Health Insurance - Registration

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Suitable for Employees, Ausbildung, Blue Card, Students (Monthly contributions for students: €115.51, plus mandatory long-term care insurance).

Starting from ^*

Personal info ^*

Male

Female

Diverse

Undefined

Given names ^*

Surname ^*

Date of Birth ^*

Street, Street Nr. ^*

Country^*

Post code, city ^*

Maiden name ^*

Place of Birth ^*

Country of Birth ^*

Nationality ^*

E-Mail ^*

I was last insured or lived abroad

Name of country ^*

I have dependants ^* Hint Also applies to stepchildren adopted children or foster children. Hint information is required to determine the long-term care insurance contribution

Yes

FREE Incoming Insurance (Travel Insurance)

Arrival Date in Germany ^*

Insurance period ^*

180 days

Passport ^*

Admission for the university/ Employment contract ^*

Personal photo ^*

I grant AF-MA, Reza Abadi, the broker mandate and broker authorisation (version 2026, German original). I here by provide my consent for this site to collect and process my personal data.And agree that i could be contacted by telephone or email. More about Data Protection at: Data Protection

Yes, I would like to register for statutory health insurance.

Signature ^*

Clear

Confirm Signature

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