Become a member

Become an AOK member in three steps

You can fill out your application for membership yourself, via the online form.
Then download the form and print it out. Additional content can be added by hand if required.
Please return us this form, signed, to us by post or e-mail. An AOK branch will contact you shortly.

I have been made aware of my rights to choose and I have selected AOK – Die Gesundheitskasse as my future health insurance provider. I apply for membership from

Start date or earliest possible date

Personal information

Title

Surname

First name

Male

Female

Street

House number

Post code

Town

Name at birth

Place of birth

Country of birth

Date of birth

Nationality

Telephone

E-mail

Pension insurance number

(required for pensioners otherwise national insurance number)

Information on employment circumstances

I am employed as:

I am self-employed as:

I am a trainee as:

Employment start date

Name of employer

Post code

Town

Street

House number

Information about most recent insurance arrangements

I have not been covered by a health insurance policy in Germany in the last 12 months.

In the last 12 months I have been covered by a health insurance policy with:

Covered by mandatory insurance

Covered by voluntary insurance

Covered by family insurance

Name / Date of birth

Information about the prior insurance period

I have been living abroad in the period immediately prior to starting membership.

Before living abroad, I most recently had a health insurance policy in Germany with: (Name of the insurance provider)

I have never been insured with a statutory health insurance provider in Germany.

I am a seasonal worker.

Family insurance

I have dependants (spouse/child) who are to be insured at no additional cost.

I found out about AOK from: Name

Address, Town