If you have an employment contract the following is applicable: According to Regulation (EC) 883/04, you are obliged to have statutory social security and you must therefore join the statutory health insurance scheme in the country in which you are employed, i.e. Germany. You can only apply to remain in the health insurance scheme in your own country in exceptional cases, such as when the duration of the stay in Germany is limited and legally-recognised relations to an employer at home continue to exist, for example in the case of leaves of absence with the right to return to your position in your own country.
If you have a fellowship you are not required to join s health insurance scheme in Germany. However, according to Art. 193, para. 3 of the German Insurance Contract Act ("Versicherungsvertragsgesetz"), as of 1 January 2009 every person residing in Germany is obliged to obtain insurance from a health insurance provider authorised in Germany. We therefore recommend that fellowship recipients obtain health insurance cover from a private German health insurance or, if possible, from a German statutory health insurance provider.
European Health Insurance Cards issued by Greek health insurance schemes are only valid for a temporary stay in Germany (holidays, business trip or job search) and only cover essential medical provision at the doctor, at the dentist or in hospital as well as necessary treatment for existing or chronic illnesses. It will become invalid as soon as you are obliged to pay social security contributions in Germany according to Regulation (EC) 883/04, such as when you are employed by a German research institute.
When new private health insurance policies are taken out, they usually exclude previously diagnosed preconditions and impose waiting periods for pregnancy treatments, as otherwise their pricing system would break down. In principle this is also the case for temporary health insurance policies for trips abroad that do not require a health check up.
The following possibilities exist for resolving such situations should circumstances allow:
- continuation of the existing private health insurance policy with the addition of an international option for coverage in Germany
- continuation of membership in the statutory health insurance scheme in the employee's own country (if the employee is on a posting)
- joining a statutory health insurance scheme in the host country, whereby this usually presupposes an employment relationship in that country.
In cases where an existing private or statutory health insurance policy is continued, preconditions or waiting periods are irrelevant, and when taking out a new policy under a host country's statutory health insurance scheme, coverage in most countries is available from day one without waiting periods, even for preconditions. However, care should be taken in Belgium where there is usually a waiting period of one year, even for the statutory health insurance scheme.
As a host university, you should make the researcher aware that there is usually no health insurance cover in cases of preconditions or an existing pregnancy. This will help you to avoid any potential liability by means of insufficient clarification. It is then up to the researchers themselves whether or not they povide any information about preconditions.
As soon as the academic resumes her employment in Belgium, she will be subject to Belgian social security regulations. Accordingly, she will also be entitled to receive Belgian social security benefits, including financial assistance and other services in the case of illness.
However, there is an issue with the waiting times for health insurance benefits in Belgium. During the first year of membership in the Belgian social security insurance scheme, you can only make contributions- health insurance benefits can only be claimed from the beginning of the second year of membership. Time accrued from membership in a German statutory health insurance scheme can be taken into account if it is certified by Form E 104 DE or a "portable document".
However, as the academic only had private health insurance in Germany, Form E 104 DE or a "portable document" will not be issued. We recommend that the academic confirm with the Belgian health insurance authority how long the waiting period will be upon re-entry into the Belgian social security scheme and, if necessary, obtain private health insurance in Belgium.
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