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Tips about German Statutory Health Insurance

Updated - April 2022

Anyone coming to Germany for work or study usually has many positive attributes: curiosity, dedication and specialist knowledge. Maybe some language skills as well. However, the most important thing of all is to stay healthy. Germany has one of the best healthcare systems in the world. The treatment provided by physicians, therapists and other healthcare professionals offers you a lot of safety. But how exactly is health care provided?

The healthcare system in Germany
The German social security system enjoys an excellent reputation all over the world. 90 % of the population are members of a statutory health insurance. Everyone else has private health insurance cover. As an employee, you are obliged to statutory health insurance when your income is below a certain level. The contributions are shared between the employees and the employers equally. Those who earn more pay more and those who earn less pay less. However, everyone profits from the same benefits. This is called the solidarity principle.

Free health insurance for family members is an example of this. As a member of a statutory health insurance, you only pay one contribution – your children, spouse or civil partner can be co insured at no extra charge and can take advantage of all the benefits. In order to use the services provided by a statutory health insurance, you receive a health insurance card (elektronische Gesundheitskarte or eGK in German). It is like an identity card and proves which insurance provider you belong to when you visit the doctor.

When you need to visit a doctor
There are over 370,000 doctors in Germany. While many work in specialist medical centers and hospitals, a significant number work in private practices. This is where you will find your general practitioner (GP). Your GP will be your first medical point of contact, and will refer you to a specialist or hospital if necessary.

He or she acts as your navigator, coordinating and planning all further steps of your treatment. This saves you unnecessary and straining tests, for instance. Members of the statutory health insurance don’t have to pay anything to visit a doctor. You just have to show your health insurance card at the doctor’s office or hospital. The statutory health insurance covers the cost of necessary Psychotherapeutic treatments too. The same applies if you need to visit a dentist. Necessary medical treatments as well as preventive check-ups are paid directly through your health insurance.

How to get your medication
You obtain tablets, drops and other medicines either at the doctor’s office, the hospital or from a pharmacy. You will generally receive a prescription by your doctor that you then have to take to a pharmacy to receive your medication. The statutory health insurance covers the cost of all medically necessary medicines. This also applies to new and innovative pharmaceuticals whose safety and quality are established. In some casees and for certain medications you may have to make a co-payment.

Emergencies
Germany has an on-call medical service for urgent medical problems for which you would normally consult your GP during regular opening hours. You can reach this service outside normal office hours (e.g. at night, at weekends and on public holidays) by dialing 116117. There are resident doctors in the emergency practices who can treat patients in urgent cases.

If you need immediate first aid – e.g. following an accident – you can contact the local emergency and rescue services by dialing 112 free of charge. The same number applies throughout Europe. As a member of the statutory health insurance you are entitled to emergency treatment.

Sick leave
Anyone who is sick and unable to work as a result is obligated to inform their employer. Moreover, a doctor’s medical certificate is required from the third day on. However, your employer can ask for the “ärztliche Arbeitsunfähigkeitsbescheinigung”(medical certificate of incapacity for work) sooner. The best thing to do to find out exactly when an employer needs the certificate is to ask your company.

The certificate of incapacity for work explains both the type and duration of the illness. You will receive sick pay for the time you are unable to work. The amount and time period of payment are set by law. Your employer is responsible for making up for the loss of earnings for the first six weeks of your sickness. After that, you receive sick pay by your health insurance. The level of sick pay you receive is lower than your regular salary and is calculated according to set rules.

Insured when traveling
As a member of the statutory health insurance, you are also covered on vacation and business trips. You are entitled to emergency treatment in 34 European countries with the European Health Insurance Card (EHIC) – this is on the back side of the health insurance card.

Germany has partner agreements with other countries too, such as Turkey. Not all of the benefits available in Germany are refundable abroad. Moreover, much higher copayments may apply in some countries. German health insurances cannot cover the cost of a medically necessary repatriation either. Consequently, it is possible for substantial amounts to accrue, and you should protect yourself by taking out a supplementary private travel insurance.

Check-ups and Prevention
Everyone can take steps to stay healthy and to prevent illness. The statutory health insurance offers many options for you to promote and protect your own health.

For example, by means of special preventive medical check-ups and vaccinations. Make sure you’re properly informed about the options. Doctors may offer you “individual healthcare services” (IGeL) that aren’t always beneficial from a medical perspective.

How’s your work/life balance? Anyone with a demanding job should stay mentally and physically fit. There are many opportunities to be active before and after work. The statutory health insurance supports you with a range of preventative programs. You also receive a bonus afterwards for participating in them, so you can benefit financially too.

Article contributed by BARMER. BARMER is one of the largest statutory health insurance providers in Germany. Their HUB for Relocation assists you quickly and in English with your membership and provides you with proof of insurance within 24 hours (on weekdays).