Germany has a dual health insurance system. In addition to the statutory health insurance funds, there is also private health insurance. The “benefits-in-kind principle” applies in statutory health insurance, according to which persons with statutory health insurance do not have to make upfront payments to the healthcare provider (for instance their doctor) for the cost of treatment. Instead, the healthcare provider provides the necessary service and subsequently bills it to the statutory healthcare insurer of the insured person, the “health insurance funds”.
The range of benefits is regulated according to statutory requirements. The various health insurance funds can offer additional benefits to supplement these prescribed benefits. More than 90 percent of the benefits offered are however stipulated uniformly by law for all patients with statutory health insurance. There are also benefits that are not listed in the Standard Schedule of Fees (Einheitlicher Bewertungsmaßstab – EBM). These benefits listed as “individual health services” (individuelle Gesundheitsleistungen – IGEL) are only available on a self-payment basis. The resulting costs will not be reimbursed to the statutory health insured person.
The “benefits-in-kind principle” does not apply in private health insurance. In the case of persons with private health insurance, the respective healthcare provider issues a bill after the treatment. The amount of the costs for the individual benefits is set by fee scales. In a normal case, the patient pays the bill and then submits it to his/her healthcare insurer to have all or part of the costs reimbursed.
You can obtain medically necessary treatment by presenting the European Health Insurance Card (EHIC), when you are temporarily staying in Germany. Medically necessary treatment refers to treatment that cannot wait for your return home. You may need such treatment in case of acute illness or accident. You can also receive treatment related to pregnancy and childbirth or to a chronic illness. The need for treatment must emerge during the course of your stay.
You will receive treatment on the same terms and at the same price as the locals. It is advisable to carry copies of your European Health Insurance Card with you, along with the card itself. If you didn’t have your EHIC with you or it was not accepted, and you were required to pay all the costs of treatment yourself, you might be able to apply for reimbursement from Kela retrospectively.
If you become ill while in Germany, present your European Health Insurance Card to the treatment provider. You need to choose one of the sickness funds to pay the costs of your treatment. You can freely choose any fund which has an agreement with the statutory health insurance system of Germany. A list of health insurance funds (in German) is available online.
Germany also has completely private healthcare providers who do not have contracts with the statutory health insurance system. If you seek treatment from the private sector, you will be liable for all the costs of treatment.
In need of a doctor, contact a doctor (Arzt/Ärztin) who has an agreement with a sickness fund (Vertragsarzt, Kassenarzt or “Alle Kassen” meaning all health insurance funds). The contact information for the doctors can be found from the of the Contact Point of Germany. You can see a specialist (Facharzt/Fachärtzin) usually without a referral from a general practitioner. Treatment is free of charge. You can also see a dentist (Zahnarzt/Zahnärztin) without a referral.
Show your European Health Insurance Card and your identity card at the doctor’s practice. The receptionist will usually ask you how long you have been staying in Germany and ensure that you have not travelled into the country in order to receive healthcare. You must also choose the sickness fund from which the doctor will charge your treatment costs. The practice will print out the form “Patientenerklärung Europäische Krankenversicherung”, which you will have to fill out and sign. The payment procedure is similar with dentists and hospitals as well. In the dentist’s office you will have to fill out and sign a form called “Muster 81”.
Outside regular consulting hours, you may turn to an out-of-hours service (emergency service) by calling the number 116117 free from anywhere in Germany.
When collecting your prescribed medication from a pharmacy (Apotheke), show the prescription, your European Health Insurance Card and your identity card. Prescription medicines are usually free for patients under the age of 18. There are also on-duty pharmacies, Apotheken-Notdienst (website in German).
In an emergency, you can go straight to a hospital that has a care agreement, zugelassenes Krankenhaus. Most hospitals in Germany have this agreement.
At the reception, show your European Health Insurance Card and your identity card. As in the doctor’s office the reception or accounting office will ask you to fill out and sign the “Patientenerklärung Europäische Krankenversicherung”. If you need to go to a hospital without a doctor’s referral, the hospital has to contact the selected assisting German sickness fund indicated on the “Patientenerklärung Europäische Krankenversicherung”. For hospital care, you will pay a deductible per day (at most 28 days per calendar year). All of the hospital healthcare services that are required for treating an illness are covered. However, you are liable for any additional services (such as the costs for private rooms). Hospital treatment is free for patients under the age of 18.
If you are required to pay full price at a place of treatment although you presented the European Health Insurance Card, please save the receipts and enter directly in contact with the national contact point of Germany. Alternatively you might be able to apply for reimbursement from Kela retrospectively.
If your illness requires you to use special transport when returning to Finland, you will be liable for the travel costs in their entirety. You are recommended to take out a travel insurance that covers these costs.
Read more about suddenly falling ill in Europe.
Read more about reimbursement of costs of treatment abroad.
If you wish to travel to Germany for the purpose of using healthcare services you can find general information on seeking treatment abroad on our site. Some useful websites concerning seeking treatment in Germany are listed below. You should direct your questions about healthcare in Germany to the German Contact Point.
You can look for a suitable service provider by using the search engine on the website of the German Contact Point. The search engine allows you to look for doctors, dentists, hospitals, physiotherapists and other treatment providers by location or treatment type.
You can compare the costs of private doctor and dentist services in the doctor fee table GOÄ -Gebührenordnung für Ärzte and the dentist fee table Gebührenordnung für Zahnärzte, GOZ. You may also be charged a higher amount if the treatment you receive is more demanding than listed in the price lists. You can receive the best estimate for the price of the treatment by contacting the provider in advance to enquire about the costs.
Quality and safety of treatment
Germany has in place common standards concerning quality of treatment and patient safety. Information concerning the quality of treatment provided in Germany is available on the following websites, among others: The German Hospital Federation (DKG) and GKV-Spitzenverband.
In the event of treatment injuries, the legislation and patient insurance of the country providing the treatment is always applied. In case you are unhappy with the treatment you received, you should primarily try to sort the matter out with the treatment provider. The national contact point can help you with finding the right authority if you wish to make a complaint.