Temporary stay in Germany

The German-Turkish Social Security Agreement
The German-Turkish Social Security Agreement comes into play when artists and persons engaged in the cultural sector who are covered by Turkish social security legislation work temporarily in Germany:
If a Turkish artist works in Germany, German social security legislation must be applied initially, as the decisive factor with regard to the respective legal system to be applies is always the place of employment. In order to prevent workers from having to pay social security contributions in both Turkey and Germany, specific rules of jurisdiction apply in relation to Turkey, which are regulated by the 1964 German-Turkish Social Security Agreement. This agreement applies to German and Turkish nationals.
The duration of an individual’s temporary work stay in Germany must be limited in time in advance due to the nature of the work (e.g., in the case of a temporary project collaboration) or due to a contractual agreement. This allows for postings and self-postings; in other words, the person from Turkey may live and work in Germany but continues to be subject to Turkish social security legislation.

The Agreement regulates the legislation pertaining to

  • health insurance, maternity insurance, insurance against occupational accidents and illnesses, invalidity insurance, old-age insurance, and survivors’ insurance for employees,
  • the pension fund for civil servants and federal employees,
  • the pension insurance of craftsmen and self-employed persons in industry and agriculture,
  • the social security funds that have been included in the social security system through social security legislation, as well as
  • other social security institutions, if they have been established on the basis of social security legislation and are included in the social security system.

Unemployment insurance is not covered by the Agreement.

Unlike other social security agreements, the German-Turkish Social Security Agreement does not stipulate a specific time limit (e.g., 12 months) for continued application of the legislation of the country of origin. Your own insurance carrier can provide additional information.

What should self-employed artists who have health insurance coverage in Turkey do if they get sick?
Artists from Turkey are considered persons from a treaty state. If they require medical treatment during their temporary stay in Germany, they are free to seek medical help. However, they may only avail of a limited range of services – only treatments that cannot be postponed are permissible.

  • The foreign health insurance institution (= responsible institution in Turkey) issues proof of entitlement (T/A 11 form). This form serves as proof of existing health insurance coverage in Turkey. Information about the T/A 11 form can be found here.
  • With this proof of coverage, the artist first contacts a health insurance fund of his/her choice at his/her place of residence (= assisting institution in Germany). This institution will either issue a billing slip, which will be presented at the practice during a necessary visit to the doctor, or, if the person is resident in Germany, a health insurance card. The chip in the card carries the additional information /SVA (= Sozialversicherungsabkommen).
    There are many different providers in Germany. Artists and persons engaged in the cultural sector from Turkey may use the following health insurance funds:
    - substitute health insurance societies (e.g., Techniker Krankenkasse, Barmer, GEK, DAK, KKH),
    - general local health insurance funds (AOK),
    - guild health insurance funds (IKK),
    - company health insurance funds (BKK),
    - German Federal Miners‘ Insurance Institution (Bundesknappschaft).
  • Necessary treatments usually do not lead to any costs. However, certain benefits are subject to co-payments (deductibles) in Germany; more information can be found here (German language).
  • Necessary drugs and therapeutic devices obtained in Germany must be approved by the selected German health insurance fund.
  • Follow-up treatments by a specialist require a prescription, which must be submitted to the German health insurance fund.
  • A certificate of inability to work can be issued by a physician. This certificate must be submitted to the employer and a copy sent to the German health insurance fund. The practices you attend will do this, if necessary. 
  • If a person has a medical condition prior to their stay in Germany that requires further treatment, the health insurance fund in Turkey must authorize such treatment. Additional proof of coverage will be issued to this effect.

Important:

If no billing slip from the German health insurance fund (that is, from the assisting institution) can be submitted during the physician’s visit (but instead only proof of Turkish health insurance coverage is available), the fee and any drugs must usually be covered initially by the patient. The costs will be reimbursed if the billing slip is submitted by the end of the quarter.

Note: Some proofs of coverage issued abroad indicate that, in urgent cases, a physician will be prepared to accept the certificate of coverage without requiring a fee and will obtain the billing slip from the chosen health insurance fund himself/herself. However, this is not always the case in practice.

What should artists employed in Turkey but posted to Germany do if they get sick?
When an employed artist is temporarily sent to Germany by a Turkey-based organization or company to work there on the company’s behalf, this is referred to as “Einstrahlung.” The posting period must be limited either contractually or inherently (e.g., for temporary project work or similar). No maximum duration is stipulated.
Such cases do not give rise to an employment relationship under German social security law. The German social security legislation does not apply to cases such as these. The employee does not have to be registered with the statutory health insurance, long-term care insurance, pension insurance, unemployment insurance, and accident insurance bodies in Germany. This applies regardless of whether sufficient insurance coverage is available in Turkey or not.

Even artists employed in Turkey can avail themselves of medically necessary services when posted to Germany. Proof of existing health insurance coverage must be provided. See comments above.

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