts- only available in German) that include health insurance have been concluded (for example, Tunisia, Turkey, Israel…). The latter, however, covers only those benefits that would be paid by the local health insurance. Any potentially necessary medical evacuation is not covered. This also applies to the privately insured. Prior to any trip, one should thus inquire with one's health insurance about covered benefits and possibly purchase additional international health insurance coverage. This applies especially to travel to countries outside the EU. Some international health insurances cover the occupational risk.
Additional international health insurance coverage costs approximately 10 euros per year depending on the insurer. One should keep in mind, however, that such plans usually provide coverage for only 42 consecutive days (up to 56 days with some insurance companies), i.e. for a maximum of six to eight weeks. However, several trips a year, each up to the maximum number of days, are covered by such plans.
One can find experienced providers based on the December 2022 results of Stiftung Warentest (only availble in German) or contact an insurance broker.
More expensive individual coverage must be purchased for longer trips (longer than 42 or 56 days). The insurance providers usually offer coverage on a daily or monthly basis. Such a health insurance plan can be purchased for a maximum period of five years.
Long-term international health insurance – a rough, non-binding price overview
-Stays up to 365 days: approx. 1.00 euro per day / approx. 3.50 euros per day starting at age 65
-Stays between 365 days and five years: higher rates apply
Notes for collectives, orchestras and theater companies etc. that give guest performances abroad
It is advisable for collectives, orchestras, companies etc. with salaried artists to purchase all-inclusive health insurance coverage. Likewise, health insurance coverage should be ensured for self-employed artists and creatives that travel abroad on behalf of the collective, the company etc. – even if the client, i.e. the collective or company is not obliged to provide such coverage. The collective/company can purchase the policy for self-employed individuals who are German residents. Self-employed individuals who reside outside of Germany must purchase their own. Companies, orchestras etc. should make proof of international health insurance coverage a condition for the work contract. Alternatively, they should ensure that the production contract contains a clause stating that the artist or creativ bears the sole responsibility for obtaining all necessary insurances.
Especially collectives and companies with self-employed artists and creatives who reside in different countries should find out in advance what is required and what documents the respective organizer requires from each individual.
Obtaining health insurance coverage for their stay in Germany is strongly recommended for foreign artists ans creatives. Artists and creatives from abroad who temporarily stay in Germany may purchase travel health insurance from German insurance companies. This is especially relevant for artists and creatives from non-EU countries. The insurance policies are valid for up to 365 days and from a certain number of days plans are usually concluded on a daily basis. Some insurers permit purchase of a policy up to 31 days after arrival in Germany or another EU country. This applies if no visa is required for the respective traveler. The contract is often offered in combination with accident and liability insurance.
Such insurance should be purchased in Germany, if possible (with the assistance of the organizers or colleagues). In case of damages in Germany, settlements with travel insurance providers in the countries of origin can be very complicated.
A rough, non-binding price overview
-Travel health insurance for 42 days: approx. 11 euros / 22 euros starting from age 60
-from day 43, additional daily insurance: 1.50 euro / 4.50 euros starting from age 60
Notes for collectives, orchestras and companies etc.
Self-employed artists must obtain health insurance coverage themselves. Collectives, orchestras, companies etc. that hire self-employed individuals should point out that health insurance coverage is highly recommended. Even better would be to make health insurance coverage a requirement for the engagement or require the A1 certificate (cf. Working abroad in an EU country) from artists or creatives from EU member countries. The organizer often requires this certificate as well. The insurance issue should be clearly defined in the production contract, which may stipulate that the artist or creative is responsible for obtaining all insurances independently.
When applying for a visa for Germany or the Schengen area, the applicant must prove health insurance coverage for the duration of his/her stay in Germany. This coverage may be purchased in the country of origin or in Germany or in another EU country. A minimum coverage of €30,000 and validity in all EU countries are required. The option of so-called visa insurance exists (depending on the individual needs, this can be combined with travel accident insurance or travel liability insurance coverage). Such insurance should be purchased in Germany, if possible, and the policy made available to the travelers upon entry because settlements with travel insurance providers in the countries of origin can be very complicated in case of damages.
Some insurance companies offer special insurances for scholarship holders.
A rough, non-binding price overview (health insurance only)
-31 days: 28.00 euros / approx. 53.00 euros starting from age 65
-180 days: approx 225.00 euros / 440.00 euros starting from age 65
-up to 365 days: 1.55 euro per day / 3.00 euros per day from age 65
If a person applies for a national visa and takes up employment subject to social security contributions in Germany, proof of international health insurance must be provided for the period between entry into the country and start of employment (at least 15 days). Upon taking up open-ended employment subject to social security contributions, the artist becomes liable for social security contributions in Germany.
Also self-employed artists must provide proof of international health insurance when applying for a national visa, and the immigration authorities require proof of adequate health insurance coverage when a residence permit is applied for.
German international health insurance providers insure persons who are staying in Germany and are not subject to social security contributions for a maximum of five years. Beyond this period and at the very latest at this point, the self-employed artist must take out private or voluntary statutory health insurance in Germany.
If an artist insures himself/herself through the Artists’ Social Security Fund, he/she is liable for social security contributions in Germany and can take out statutory health insurance coverage or, from a certain minimum income, private insurance coverage.