Short Answer
The European Health Insurance Card is valid only for short-term tourists and becomes legally void for local care the moment you register a permanent address.
Once your "Anmeldung" is complete, you are a legal resident and are required by law to enroll in the domestic insurance system.
What Most Expats Don't Realize
You moved from Spain to Germany and kept using your Spanish EU health card for a year to save on monthly premiums. When you finally visited a doctor for a chronic issue, the insurer investigated your records and discovered your registration date from twelve months prior. You received a mandatory back-payment invoice for €3,600 because the law forces you to pay premiums retroactively for every month since your address was registered.
What To Do
- Open a registration application with a German public insurance provider within the first 30 days of arriving in the country.
- Show your physical "Meldebestätigung" (registration certificate) to the insurer to establish your correct entry date.
- "Ich muss mich nach meiner Anmeldung in Deutschland gesetzlich versichern." (I need to get public insurance after registering my address in Germany.) — State this to the provider to initiate the transition.
The Truth
Many EU citizens mistake freedom of movement for freedom from local insurance laws. The system tracks your address registration relentlessly, and using a foreign card to dodge premiums simply builds a massive state debt that Germany will eventually collect by force.