Health insurance:    

Almost everybody in Germany has health insurance. Ninety percent of the population subscribes to the public programme (Krankenkasse), which is mandatory unless you are above a certain income bracket. The other 10 percent have private insurance.

If you've managed to wiggle your way into the country without health insurance, chances are you won't be able to stay that way for long. For one, to get a visa or a residence permit, you have to be insured and you have to have the documents to prove it.

Most doctors will not be willing to see patients who don't have health insurance. If you have a foreign insurance, you will probably have to pay, in cash, at the end of your visit.

If you are staying here for a long period of time, you will certainly have to consider whether you want a public or private insurance, a German programme or one from your home country.

Although the overwhelming majority of German citizens have public insurance, many doctors prefer to see patients with private policies. Some of them even specify that they will only see patients with private policies. This is simply because they get paid more for it.

You might have trouble enrolling in a German university without German insurance, even if your insurance is valid abroad. In this case, the cheapest alternative is to get a public policy. Their student rates run to around 70 euros per month.

UK citizens who pay for the British National Health Service can get medical and dental treatment in Germany for free, if you have an E111 form from a UK post office. This includes treatment in public hospitals (with doctor referral except in emergencies) minus a small daily charge, for up to 14 days. You will still have to pay for some prescription medicines.

Otherwise, you will probably be better off with a private insurance for people living abroad. They will cover some areas that are specific to the expatriate lifestyle and are often cheaper than German packages.

If you are American, make sure that the insurance you have will cover you when you are outside the US. Most of them (including Medicare and Medicaid) don't, so you will probably have to get new coverage.

When you shop for an insurance company, check to see if you have to pay for your visit up front and then collect reimbursement, or if the company will accept receipts from your doctor. Many American companies will require that you translate into English all claims you send to them.

Going to the hospital:

Unlike in some other countries, if you have an overnight or extended stay in a German hospital, you might be assigned a new doctor. German doctors work in independent private practices; they don't have the same working relationship with medical campuses or hospitals that they do in Britain or the US. Some physicians have their own beds reserved in hospitals so they can see their patients there but this is not always the case.

Moreover, a "private" room in a hospital isn't necessarily a room that you get to have all to yourself. Hospitals have a certain amount of space allotted to patients with public insurance and for those with private insurance. "Private" means private insurance – and these rooms are generally used for two patients who are separated by a curtain.

Many expatriate patients come out of a hospital stay saying their only complaint was the food. German hospital food might be quite different to what you expect – a hot meal at lunchtime and rye bread and some sausage in the evening. Some hospitals are updating their menus but be prepared for those who haven't.

Bring towels and soap with you, as well as any other personal hygiene products you will want. Sheets will be provided by the hospital.

Reproductive health:

The "morning-after pill," or RU487, is widely available in Germany (weekdays you can get a prescription from a gynaecologist and at weekends through a hospital), although some Catholic hospitals won't administer it. Go to the emergency room if you need to take it.

Abortions are legal in Germany, although there is a law that you have to receive counselling beforehand.

Catholic and Protestant churches both used to offer their own free abortion counselling services. When the pope forbade the Catholic church to continue, the Protestant church had a field day advertising their comparative open mindedness.

There are also private counselling services available for free. Centres in eastern Germany are traditionally a bit more supportive of the right to abortion than in western areas but you should find helpful advice wherever you choose to go. Counsellors will also be able to refer you to a doctor if you choose to have the operation.

Pregnancy tests (Schwangerschaftstest or B Test) are available in pharmacies (Apotheke), but you have to ask for them at the counter.

If you plan to have a baby in Germany, you will find a number of obstetricians and midwives to help you through the process.

To make sure that your doctor is there when you deliver, call for transportation as soon as you start feeling contractions. If you wait too long, transport services will only take you to the nearest hospital, for fear you will have the baby in the car.

Pharmacies and prescription medication:

Pharmacies (Apotheke) are open 9 am to 6 pm Monday to Friday and 9 am to 12 pm Saturday. They all provide addresses for services outside of opening hours.

At pharmacies, you will be able to buy prescription medication and a few health care products. You'll be able to find most over-the-counter items and a wide range of other personal care products for a cheaper price at the larger chain drug stores like Schlecker, Rossman or Drospa.

Prescription medication is sold in Germany by company name, not by the active ingredients in them (as they are in the US, for example). Usually doctors prescribe the most expensive one, so ask your doctor if there is a cheaper medicine available with the active ingredients you need.

Medication does not come with dosage instructions on the package. Make sure you ask your doctor when and how much you should take and write down the information so you have it later. Sometimes your pharmacist will also be able to tell you about dosages but they are less likely to speak English so if your German is not good, make sure you get all the information you need from your doctor.

In the package, you will find a long-winded description of the medication. It is there to free the pharmaceutical companies from liability. Other than that, it has little practical use. You will find the medicine's active ingredient in small type somewhere on this sheet, though, if you want to know what you are taking.

Doctors give out two different types of prescriptions. Those that are on a pink slip of paper, mean you have to pay a small supplementary fee, or "state fee," that is usually around EUR 6 per package.

If you have private insurance, you will most often get prescriptions on a blue sheet of paper, which means you have to pay the full price of the drug up front and then send the receipt to your insurance for reimbursement.

Bupa International is a leading international expatriate health insurer that covers healthcare in over 190 countries.

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