Callback request

*Mandatory field

Desired date

We will accommodate your desired date whenever possible.

Personal information

Gender

Man Woman non-binary

My membership

Are you already insured at our health insurance company named Mobil-Krankenkasse?

Yes No

In order to clearly identify your request, we need your ten-digit insurance number. It begins with a capital letter (example: A123456789). Please note: Your card number is not part of your insurance number.

Date of birth

If you do not have your insurance number handy, please provide your date of birth.

Wenn das Feld ausgefüllt wurde, wird der Text "Das Formular kann nicht abgeschickt werden" ausgegeben.

As the data processor, the company health insurer Mobil Oil (insurance headquarters: Friedenheimer Brücke 29 in 80639 Munich, phone number: 0800 255 0800, contact form) needs the requested details in order to determine the insurance relationship and membership in accordance with Section 5 Social Act (SGB) V, Section 9 SGB V, Section 186 ff. SGB V, § 20 SGB XI and § 57 SGB XI. If applicable, your data will be forwarded to the tax office, your employer and your paying agency.

The data contact form you filled in with your information will be transmitted via a secure SSL connection.

Please note that, due to technical reasons, this level of security can only be guaranteed if you use our contact forms. It does not apply to email correspondence sent through conventional channels.

Further information can be found by visiting: mobil-krankenkasse.de/datenschutz. (This page in German.)

Desired date

Personal information

My membership

Data protection notice