We explain how the German healthcare system works, including how to get health insurance, find hospitals, use emergency services, and more.
Understanding how the healthcare system works in a new country can seem like a daunting task, especially if you are faced with a language barrier. However, if you are living and working in Germany, you may be eligible for state healthcare, provided that you are registered with state health insurance. Otherwise, you need to take out private health insurance.
This helpful guide explains how to access the German healthcare system, and includes the following sections:
- Overview of healthcare in Germany
- Healthcare system costs in Germany
- Health insurance in Germany
- How to register for healthcare in Germany as an expat
- Private healthcare in Germany
- Doctors and specialists in Germany
- Women’s healthcare in Germany
- Children’s healthcare in Germany
- Dentists in Germany
- Hospitals in Germany
- Health centers and clinics in Germany
- Pharmacies in Germany
- Mental healthcare in Germany
- Other forms of healthcare in Germany
- In an emergency
- German healthcare system: useful phrases
- Useful resources
Cigna Global provides comprehensive health insurance to over 86 million customers in over 200 countries. They have wide access to trusted hospitals, clinics, and doctors and provide expats with help on tailoring a plan to suit their individual healthcare needs.
COVID-19 in Germany
The COVID-19 pandemic has been a difficult time for everyone. Many expats find themselves separated from family and loved ones in their home countries. As a foreigner, it is also sometimes difficult to find critical information regarding coronavirus infection rates, local measures and restrictions, and now, thankfully, vaccinations.
Overview of healthcare in Germany
The German healthcare system
The German healthcare system is a dual public-private system that dates back to the 1880s, making it the oldest in Europe. Today its doctors, specialists, and facilities make it one of the very best healthcare systems in the world.
Healthcare in Germany is funded by statutory contributions, ensuring free healthcare for all. In addition, you can also take out private health insurance (Private Krankenversicherung or PKV) to replace or top up state cover (gesetzliche Krankenkasse or GKV). The Federal Ministry of Health is responsible for developing health policy in Germany. The sector is regulated by the Joint Federal Committee.
Germany ranked 12th on the 2018 Euro Health Consumer Index. It has been praised for the level of choice given to customers in terms of treatment. However, it was criticized for having a low number of specialist hospitals, therefore this affected its score on quality.
Who can access healthcare in Germany?
All German residents can access the healthcare system through public health insurance in Germany. Non-residents need to have private insurance coverage to access healthcare. Temporary visitors will typically need to pay for treatment and claim reimbursement later.
If you are from the European Union (EU), European Economic Area (EEA) or Switzerland and staying only temporarily, you may use your EHIC card. Once you become an official resident, you will have to take out compulsory German health insurance.
Healthcare system costs in Germany
Germany is one of the biggest spenders on healthcare in Europe. It spends 11.1% of annual GDP on healthcare expenditure. Only Switzerland and France spend more in terms of GDP percentage. German healthcare spending works out at just over €4,000 per inhabitant each year.
Public and private insurance contributions cover the majority of costs. On top of this, everyone has to pay a fee of around €10-15 for their first medical visit every quarter. You don’t pay this if you don’t seek any help during that quarter. Those with private health insurance can reclaim this.
Health insurance in Germany
If you are an employee and you earn less than €57,600 a year (€4,800 a month in 2017), you have to take part in the government health scheme – Gesetzliche Krankenversicherun or GKV – taking out health insurance as soon as you have signed your work contract.
The scheme is administered by around 110 Krankenkassen (non-profit making associations) which must all charge the same basic rate of 14.6% of your eligible gross salary; up to a maximum of €4,350 a month in 2017 (€52,200 annually). This amount is shared equally between you and your employer. You have to stay with a particular Krankenkasse for 18 months, after which time you can switch to another government scheme. Employed workers only pay contributions if they earn over €850 per month.
GKV covers you for primary care with registered doctors, hospital care (both in- and out-patient) and basic dental treatment. Non-working dependents living at the same address and registered with the Krankenkasse are covered at no extra cost.
GKV does not cover consultations with private doctors, private rooms in hospitals, alternative or complementary treatments, dental implants, or glasses/contact lenses for adults. You can read more in our guide to health insurance in Germany.
How to register for healthcare in Germany as an expat
If you live long-term or work in Germany, you must register with the German authorities at your local town hall (Einwohnermeldeamt). Once you are registered, have a German social insurance number (Sozialversicherungsnummer), and are making national insurance contributions, you are entitled to state-run healthcare the same as German nationals.
In order to access this, you also have to register with a health insurance fund. See rates offered by different state insurers here. A non-working spouse and children are covered by the same insurance.
Your insurer will give you a health insurance card (Krankenversichertenkarte), which you have to take with you each time you visit a German doctor or German dentist. Since 2014 an electronic eHealth card with a photo of the holder (unless under 15) is proof of entitlement to medical services and benefits. The card, which contains your name, date of birth, address, and health insurance data, is scanned when you visit a medical service.
Private healthcare in Germany
You can choose to opt out of the state insurance plan and take out private health insurance cover (Private Krankenversicherung or PKV) if you are:
- an employee earning more than €57,600 (2017);
- working part-time and earning less than €450 a month;
- a freelance professional;
- an artist;
- a civil servant or other public employee
PKV usually covers a much wider range of medical and dental treatments than GKV. Companies offer different levels of cover. Premiums depend on age at entry into the scheme and any pre-existing conditions and coverage is usually per person; rather than per family as with the government insurance schemes. Part of medical insurance premiums is tax-deductible.
Employers in Germany also contribute to private health insurance fees; up to a maximum of €317.55 per month.
If you are not eligible for state health insurance, you can opt to take out private health insurance from a health insurance company. In Germany, you’ll find a range of local and international insurers, including:
The PVK maintains a full list of private German health insurance companies.
Doctors and specialists in Germany
Doctors are called Ärzte; a Hausarzt is the equivalent of a GP or primary care doctor. Under the German healthcare system, you are free to choose your own doctor. Many speak at least basic English. Some doctors only treat private patients, therefore if you have state insurance, make sure to check beforehand otherwise you will have to pay for treatment.
Practice hours are usually from 8am-1pm and from 3pm-6pm from Monday to Friday; many close on a Wednesday afternoon. Few practices are open on Saturdays and only emergency services operate on Sundays.
Some doctors have an open-door policy where you can just turn up at the surgery; however, you may have a long wait. You will need a referral from your GP to see many specialist doctors, although some specialists take direct bookings.
Women’s healthcare in Germany
Gynecologists are accessible in Germany through public health insurance. They will provide care and support during pregnancy. Your gynecologist is also the person to see for sexual health matters, cancer screenings, and urinary tract infections.
All maternity costs are covered by statutory insurance. However, some private insurers do not unless you have chosen to be covered for this, so it’s wise to check.
Pregnancy tests and basic forms of contraception are available in pharmacies. However, a gynecologist will need to prescribe birth control pills, intrauterine devices (IUDs), and diaphragms. Emergency contraception is widely available and doesn’t need a prescription. Public health insurance doesn’t cover most contraception costs.
Statutory insurance covers annual screenings for every woman aged over 20 for cervical cancer, breast cancer, and ovarian cancer.
Abortions are legal in Germany during the first 12 weeks of pregnancy, however you will need to undergo counseling sessions first. An abortion can be carried out up to 22 weeks into the pregnancy if the mother’s life is in danger or if the pregnancy poses serious risks to the mother’s health and well-being.
Children’s healthcare in Germany
Public health insurance will cover your children until the age of 18. Pediatricians will typically provide healthcare for children up until the age of 12 when they transfer to a GP. Around 90% of German children aged under 6 are seen primarily by a pediatrician. In addition, you are free to choose a pediatrician for your child.
Many specialist children’s hospitals offer emergency and outpatient care. These provide treatment for a range of illnesses and diseases as well as services such as speech therapy.
Vaccinations for children in Germany are free. There is a national vaccination schedule which includes immunization against conditions including:
- Hepatitis B;
- Measles, mumps and rubella (MMR)
More information can be found in our guides to children’s healthcare in Germany and vaccinations in Germany.
Dentists in Germany
You can find a dentist (zahnärzte) who operates within the statutory health insurance scheme on the KZBV website (in German). Otherwise, when you visit a dentist look for a sign saying Kassenarzt or Alle Kassen, which means that the dentist operates under the state German healthcare system.
Children and young people up to the age of 18 do not pay for dental treatment. However, check with your insurer about what the state insurance covers as there is limited cover. Furthermore, even private insurers won’t fully reimburse for all treatments. In addition, dental costs in Germany are extremely high. Routine procedures are covered, however more extensive work (such as dentures and crowns) are only partially covered.
See more detailed information in our guide to dentistry in Germany.
Hospitals in Germany
Hospitals are called Krankenhäuser. There are three main types:
- public hospitals (Öffentliche Krankenhäuser) which are run by the local and regional authorities;
- voluntary, non-profit making hospitals (Frei gemeinnützige Krankenhäuser) run by churches or organisations run by the German Red Cross;
- private hospitals (Privatkrankenhäuser)
Your GP will need to refer you to a specialist in a hospital. You should take your EHIC or German health insurance card when you visit. Adults have to pay a fixed charge of around €10-15 per day, up to a maximum of 28 days in a year.
If you are going to be an in-patient, note that hospitals have a certain amount of space allotted to patients with public insurance and for those with private insurance.
If you have a ‘private’ room it means that private insurance covers it; it doesn’t mean that only you can use the room. These private rooms usually accommodate two patients with a curtain separating them. Take your own soap and personal items.
Health centers and clinics in Germany
Outpatient care in Germany is generally provided by doctors and specialists from individual or joint practices. You will also find many medical centers, both public and private, where various different health professionals operate. These can include GPs, medical specialists, physiotherapists, psychotherapists, and nurses.
Pharmacies in Germany
Pharmacies (Apotheke) are open 9am-6pm from Monday to Friday and 9am-12pm on Saturdays. They all provide addresses for services outside of opening hours.
Medication does not always 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, however they are less likely to speak English. If your German is not good, it is easier to get information you need from your doctor.
Check here for information about local on-call pharmacies.
You can take a prescription from your GP to any pharmacy. If the prescription is on a pink slip of paper, you will have to pay a non-refundable fixed charge (around €5-10). You have to pay the full cost for certain medications for minor ailments such as cough mixture.
If you have private insurance, you will most often get prescriptions on a blue sheet of paper; this means you have to pay the full price of the drug upfront and then send the receipt to your insurance for reimbursement.
Mental healthcare in Germany
Like many European countries, Germany has seen more of a focus on mental health and mental healthcare services in recent years. There is not as much stigma around mental illness as there once was and there is more recognition of the need to look after mental well-being.
Research reveals that 5.3 million Germans suffer from depression each year. GPs can initially deal with general mental health issues, and they will prescribe necessary medication or refer patients on to specialist treatment. It is also possible to access some services such as psychiatrists, psychologists, and mental health specialists directly without referral. However, you will need to check what treatments your insurance policy covers.
You can seek treatment for more serious and enduring mental health problems in either:
- psychosomatic clinics, which can deal with conditions such as severe depression, anxiety, and eating disorders;
- psychiatric hospitals, which have facilities for in-patient stays ranging from a few days to several months.
Other forms of healthcare in Germany
Germany recognizes and practices alternative and complementary medicine. Generally speaking, around 20-30% of the population has used some form of alternative treatment. Furthermore, practitioners often use it when standard treatments are not available.
All licensed health practitioners have permission to use complementary techniques and many pharmacists train in herbal medicine. In fact, around three-quarters of qualified physicians use some type of alternative medicine and 77% of pain clinics provide acupuncture treatment.
Licensed Heilpraktikers can also deliver alternative and complementary treatments. These are practitioners of natural therapies who don’t require formal medical degrees, but have to pass an exam set by the health authorities. Chiropractors in Germany need the Heilpraktiker license even if they have a medical degree.
German health insurance covers some alternative medicine, however, there have been discussions to stop reimbursing homeopathic treatment.
Public health insurance will likely cover alternative treatments if:
- there are no other treatments available;
- if standard treatments are likely to have detrimental side effects;
- if they are cheaper and doctors consider them safe and cost-effective
In an emergency
For urgent medical treatment, go to the A&E or ER which are called Notaufnahme. Both state and private health insurance cover emergency services. If you need an ambulance, you can call the pan-European number 112 free of charge. In addition, the fire brigade ambulance service (Rettungswagen) will take you to the nearest hospital.
Other numbers to call in a medical emergency are:
- For an emergency doctor: 19 242
- For a non-emergency doctor on call: 116 117
You can also phone your local surgery for details of their out-of-hours service. See this full list of emergency numbers in Germany.
German healthcare system: 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
- Patient – Patient
- Sick – Krank
- The Federal Ministry of Health: information about health and long-term care insurance in Germany (in English).
- Joint Federal Committee: the regulating and decision-making body on German healthcare and health insurance.
- KZBV: National Association of Statutory Health Insurance Dentists.
- Aponet: find a local pharmacist.
- Unabhängige Patientenberatung Deutschland (UPD): independent health advice for patients, in German, Russian and Turkish.