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Travelers Guide to Healthcare in Germany

An in-depth guide to healthcare in Germany for travelers, from pharmacy runs to emergencies – here's everything you need to know.

Germany is the second most populated country in Europe, after Russia, and the most populated state of the European Union. This Western European country has a landscape of forests, rivers, mountain ranges, and North Sea beaches – as well as over 2 millennia of history.

Germany is a federal state and is made up of 16 constituent states, collectively called Länder. Each state has its own constitution and, for the most part, is autonomous in its internal organization. Each of these federal states is also unique in terms of their cultural and linguistic distinctions – often, the dialects diverge so vastly that people across federal borders don’t understand each other. 

If you are planning a trip to Germany, then this healthcare guide will give you everything you need to know to stay safe and informed during your stay.

Contents

Healthcare In Germany – The Basics

Germany’s healthcare system is a dual public-private system, dating back to the 1880s – making it the oldest healthcare system in Europe. Today its medical and healthcare professionals make it one of the very best healthcare systems in the world.

Statutory contributions fund healthcare in Germany, ensuring free healthcare for all. People can also take out private health insurance (Private Krankenversicherung or PKV) to replace or top upstate cover (gesetzliche Krankenkasse or GKV).

Germany’s Federal Ministry of Health is responsible for developing health policies in the country and is regulated by the Joint Federal Committee.

Public Healthcare

All German residents can access healthcare through public health insurance; however, non-residents must have private insurance coverage to access healthcare. Temporary visitors usually need to pay for treatment and claim reimbursement later.

All workers in Germany whose annual income is less than EUR 64,350 must have public health insurance (GKV). If someone begins to earn more, they can change from public to private health insurance if they wish to.

Public health insurance will cover children until the age of 18. Pediatricians typically offer healthcare for children up to the age of 12; thereafter, they are transferred to a GP.

EHIC Holders:

People from the European Union (EU), European Economic Area (EEA) or Switzerland who are staying only temporarily may use their EHIC card (European Health Insurance Card). But official residents will have to take out compulsory German health insurance.

The EHIC allows all legal residents of Germany to benefit from emergency medical treatment and care when temporarily elsewhere in the EEA. All residents must have health insurance, and the EHIC is part of the health insurance card.

If you need medical care during a temporary stay in Germany and you submit your EHIC to the healthcare provider, this allows you to show that you wish to be treated as a patient who has statutory health insurance, and the insurer in your native country will pay the bill. If you are already in Germany and don’t have an EHIC card with you, you should request a Provisional Replacement Certificate (PRC) from your healthcare insurance provider.

The EHIC allows you to get healthcare and claim reimbursement for the costs incurred the same way nationals can. If the treatment you need is free for locals, you won’t need to pay. If you have to pay for your treatment, you can request reimbursement from either the national institution or from your health insurers.

In Germany, the EHIC is only valid in practices that operate under the state health insurance system—usually depicted by a sign that says: Kassenartzt or Alle Kassen.

The EHIC can only be used in Germany for up to 6 months. If you are planning to stay longer, you need to explore private health insurance schemes.

Additionally, the Künstlersozialkasse (KSK) (The Artists’ Social Insurance Act) ensures that self-employed artists and publicists have similar health protection in public health insurance as employees.

Private Healthcare

Germany’s Private Krankenversicherung or PKV covers much more medical treatments than the GKV. With contributions depending on your age, state of health, and benefits included.

People can choose to take out private health insurance cover if they are:

  • An employee earning more than EUR 64,350
  • Self-employed
  • Working part-time
  • A freelance professional
  • An artist
  • A civil servant or other government employee

Insurance providers offer different levels of cover, with premiums depending on various factors.

Those who are not eligible for state health insurance can take out public health insurance, with popular local and international insurers including:

The PKV has a list of private German health insurance companies.

In some cases, taking out private insurance cover may be more cost-effective than the public health insurance since the amount you pay for GKV depends on your income, so higher earners end up paying more.

Cost of Health Care In Germany

Germany is one of the highest spenders on healthcare in Europe, spending 11.1% of annual GDP on healthcare expenditure. With only Switzerland and France spending more in terms of GDP percentage, German healthcare expenditure works out at over EUR 4,000 per inhabitant annually.

Most of the costs are covered by public and private insurance contributions. And above this, every person must pay a fee of around EUR 10 -15 for their first medical visit each quarter. People who don’t seek medical attention during this quarter are exempt from this, and those with private health insurance can reclaim these costs. 

Patients with public health insurance or GKV only pay small co-payments for medication and inpatient care. All other expenses are fully covered by the insurance company. Whereas PKV is based on reimbursements which usually include excess payments on an annual or per-service basis.

EHIC holders pay about 10% towards the cost of medication, treatment, ambulance transportation, and hospital stays. Patients who stay in the hospital also need to pay EUR 10 for each day spent in the hospital.

Available Payment Methods

In Germany, a bank transfer is the most common payment method, however, bank cards and cash are widely accepted throughout the country.

Doctors And Specialists In Germany

In Germany, doctors are called Ärzte – a Hausarzt is the same as a GP or primary care doctor. Under the German healthcare system, you can choose your own doctor. Most speak at least basic English. Some doctors only treat private patients, meaning you will have to pay for treatment if you have public insurance.

Typical practice room hours are from 8 am-1 pm and from 3 pm-6 pm from Monday to Friday; many practices are closed on a Wednesday afternoon. In addition, few are open on Saturdays and only emergency services operate on Sundays.

Seeing A Specialist

Typically, a referral is not mandatory, and patients can directly visit a specialist without having to visit a family doctor first. But there are some restrictions. The following specialist medical services do not require a referral:

  • Gynecology
  • Ophthalmology
  • Pediatrics
  • Dentistry
  • Emergency treatment

With some specialists, access is usually only possible through a referral from the family doctor, these include:

  • Specialists in special diagnostic procedures and treatments that are associated with high technical or medical effort, and special risks
  • Specialists in laboratory medicine
  • Specialists in nuclear medicine
  • Radiology
  • Radiotherapy
  • Microbiology
  • Infection epidemiology
  • Pathology and transfusion specialists

People who have PKV can contact a doctor of their choice at any time without any obligation for a referral. However, it affects reimbursement by the health insurance company on the basis of the need for treatment being a prerequisite.

Drugstores And Pharmacies

Pharmacies are called Apotheke and are easily recognizable by a large red-letter A. Most are open 9 am – 6 pm on weekdays and 9 am – 12 pm on Saturdays.

Pharmacies are not to be confused with drugstores; Drogerie – brands like DM and Müller, do not sell medicine and are actually general stores selling toiletries and consumer items.

You can take a prescription from your GP to any pharmacy. If it is written on a pink slip of paper, you will have to pay a non-refundable fixed charge of around EUR 5 – 10. But you will need to pay the full amount for certain medicine for minor ailments like cough mixture.

For those with private insurance, the prescription will be issued on a blue slip of paper, meaning the full amount must be paid at the pharmacy upfront and then reimbursed through the insurance provider later.

It’s important to note that medication does not always come with dosage instructions on the package, so it’s important to check with your doctor when and how much you should take and write it down, so you have it later. Often the pharmacist will also be able to tell you about dosages, however, they are less likely to speak English.

Here is information about local on-call pharmacies.

Hospitals In Germany

Hospitals are called Krankenhäuser, and in Germany, there are three main types:

  • Public hospitals (Öffentliche Krankenhäuser) are run by local and regional institutions.
  • Voluntary, non-profit hospitals (Frei gemeinnützige Krankenhäuser) are run by churches or German Red Cross organizations.
  • Private hospitals (Privatkrankenhäuser).

By international comparison, hospitals in Germany are considered excellent. Only a doctor can authorize hospitalization for non-emergency conditions.

Typically, your GP will need to refer you to a specialist in a hospital. If you are going to be an inpatient, hospitals only have a certain amount of space allocated to patients with public insurance and those with private insurance. You will need to take your EHIC/German health insurance card when you visit.

Patients covered by GKV will have hospital bills sent directly to the insurer, while those covered by PKV will need to pay all bills upfront and claim reimbursement from their insurer. Those without health insurance will need to pay all fees upfront.

Health Centers & Clinics In Germany

In Germany, outpatient care is typically provided by doctors and specialists from individual or joint practices. You may also find medical centers – both private and public – where various healthcare professionals practice out of, including GPs, medical specialists, physiotherapists, psychotherapists, and nurses.

Emergency And After-Hours Healthcare

Urgent medical treatment requires patients to go to the A&E or ER, which are called Notaufnahme in Germany. Both state and private health insurance cover these emergency services.

If you need ambulance transportation, call the pan-European number 112 (free of charge).

The fire brigade ambulance service, Rettungswagen, will also take you to the nearest hospital.

Other emergency medical numbers are:

  • Emergency doctors: 19 242
  • Non-emergency doctors on call: 116 117

Patients can also contact their local practices for information on their out of hours service.

Telehealth In Germany

Telehealth in Germany is highly dynamic and is permitted, within certain restrictions, however, there are no limitations to specific fields of medicine. Telehealth applications and technologies must be approved; for instance, Zoom or Skype consultations are not typically allowed, and medical apps can apply for “fast track” market entry.

Doctors in Germany can advertise telemedicine services and may use telehealth practices in all cases where they deem it practical, whether for known or unknown patients. Today, e-prescriptions are permitted within the scope of several pilot projects.

Tips For Tourists In Germany

Germany is a beautiful country to visit. Along with its rich history, interesting culture and food, and natural sites such as the Black Forest, you could spend weeks here.

German culture is very much centered around the idea that rules and policies are made to regulate life. Punctuality is king, and locals don’t take lightly to being kept waiting. After all, Germans are known for making clocks and watches. It would also be a good idea to be aware of the volume of your voice.

Germany has strict laws when it comes to anti-corruption and honesty within the healthcare system.

Some Useful Phrases:

  • I need an ambulance – Ich brauche einen Krankenwagen
  • Heart attack – Herzinfarkt
  • I need a doctor – Ich brauche einen Arzt
  • I need a hospital – Ich brauche ein Krankenhaus
  • There’s been an accident – Es gab einen Unfall
  • I am allergic to… – Ich bin alergisch gegen…
  • Hospital – Krankenhaus

If you are a tourist in Germany and would like to speak to a medical professional connected to an international network of doctors, you can make an appointment on the Air Doctor app right now and have an in-person or virtual consultation within minutes.

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Jenny Cohen Drefler

Jenny Cohen Derfler

Air Dr CEO & Co-Founder

Jenny is the CEO and one of the Co-Founders at Air Doctor. She spent more than 20 years at Intel, most recently as general manager of its manufacturing facility in Israel and before that in various engineering and manufacturing roles in Silicon Valley. Air Doctor is her second startup having previously founded electric vehicle company ElectRoad.