Healthcare during a stay in another member state

During a stay in another member state of the European Union, an EEA state such as Iceland, Liechtenstein and Norway, Switzerland and the United Kingdom, you have the option of making use of healthcare. You will be treated to the same extent and under the same conditions and costs as those applicable to insured persons in the respective country of residence.

Persons with statutory and private insurance

In Germany, in addition to those with statutory health insurance, there are also those with purely private health and long-term care insurance. In terms of service providers, there are also doctors and hospitals that only treat private patients.

The majority, over 87%, of insured persons in Germany have statutory health insurance and the majority of service providers treat both privately and statutorily insured persons.

Healthcare with a European Health Insurance Card (EHIC)

Before going on vacation to the above-mentioned countries, you should speak to your health insurance company and, if necessary, obtain a European Health Insurance Card (EHIC) or a certificate of entitlement. In Germany, the EHIC does not have to be applied for separately, as it is on the back of the insurance card for people with statutory health insurance. Upon presentation of the EHIC, you are entitled to benefits that prove to be medically necessary during your stay abroad. This includes in particular immediately necessary medical care in emergencies but also ongoing treatment for chronic illnesses . Any remaining cost risks, for example due to higher deductibles abroad or the costs of repatriation to the Federal Republic of Germany, can be covered by private travel health insurance. private foreign travel health insurance can be covered. You can also find out more about this from your health insurance company, which has often also provided information on the scope of benefits and special features when using medical services in the respective host country. The National Contact Point for Cross-border Healthcare EU-PATIENTEN.DE can also provide information free of charge.

Healthcare without an EHIC

People with statutory health insurance also have the option of receiving medical treatment in other EU member states or in Norway, Iceland and Liechtenstein, the so-called EEA states and Switzerland instead of in Germany. The costs incurred costs can then be reimbursed by the health insurance fund at home. It does not matter whether the specific treatment was medically necessary during a stay abroad, nor how the specific benefit and reimbursement conditions are structured abroad. The type and scope of the reimbursable benefits are based on what is also covered by the statutory health insurance fund in Germany.

This means that the insured person's health insurance fund will only cover the costs that would also be incurred for comparable treatment in the country of insurance. comparable treatment in the country of insurance would have been covered - minus a deduction for administrative costs. Prior consent of the health insurance fund is only required for hospital treatment in other EU countries and for treatment for which prior authorization is also required in Germany. Nevertheless, it is advisable to ask your health insurance fund in advance which services are actually eligible for reimbursement, even for planned outpatient treatment.

As a result, patients have the right to choose whether they want to pay the treatment costs and then receive reimbursement in accordance with the law of the country of insurance or whether they receive necessary medical treatment in accordance with the law of the country of treatment on presentation of the EHIC. Due to the large number of different constellations, insured persons should always contact their health insurance fund to find out which service providers can be used abroad and under what conditions. The National Contact Point for Cross-border Healthcare EU-PATIENTEN.DE can also provide information free of charge.

Temporary stay in Germany

During a temporary stay in Germany you will receive benefits via the European Health Insurance Card (EHIC) from your home country.

Please apply for the EHIC from your competent health insurance fund in your home country before your stay in Germany. Make sure that it is valid for the entire period of your stay. If you have forgotten your EHIC, please ask your health insurance company for a provisional replacement certificate by fax or e-mail.

Requirements for treatment with the EHIC in Germany

If you want to receive treatment in Germany with the European Health Insurance Card (EHIC), there are three things you need to bear in mind:

1. Only practitioners who treat people with statutory health insurance, so-called contracted service providers, can be used.
   You can obtain information directly from the person providing treatment or from the statutory health insurance funds.
2. The contracted service provider is entitled to offer you additional services. You must pay for these yourself. Before the doctor can provide and invoice such services, he/she requires your written consent.
3. Before treatment, you must select one of the more than 90 statutory German health insurance companies on a German form. This insurance company will initially pay for the treatment and will later be reimbursed by your health insurance company. You can obtain the multilingual form directly from the service provider.

The EHIC can only be used to claim benefits that are included in the statutory scope of benefits and are considered medically necessary by the treating physician, taking into account the length of stay. You can find more information in the leaflet " Vacation in Germany ", which is linked in various languages in the next section, as well as on the website of the National Contact Point for Cross-border Healthcare EU-PATIENTS.COM .

Ordinary stay/change of residence to Germany

If you have moved your place of residence/center of life from another European country to Germany, treatment with the EHIC from your former country of residence is no longer possible. You may then be insured in Germany, for example if you take up employment. For pensioners who only receive a pension from their former country of residence, treatment via the S1 form from the health insurance fund from the former country of residence.

If you are eligible for care, you should have the S1 form issued by your health insurance fund in your home country before you move to Germany. If this is not possible, you can also contact a statutory health insurance fund in Germany, which will then request the S1 form for you from the health insurance fund in your country of residence.

The S1 form will be exchanged for a health insurance card by the German statutory health insurance fund you have chosen. With this card, you will receive all the same benefits in kind as a person insured with this health insurance fund in Germany. Cash benefits, such as care allowance, remain with the competent institution, your health insurance fund in your home country. They cannot be provided in accordance with German law. Further details can be obtained from the GKV-Spitzenverband, German Liaison Office Health Insurance - Abroad (DVKA) .

• EU-PATIENTS.COM
• Information sheet European Health Insurance Card
• German Liaison Office Health Insurance - Abroad (DVKA)