Public health insurance personal information

Your public health insurance application

Insurance provider: TK

Occupation

No Data

Annual Gross Income

No Data

Number of Children

No Data

Age

No Data

per month

Questionnaire

Personal information

First name*

Last name*

Last name at birth*

Birthdate*

Your gender*

Your country of birth*

Your city of birth*

Your nationality*

Marital status*

Do you have a German address?*

Yes

No

If you do not currently have a German address, we will use your employer's c/o address instead.
All documents will be sent to this address, as well as to you by email. As soon as you have an address in Germany, you can inform TK of this by email.

Your personal email address*

Your personal phone number

Country of previous residence*

Did you have a previous insurance coverage during the last 12 months?*

Yes

No

Shall we apply for your TK health insurance card?*

Yes

No

Please upload a portrait photo of yourself (neutral background, no headwear or sunglasses)*

Please fill in all required fields.

Personal information

Employer's information