After Russia, Germany is the second most populous country in Europe and the most populous member state of the European Union. Its Western European terrain boasts forests, rivers, mountain ranges, and North Sea beaches, all of which serve as a testament to its more than 2,000-year-old history.
Germany is a federation comprising 16 constituent states, known as Länder, each with its own constitution and a high degree of internal autonomy. The cultural and linguistic differences among these states are unique, with dialects often so divergent that people across state borders have difficulty communicating with each other.
If you are planning a trip to Germany, this healthcare guide will provide you with all the essential information needed to ensure your safety and knowledge during your stay.
- Healthcare Basics
- Cost of Healthcare in Germany
- Available Payment Methods
- Seeing a Specialist
- Drugstores and Pharmacies
- Hospitals and Clinics in Germany
- Emergency and After-Hours Healthcare
- Tips for Tourists
Healthcare In Germany – The Basics
Germany boasts one of the world’s best (and oldest) healthcare systems. There’s a dual public-private system that’s been in place for nearly two centuries, which has undergone significant advancements.
The system operates on statutory contributions guaranteeing free healthcare for all. However, individuals also have the option to purchase private health insurance (Private Krankenversicherung or PKV) to supplement or replace state coverage (Gesetzliche Krankenkasse or GKV).
The Federal Ministry of Health in Germany is tasked with the development of health policies and overseen by the Joint Federal Committee. Whether you’re a resident or a visitor, understanding this healthcare system can help keep you informed and safe during your stay.
Healthcare in Germany is accessible to all residents through public health insurance – this system covers 90% of residents. While non-residents require private insurance coverage to receive medical care. Visitors to Germany usually have to pay for treatment and then claim reimbursement at a later stage.
Temporary visitors from the EU, EEA, or Switzerland can use their EHIC card to access emergency medical treatment in Germany. However, legal residents must have German health insurance. The EHIC is part of the health insurance card for all residents in Germany, allowing them to benefit from emergency medical treatment and care when temporarily elsewhere in the EEA.
If you need medical care during a temporary stay in Germany, presenting your EHIC to the healthcare provider indicates that you have statutory health insurance and that your native country’s insurer will cover the costs. If you do not have an EHIC card, you can request a Provisional Replacement Certificate (PRC) from your healthcare insurance provider.
The EHIC can be used to claim reimbursement for costs incurred in the same way as German nationals. You will not have to pay if the treatment is free for locals. If you have to pay for treatment, you can request reimbursement from the national institution or your health insurer.
The EHIC is only valid in practices operating under the state health insurance system, identifiable by a sign that says: Kassenarzt or Alle Kassen. It is valid for up to 6 months, after which visitors planning to stay longer must explore private health insurance schemes.
Self-employed artists and publicists can also receive health protection in public health insurance similar to employees through the Künstlersozialkasse (KSK) or Artists’ Social Insurance Act.
Private Krankenversicherung (PKV) provides more extensive medical coverage in Germany than GKV. People who are self-employed, part-time employees, freelance professionals, artists, government employees, or those who earn more than EUR 64,350 annually can choose to take out private health insurance.
Premiums for private health insurance vary depending on the level of coverage and the insurance provider.
In some cases, private insurance may be more cost-effective than public health insurance since GKV contributions depend on income, resulting in higher earners paying more.
The PKV maintains a list of private German health insurance companies.
Cost of Health Care In Germany
Germany ranks among the top healthcare spenders in Europe, allocating 11.1% of its annual GDP to healthcare expenditure. Only Switzerland and France outspend Germany in terms of GDP percentage, with German healthcare costs averaging over EUR 4,000 per resident each year.
Most of these costs are covered by contributions from both public and private insurance plans. Additionally, individuals are required to pay a fee of approximately EUR 10-15 for their first medical consultation each quarter. Those who do not require medical attention during this period are exempt from this fee, and those with private health insurance can reclaim these expenses.
Patients enrolled in public health insurance or GKV typically pay modest co-payments for medication and hospitalization, with all other expenses fully covered by their insurance provider. In contrast, PKV is based on reimbursements, which often involve excess payments on either an annual or per-service basis.
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
Doctors in Germany are referred to as “Ärzte,” and a “Hausarzt” is equivalent to a GP or primary care physician. In the German healthcare system, patients have the freedom to choose their own doctor. While most doctors have at least basic knowledge of English, some only treat private patients, which means patients with public insurance must pay for their treatment.
Typically, practice hours for doctors are from 8 am-1 pm and 3 pm-6 pm, Monday to Friday. Many practices are closed on Wednesday afternoons, and only a few are open on Saturdays. Emergency services are available on Sundays.
Seeing A Specialist
Referrals are not mandatory in Germany, and patients can directly visit a specialist without seeing a family doctor first. However, some restrictions apply. Referrals are not required for emergency treatment, dentistry, pediatrics, gynecology, and ophthalmology.
For certain specialists, a referral from a family doctor is typically required. These include experts in laboratory medicine, microbiology, nuclear medicine, pathology, radiology, radiotherapy, and infection epidemiology. In addition, referrals are necessary for special diagnostic procedures and treatments that require significant technical or medical effort and involve high risks.
Private health insurance (PKV) policyholders have the freedom to choose any doctor they want without needing a referral. However, this may impact reimbursement by the insurance provider as treatment necessity is a prerequisite for coverage. Medical practices in Germany generally operate from 8 am-1 pm and from 3 pm-6 pm on weekdays, with few offices open on Wednesdays and weekends.
Drugstores And Pharmacies
Apotheke (or pharmacies) in Germany can be identified by a prominent red-letter A. These establishments typically operate from 9 am to 6 pm on weekdays, and from 9 am to 12 pm on Saturdays.
It’s worth noting that drugstores, known as Drogerien, such as DM and Müller, should not be confused with pharmacies. These retailers do not sell medication, but rather a variety of consumer items and toiletries.
Should you require medication, you can take a prescription from your general practitioner to any pharmacy. However, if your prescription is on a pink slip of paper, this is an indication that you’ll need to pay a non-refundable flat rate – approximately EUR 5-10. In the case of minor ailments like cold and flu, you’ll need to pay the full amount for the medications.
Those with private insurance will be issued their prescription on a blue slip of paper, requiring them to pay the full amount upfront at the pharmacy and then seek reimbursement from their insurer.
It’s important to note that medication packaging may not always include dosage instructions, so it’s crucial to consult with your doctor or pharmacists for guidance and record the details for future reference. While pharmacists may also offer dosage information, their English proficiency may be limited.
Here is information about local on-call pharmacies.
Hospitals In Germany
In Germany, Krankenhäuser is the term used for hospitals, which can be categorized into three main types:
- Öffentliche Krankenhäuser – public hospitals.
- Frei gemeinnützige Krankenhäuser – voluntary non-profit hospitals.
- Privatkrankenhäuser – private hospitals.
Compared to other countries, hospitals in Germany have a reputation for excellence. However, only a doctor can approve hospitalization for non-emergency cases.
When referred to a specialist in a hospital, your GP will play a significant role. If you plan to stay as an inpatient, be mindful that hospitals have limited space allocated to patients covered by public or private insurance. Therefore, it’s crucial to bring your EHIC/German health insurance card when you visit.
Hospital bills for those covered by GKV are sent directly to the insurer. On the other hand, patients with PKV must pay all bills upfront and claim reimbursement later.
It’s important to note that hospital stays in Germany are structured, with specific visiting hours and strict rules on mobile phone usage and smoking. Additionally, many doctors and nurses in hospitals may not speak English fluently, so be prepared to communicate using German or bring a translator.
Health Centers & Clinics In Germany
Outpatient care in Germany is generally offered by doctors and specialists in individual or joint practices. There are also medical centers, both public and private, where healthcare professionals like GPs, medical specialists, physiotherapists, psychotherapists, and nurses provide their services.
Emergency And After-Hours Healthcare
If you require urgent medical attention in Germany, you should visit the A&E or ER, known as Notaufnahme. In Germany, emergency services are covered by both state and private health insurance.
In the event that you require ambulance transportation, dial 112, (a pan-European number for free). The fire brigade ambulance service, called Rettungswagen, is also able to transport you to a hospital nearby.
For emergency medical assistance, dial 19 242 to reach emergency doctors. To access non-emergency doctors on call, dial 116 117.
Patients can also contact their local practices for information on their out-of-hours service.
Telehealth In Germany
In Germany, telehealth is a rapidly evolving field and is allowed with certain restrictions, though there are no limitations on specific medical fields. However, telehealth applications and technologies must be approved, and platforms like Zoom or Skype consultations are generally not allowed. Medical apps may apply for “fast track” market entry.
Doctors in Germany are permitted to advertise telemedicine services and can use telehealth practices in all cases they find appropriate, whether for existing or new patients. Currently, e-prescriptions are allowed as part of several pilot projects.
German health insurance for foreigners
In Germany, healthcare insurance is mandatory for all residents, including foreigners. There are two main options: statutory health insurance (GKV) and private health insurance (PKV). Statutory insurance is typically for those with lower incomes, while private insurance offers more flexibility but can be costly. EU citizens can transfer coverage using the EHIC or EHID, while non-EU citizens may need private insurance initially. Healthcare insurance in Germany provides access to quality care, including doctor visits, hospitalization, medications, and preventive services. It’s important to understand the specific coverage and consider supplementary insurance if needed. Seeking advice from experts can help navigate the healthcare system and find the right insurance for your needs.
Tips For Tourists In Germany
Germany offers visitors a wealth of attractions. From its captivating history and culture to its scenic natural landscapes like the Black Forest, making it an ideal destination for an extended stay.
The German way of life revolves around the belief that regulations and policies serve as a guide to regulate everyday activities. Promptness is highly valued, and tardiness is frowned upon as Germans are known for their excellent watchmaking skills. Additionally, it’s advisable to be mindful of your vocal volume.
In Germany, healthcare is subject to stringent anti-corruption and transparency laws.
Travel Health Insurance for Germany
When traveling to Germany, it’s crucial to have travel health insurance that provides coverage for unexpected medical expenses. This insurance typically includes emergency medical treatment, hospitalization, and medication costs. It may also offer benefits like emergency evacuation or repatriation. Remember to carefully review the policy details, including coverage limits and exclusions. Non-EU citizens should note that the European Health Insurance Card (EHIC) might not be valid, so obtaining comprehensive travel health insurance is vital. With proper coverage in place, you can explore Germany knowing you’re protected in case of any medical emergencies.
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.