Navigating the German Healthcare System: A Simple Guide for Foreigners

Germany’s healthcare system is renowned for its efficiency and high-quality care. However, for foreigners, understanding how to access medical services and maximize health insurance benefits can be challenging. This guide provides a step-by-step breakdown of everything you need to know—from booking appointments to uncovering hidden insurance benefits.

1. Understanding Health Insurance in Germany

Types of Health Insurance

Health insurance is mandatory for all residents in Germany. There are two main types:

1. Public Health Insurance (Gesetzliche Krankenversicherung - GKV):

- Covers around 90% of residents.

- Funded through salary-based contributions (split between employer and employee).

- Covers in a large extent doctor visits, hospital stays, medications, and preventive care.

2. Private Health Insurance (Private Krankenversicherung - PKV):

- Available to high-income earners (over €69,300/year as of 2024), self-employed individuals, and students under certain conditions.

- Premiums (the amount you pay) are based on age, health status, and coverage level.

- Provides additional benefits like private hospital rooms, faster specialist access, and alternative therapies.

Tip: If you’re employed and earn below the threshold, you’re required to enroll in public insurance. Above this threshold, you can choose between public and private insurance.

Can You Change Health Insurance Providers?

- Public Insurance: You can switch providers after 12 months of membership. Popular options include TK (Techniker Krankenkasse), AOK, and Barmer, which offer competitive contributions and services. The cheapest one being BKK firmus.

- Private Insurance: Switching is more complex and may require a health check. If your income drops below the threshold, you can switch back to public insurance.

2. Booking an Appointment with a Doctor

Step 1: Finding a General Practitioner (Hausarzt)

Your Hausarzt is your first point of contact for non-emergency medical issues. To find one:

- Use online platforms like Jameda.

- Use Kassenärztliche Bundesvereinigung directory, which is the association of statutory health insurance physicians and psychotherapists in Germany.

- Or just google Hausarzt near me, then check the results near your surroundings.

Step 2: Scheduling an Appointment

- Call the doctor’s office, always the assistant will pick up a phone and in German so prepare few important phrases to make yourself clear.

- For urgent but non-life-threatening issues, visit during "offene Sprechstunde" (open consultation hours).

In some cases you have to be patient as you may wait for several days or weeks to get an appointment.

Step 3: Visiting the Doctor

- Bring your health insurance card (Gesundheitskarte).

- If medication is prescribed, you can get it from any Apotheke (pharmacy).

3. Seeing a Specialist

When Do You Need a Referral?

- A referral is required for most specialists (e.g., dermatologists, cardiologists).

- Exceptions include gynecologists, ophthalmologists, and dentists.

Steps to Seeing a Specialist

1. Get a referral from your Hausarzt.

2. Find a specialist through your insurer’s website.

3. Book an appointment (wait times can be long).

4. Visit the specialist with your referral and health card.

4. Emergency Medical Services

What to Do in an Emergency

- Life-Threatening Emergency: Call 112 for an ambulance (free of charge under public insurance).

- Urgent but Non-Life-Threatening: Visit the Notaufnahme (emergency room) at the nearest hospital.

- After-Hours Care: Call 116 117 to find an emergency doctor (Ärztlicher Bereitschaftsdienst).This is the medical assistance at night, weekends and holidays.

5. Hidden Benefits of German Health Insurance

Many expats are unaware of the additional benefits included in their health insurance. Here are some services you can take advantage of:

Preventive Care

- Free annual general health check-ups (from age 35).

- Dental cleanings are partially or fully covered. Visit the dental clinic (you do not need a referral)

- Free vaccinations (including flu, COVID-19, HPV, and travel vaccines in some cases).

- Cancer screenings (starting at age 20 for women, 45 for men).

Mental Health Services

- Psychotherapy (talk therapy) is covered if referred by a doctor.

- Online therapy sessions are available under some providers.

Alternative Medicine

- Partial coverage for homeopathy, acupuncture, and osteopathy.

Online health courses

This include but not limited to fitness classes, course on dealing with alcohol, smoking cessation course, prevention of depression and many more.

Maternity and Family Benefits

- Birth preparation courses and postpartum care are covered.

- Paid parental leave (Elterngeld) and free midwife support.

Take home tip: Utilize the preventive care benefit for regular check-ups can catch issues early, saving your health and money in the long run. Remember your health insurance provider covers the costs of all urgently needed medical treatments, not everything.