Overview: Health care in Germany

Introduction

In Germany, it is usually not hard to find medical help if you become ill. There is an extensive network of easily accessible places to go for treatment. Health insurers will cover most of the costs of treatments and examinations.

But it's still not that easy to navigate the German health care system. That was the impulse behind creating this information on health care in Germany: to provide a general overview of the system as a whole and offer a practical guide. It is mainly aimed at people from other countries who are living and working in Germany – whether they're here for a short time or permanently. Being prepared in case you become ill, and knowing where to turn to for help, is important to ensure you get quick treatment.

Health insurance

Insurance coverage is compulsory in Germany, which means that everyone must have health insurance. The aim is to ensure that no one runs into financial difficulties due to an illness. If you are insured, you typically pay none – or only a reasonable part – of the treatment costs and also have financial security if you're unable to work.

Employees who earn a gross salary below a specific threshold must join a statutory insurer. If you earn more, you can choose to have private insurance.

Health care is mostly financed through the premiums paid by insured employees and their employers. The premium is determined solely by the income level of the insured person, but everyone with statutory insurance is entitled to the same health care – regardless of how high their premium is.

Outpatient treatment

In Germany you can decide for yourself which doctor, dentist or psychotherapist you want to visit. For their part, doctors generally have to treat anyone who is insured.

The family doctor (Hausarzt) or pediatrician (Kinderarzt) is usually the first stop for people who are ill or have other health-related problems. That doctor will decide whether you also need to see a specialist.

If you do, you will be referred to a specialist, such as a gynecologist or a dermatologist. It's also possible to go straight to a specialist or psychotherapist without seeing your family doctor first.

If you need to see a doctor at night, at the weekend or on a bank holiday, you can call the out-of-hours information services (ärztlicher Bereitschaftsdienst) on 116 117 to find out which doctors are on duty near you.

In an emergency such as an accident or a heart attack, emergency services can be reached by dialing 112.

In addition to doctors and dentists, there are a number of other health care professionals, including physiotherapists, speech therapists, nurses and midwives. You will usually need a doctor’s prescription for physiotherapy, speech therapy or home care.

Most medical and dental practices have what is known as a “Kassenzulassung” (statutory health insurance accreditation). You will need to take your insurance card along so that the practice can bill your insurer. The statutory insurers pay fixed amounts for some services such as high-quality dental prosthetics. Any additional costs must be paid out-of-pocket. The exact amount to be paid will depend on the type of dental treatment. Adults also usually need to pay part of the costs of outpatient physiotherapy or speech therapy.

Privately insured patients pay for their treatment up front and are then reimbursed later by their insurer. The level of reimbursement will depend on the individual insurance policy.

Inpatient treatment

Most hospitals in Germany treat all patients, regardless of whether they have statutory or private health insurance. Your family or specialist doctor will decide whether hospital treatment is needed – unless it's an emergency situation. Treatment that allows you to return home on the same day is referred to as “outpatient” care ("ambulant"). “Inpatient” care ("stationär") refers to treatment where you have to stay overnight in the hospital. Additional fees are charged for accommodation and meals that are not covered by statutory insurers.

In addition to inpatient treatment, there is also inpatient medical rehabilitation. Rehabilitation centers offer treatments lasting from a few days to several weeks that are designed to improve independence and physical fitness after a severe illness.

There are also rehabilitation centers for people who have mental illnesses or addiction problems.

Pharmacies

Medication is available in pharmacies, where you can also seek advice and information on the different medications. If your pharmacy is closed, you will find a list at the entrance directing you to the nearest pharmacy that is open "out-of-hours" – in other words, at night and on weekends as well.

If medication is prescribed by a doctor, the cost is mostly covered by statutory health insurers, and only a small amount needs to be paid out-of-pocket. This co-payment is capped at 10 euros per medicine, and doesn't have to be paid when medicine is prescribed for children and teenagers under the age of 18. If you're privately insured, you have to pay the full cost up front and your insurer will reimburse you afterwards.

Guidance and self-help

Germany offers a wide variety of different services offering personal advice and other forms of support if you become ill: These include self-help groups, independent patient advice, (psycho)social information centers, and information services provided by the statutory insurers and public health departments.

Information material and leaflets specially designed for immigrants are offered by the Federal Ministry of Health on the website "Migration and Health" in many different languages.

Seeking information and guidance and sharing experiences with others can also be very useful when choosing between different treatment options. This can be quite difficult, and reliable information is crucial for making the right choice.

Sources

• Bundesministerium für Gesundheit (BMG). Migration und Gesundheit. 2018.

• Bundesministerium für Gesundheit (BMG). Schaubild "Das Gesundheitssystem" - der Staat setzt den Rahmen. August 2015.

• Bundeszentrale für politische Bildung (bpb). Dossier Gesundheitspolitik. Das Gesundheitswesen in Deutschland. Ein Überblick. March 01.2012.

• Busse R, Blümel M, Ognyanova D. Das deutsche Gesundheitssystem: Akteure, Daten, Analysen. Berlin: Medizinisch Wissenschaftliche Verlagsgesellschaft; 2013.

• Klemperer D. Sozialmedizin – Public Health – Gesundheitswissenschaften. Bern: Huber; 2014.

• Obermann K, Müller P, Müller HH, Schmidt B, Glazinski B. The German Health Care System. A concise overview. 2013.

• Statistisches Bundesamt (Destatis). Eckdaten der Krankenhäuser 2013.

• IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

  Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

  Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.