The German Healthcare System — Overview for Foreigners

Health Insurance Requirement

In Germany, health insurance is mandatory — for everyone who lives and works here. There are two systems:

Gesetzliche Krankenversicherung (GKV)

• Approximately 90 % of the population is publicly insured.
• Contribution: 14.6 % of gross income (employer and employee each 50 %) + additional contribution (approx. 1.0–1.7 %).
• Insurance funds: TK, AOK, Barmer, DAK, IKK, HKK and others.
• Family insurance: Spouse and children are covered free of charge if they have no income (over €505/month).

Private Krankenversicherung (PKV)

• For self-employed, civil servants and employees earning gross income above €69,300 annually (2026).
• Contribution depends on age, health status and tariff — not on income.
• Important: Switching back to GKV from age 55 is almost impossible.

Hausarzt — Your First Point of Contact

The Hausarzt (general practitioner) is the central contact point for all health matters in Germany:

• Registration: Call or visit in person. Bring your health insurance card (eGK).
• Your Hausarzt knows your medical history and coordinates treatment.
• For most specialists, you need a Überweisung (referral) from your Hausarzt.

Finding a Hausarzt

• KBV doctor search at arztsuche.kbv.de — search by specialty, language and location.
• Jameda.de — rating portal with patient reviews.
• Tip: Ask neighbors, colleagues or your community for recommendations — especially for doctors who speak your language.

Facharzt and Überweisung

For specialists (eye doctor, orthopedist, dermatologist, ENT, etc.) you typically need a Überweisung from your Hausarzt:

• Without a referral: Many specialists will still see you, but waiting times are often longer.
• Waiting times: 3–8 weeks are normal (psychotherapy: 3–6 months!).
• Appointment service: Call 116 117 — the Kassenärztliche Vereinigung will arrange a specialist appointment within 4 weeks.

Exceptions — without a referral

You can visit these specialists directly:

• Eye doctor and gynecologist
• Pediatrician (for children)
• Dentist
• Emergency room (in acute emergencies)

Emergency Room and On-Call Service

Notaufnahme (Hospital Emergency Room)

The emergency room is for life-threatening situations:

• Heart attack, stroke, severe injuries, breathing difficulties
• Emergency number: 112 (ambulance, fire department)
• Costs are covered by your health insurance.

Ärztlicher Bereitschaftsdienst (On-Call Medical Service)

For urgent, but not life-threatening complaints outside office hours:

• Phone: 116 117 (free, 24/7)
• On-call clinics in hospitals (evenings and weekends).
• Do not visit the emergency room for non-emergencies — it overwhelms the facility and you wait very long.

Krankschreibung (Sick Leave Certificate)

If you are ill and cannot work:

• From day 1 of illness (or from day 3 according to your employment contract) you need a Krankschreibung (AU) from your doctor.
• Since 2023: The AU is transmitted electronically directly to your health insurance and employer (eAU).
• Continued pay: Your employer pays your full salary for 6 weeks.
• From week 7 onwards: Your health insurance pays sick benefit (70 % of gross income, max. 78 weeks).

Preventive Examinations — Free

Your statutory health insurance covers numerous preventive examinations:

• Health check-up from age 35 (every 3 years).
• Dental care (2× per year — definitely take advantage for bonuses on dental prosthetics!).
• Cancer screening from certain ages.
• Child preventive check-ups (U1–U9) — mandatory and free.

Co-payments and Exemptions

For some services, publicly insured people pay a co-payment:

• Medications: €5–10 per prescription.
• Hospital stay: €10 per day (max. 28 days/year).
• Payment limit: max. 2 % of gross income per year (1 % for chronically ill). After that you can apply for exemption.

Status: March 2026. All information without warranty.