Germany has one of the world’s most comprehensive healthcare systems. For newcomers, though, figuring out insurance options, terms, referrals, and paperwork in German can be tough.
This guide gives you a clear overview of the German healthcare system. No matter if you are a professional, student, job seeker, or moving with your family, knowing these basics will help you get care with confidence and avoid mistakes.
The Two Pillars: Public and Private Health Insurance
Health insurance is mandatory for all residents in Germany. Coverage must be through either the public system (GKV) or private insurance (PKV); opting out is not permitted.
Public Health Insurance: Gesetzliche Krankenversicherung (GKV)
GKV is the statutory insurance system, covering most residents. Contributions are based on your gross salary, currently about 14.6 percent, split equally with your employer. An additional supplementary surcharge (Zusatzbeitrag) varies by insurer.
GKV is especially beneficial for families, as it covers a non-working spouse and dependent children at no extra cost. This is called Familienversicherung.
Private Health Insurance: Private Krankenversicherung (PKV)
Private insurance is available to employees earning above the annual threshold (about €73,800 in 2024), civil servants, and the self-employed. Premiums depend on age, health status, and chosen coverage, not salary.
Private insurance often provides broader coverage, shorter specialist waiting times, and access to senior consultants (Chefarzt). However, each family member needs a separate policy, which can increase costs for families.
💡 Key point: Employees earning below the threshold are automatically enrolled in GKV. Self-employed individuals and high earners must select and arrange insurance before starting work.
GKV vs PKV at a Glance
| Public Insurance (GKV) | Private Insurance (PKV) | |
| Who qualifies | Employees earning below ~€73,800/year; students; job seekers | High earners (above threshold), civil servants, self-employed |
| Premium basis | Percentage of gross salary (~14.6% + surcharge), shared with employer | Based on age, health status, and chosen coverage |
| Family coverage | Non-working spouse and children covered for free | Each family member needs a separate policy |
| Coverage scope | Comprehensive — GP, specialist, hospital, dental basics | Often broader, faster specialist access, private rooms |
| Card issued | Elektronische Gesundheitskarte (eGK) | Private insurance card or reimbursement model |
Your Insurance Card – The Elektronische Gesundheitskarte (eGK)
After enrolling with a public health insurer (Krankenkasse), you will receive your electronic health card (Elektronische Gesundheitskarte or eGK). This card grants you access to the healthcare system.
You must present this card at every medical appointment. Without it, many practices will either ask you to pay out of pocket (and claim reimbursement later) or reschedule your visit. So, it’s better to always carry it with you.
The card contains a chip with basic personal and insurance data. It does not store your full medical history. If you lose it, contact your Krankenkasse immediately to request a replacement.
If you have private insurance, you usually pay for appointments first and then send the invoices (Rechnungen) to your insurer to get reimbursed. Keep all your medical receipts.
Choosing Your Krankenkasse (Public Insurer)
Germany has many statutory health insurers, including TK (Techniker Krankenkasse), AOK, BARMER, DAK, and IKK. All GKV providers offer the same statutory benefits by law. Differences include supplementary services, customer support, digital features, and the Zusatzbeitrag (supplementary premium).
Consider the following when choosing an insurer:
- English-language support: TK and some others offer English-language customer service, which is especially helpful when you first arrive.
- Digital services: Many insurers offer apps for submitting receipts, managing your data, and booking appointments.
- Supplementary premium (Zusatzbeitrag): Compare the current rates, as this varies between insurers.
- Special programmes: Some offer additional preventive health checks, dental coverage, or reimbursements for alternative medicine.
You may switch your Krankenkasse at any time with two months’ notice, providing flexibility if you find a better option.
How to Access Medical Care: The GP-First Model
Germany primarily uses a GP-first model. For most health concerns, your first contact should be your Hausarzt, or registered general practitioner. This is a core part of the referral system.
The Role of the Hausarzt
Your Hausarzt manages your primary care, including check-ups, prescriptions, initial diagnoses, sick notes (Krankmeldung), and specialist referrals. Registering with a Hausarzt makes you a Stammpatient (regular patient), which prioritizes you for appointments and ensures continuity of care.
Register with a Hausarzt as soon as you arrive, even if you are healthy. Many practices have waiting lists, and it is best to avoid searching for a doctor when you are unwell.
→ Read the full guide: How to Register with a Hausarzt in Germany: A Step-by-Step Guide
Seeing a Specialist – Facharzt
For specialist care, such as cardiology, dermatology, or orthopaedics, you typically need a referral (Überweisung) from your Hausarzt. This referral is valid for the current quarter and must be presented at the specialist’s reception.
There are three exceptions where you can visit a specialist directly without a referral:
- Dentist (Zahnarzt)
- Gynaecologist (Frauenarzt / Gynäkologin)
- Ophthalmologist (Augenarzt)
Specialist appointment waiting times in Germany can be several weeks. If your condition is urgent, your Hausarzt can issue a dringlicher Fall (urgent case) note, requiring specialists to provide an appointment within four weeks.
→ Read the full guide: Seeing a Specialist (Facharzt) in Germany: A Step-by-Step Guide
Children’s Healthcare – Kinderarzt
If you are moving to Germany with children, sign up with a Kinderarzt (paediatrician) as soon as possible. Kinderärzte handle all regular health needs for children from birth to adolescence, including U-Untersuchungen (required health checks).
The U-Untersuchungen
Germany provides structured preventive health checks for children, labelled U1 to U9, plus the J1 adolescent check. These assess physical development, motor skills, vision, hearing, and vaccination status. Some checks are mandatory for daycare (Kita) or school enrollment; others are strongly recommended.
Your Krankenkasse fully covers these examinations. Each check is recorded in the Kinderuntersuchungsheft, the yellow booklet provided to every child at birth.
💡 If relocating with a newborn or young child, bring existing vaccination records. Your Kinderarzt will review them to determine which vaccinations are still required.
→ Read the full guide: Finding a Kinderarzt in Germany and What to Expect
Prescription Medication in Germany
Germany differentiates between prescription-only (verschreibungspflichtig) and over-the-counter (nicht verschreibungspflichtig) medications. Many drugs available without a prescription elsewhere require one in Germany.
Your Hausarzt issues prescriptions (Rezept) as needed. For GKV patients, most prescription medications require a co-payment (Zuzahlung) of €5-€10, regardless of the medication’s cost. This is capped annually at two percent of your gross income, or one percent for those with chronic conditions.
Prescriptions can be filled at any Apotheke (pharmacy). Many pharmacies offer online ordering with click-and-collect services. Look for the red “A” sign.
Sick Leave – Krankmeldung
If you are ill and cannot work, inform your employer on the first day of absence. You must provide a Krankmeldung (medical certificate) from your Hausarzt, also called an Arbeitsunfähigkeitsbescheinigung (AU). Few companies ask from the third calendar day, and even fewer ask from the second day.
Your employer pays your full salary for up to six weeks. After this period, your Krankenkasse provides Krankengeld (sick pay) at about 70 percent of your gross salary, for up to 78 weeks for the same illness.
💡 Since 2023, Krankmeldungen have been increasingly issued digitally (eAU). Your Hausarzt sends it directly to your Krankenkasse. You can download a copy from your Krankenkasse account and notify your employer by providing either the copy or the slip from your doctor, as the digital process does not do this automatically.
Booking Appointments
Online appointment booking has become common in Germany. The following platforms are widely used and offer English-language interfaces:
- Doctolib (doctolib.de): the most widely used platform, similar to Zocdoc. Many practices list their availability online.
- Jameda (jameda.de): primarily a doctor-review platform, also offers booking for many practices.
- Kassenärztliche Vereinigung (KV): each state has a KV that maintains an official directory of registered doctors.
For GKV patients, the Terminservicestelle (TSS) is a statutory appointment service operated by the KV. If you cannot secure a specialist appointment within four weeks, call 116 117 for assistance. The TSS must arrange an appointment within 4 weeks.
→ Read the full guide: How to Book Doctors in Germany — Doctolib, Jameda and Beyond
Language Barrier – Practical Tips
Not all practices in Germany have English-speaking staff. Larger cities such as Berlin, Munich, Frankfurt, and Hamburg offer more internationally experienced practices, but language barriers may still arise, especially with specialists.
Here are practical strategies:
- Search specifically by using keywords such as “English-speaking doctor” or “Arzt Englisch” on Doctolib or Jameda.
- Prepare written notes by translating your symptoms and medical history in advance using DeepL. Bring a printed or digital copy to your appointment.
- Use the DeepL app for real-time translation during appointments.
- If possible, bring a German-speaking friend, especially for complex consultations.
- Ask your Krankenkasse if they offer phone interpretation services. Many provide this for free.
Key Phone Numbers to Know
Save these important numbers now so you have them when you need them:
- 112: Emergency services (Notruf). Call for life-threatening emergencies like fire, ambulance, or cardiac arrest.
- 110: Police (Polizei).
- 116 117: Medical on-call service (ärztlicher Bereitschaftsdienst). Use this for non-emergency medical help outside regular hours, like evenings, weekends, and holidays. This is not an ambulance service.
- 0800 111 0 111: Telephone counselling service (Telefonseelsorge). Free, 24/7 support in German.
→ Read the full guide: Emergency Numbers in Germany: What to Call and When
Summary
The German healthcare system is thorough, well-organized, and easy to use once you understand it. Here are the most important steps when you arrive:
- Confirm your health insurance status (GKV or PKV) before or on your first day.
- Obtain your Krankenversicherungskarte and carry it to every appointment.
- Register with a Hausarzt as soon as possible, even if you are currently healthy.
- If you have children, register with a Kinderarzt and bring vaccination records.
- Save 116 117 for out-of-hours medical advice, and 112 for emergencies.
