Germany’s healthcare system can feel like a well-run train station: lots of tracks, clear rules, and (most days) you’ll get where you need to go. If you’re planning a move, studying, working, or just curious, this guide explains how German healthcare works in plain English—what you pay, what you get, and what to do first.
Quick Snapshot
- Health insurance is mandatory for people living in Germany—no “I’ll sort it later” loophole.
- There are two main routes: Statutory/Public (GKV / SHI) and Private (PKV / PHI).
- Most residents use statutory insurance, often through a “Krankenkasse” (health fund).
- Seeing a doctor usually means showing your health card and paying only small, regulated co-payments.
- Many people start with a Hausarzt (family doctor/GP), who can guide you to specialists.
The Big Picture
Germany organizes healthcare around insurance coverage, not a single “one-size-fits-all” provider. Think of it like a membership model: once you’re insured, you can use doctors, hospitals, and pharmacies across the country—your insurer settles most costs in the background.
Statutory (GKV / SHI)
Most people in Germany are in this system. It’s funded mainly by income-based contributions, and it follows a “solidarity” approach: contributions scale with earnings, while core benefits are broadly standardized.
- Typical for employees, students, and many families
- Often includes family coverage for non-earning dependents (depending on situation)
- Easy, practical access: show your electronic health card and go
Private (PKV / PHI)
Private insurance works more like a tailored contract. Eligibility depends on your status (for example, certain income levels for employees, or being self-employed). Premiums are usually based on your plan and personal profile rather than a simple percentage of salary.
- Common among some self-employed people and high earners
- Coverage can be more customizable
- Switching between systems isn’t always simple—choices matter
GKV vs PKV (At a Glance)
| Topic | Statutory (GKV / SHI) | Private (PKV / PHI) |
|---|---|---|
| How costs are calculated | Mainly income-based contributions (with a contribution cap) | Plan-based premium, often tied to personal factors and benefits |
| Family coverage | Often possible for non-earning dependents under specific conditions | Family members usually need their own contracts |
| What’s covered | Broadly standardized essential care, plus fund-specific extras | Depends on your chosen plan and options |
| Doctor access | Wide access; referrals sometimes help with specialists | Wide access; billing process can differ |
| Best fit for | Many employees, students, families, and people wanting predictable structure | People who qualify and want tailored coverage |
What You Typically Pay
If you’re in statutory insurance, contributions usually come out of your paycheck automatically. A key detail: there’s a general contribution rate and an additional contribution that can vary by health fund. Employers typically share the cost for employees.
Real-world cost touchpoints
- Doctor visit: often no payment at the practice when covered; you show your card and you’re set.
- Prescription medicines: co-payments are commonly regulated (often within a small € range, depending on price).
- Hospital stays: a fixed daily co-payment can apply up to a yearly limit in statutory insurance.
- Cost caps: statutory co-payments can have an annual burden limit for households, which can protect you if you need lots of care in a year.
Private insurance is different: you pay a premium to your insurer and your plan defines what’s included. Some arrangements involve paying a bill first and claiming reimbursement later, depending on the provider and treatment type.
If Germany’s healthcare were a gym, your insurance is the membership card—once you have it, the doors open almost everywhere.
How Care Works (From “I don’t feel great” to treatment)
1) Pick a doctor
Many people start with a Hausarzt (GP). It’s not always mandatory, but it’s practical—one doctor who knows your story, keeps an overview, and can point you to the right specialist when needed.
- Bring your health card (or insurance proof)
- Have your address and basic details handy
- Ask if the practice accepts new patients
2) Get a prescription (if you need one)
Prescriptions are filled at a pharmacy (Apotheke). With statutory insurance, co-payments are usually standardized. Keep the reciept if you’re tracking your annual co-payments.
3) Know the emergency route
For serious emergencies, Germany uses the nationwide number 112. For urgent issues that aren’t life-threatening (when regular practices are closed), there’s also an out-of-hours medical service number: 116 117.
The Health Card (and why it matters)
If you’re in statutory insurance, you’ll use an electronic health card (often called eGK). It’s the “show this first” item for appointments, prescriptions, and hospital admissions. Many cards also double as the European Health Insurance Card (EHIC) for temporary stays in other European countries.
Small tip that saves time
Take a photo of your insurance details and keep it on your phone (securely). If you ever forget your card, having your insurer name and insurance number can help you get unstuck quickly.
What’s Covered (the practical version)
Coverage varies slightly by insurer and plan, but the day-to-day essentials are what most people care about—and Germany focuses heavily on those. Here’s what you can generally expect from the system when you’re properly insured.
Outpatient care
- GP and specialist visits
- Basic diagnostics
- Preventive check-ups (depending on eligibility)
- Prescriptions and therapies (with regulated co-payments)
Hospital care
- Inpatient treatment when medically necessary
- Specialist teams and hospital diagnostics
- Post-treatment care planning (where relevant)
- Statutory co-payment rules may apply
Germany also has long-term care insurance (Pflegeversicherung) tied to the system. It’s designed to support people who need ongoing help with daily life—think mobility, personal care, and household assistance—especially as needs grow over time.
If You’re New in Germany (what to do first)
This is the part most newcomers wish they’d read earlier. If you do these steps in order, you’ll avoid the classic “I’m registered in the city, but I can’t book a doctor” headache.
Newcomer checklist
- Confirm your route: statutory (GKV) or private (PKV), based on your job/study status.
- Choose an insurer: pick a Krankenkasse (for statutory) or a private plan (if eligible).
- Collect documents: passport/ID, address registration (if available), employment contract or university enrollment, and banking details if needed.
- Get your insurance confirmation: you may need this for enrollment, HR onboarding, or admin steps.
- Submit a photo: many statutory insurers need a photo for the health card (adults).
- Find a Hausarzt: do this before you’re sick. Future-you will be grateful.
Common “first-week” questions
- Do I need insurance before I arrive? Many visa and onboarding processes require proof of coverage, so planning early helps.
- Can I just walk into any doctor? Often yes, but availability depends on the practice. Calling ahead saves time.
- Will English be spoken? In bigger cities it’s more common, but it varies. Some practices advertise English support.
Mini Glossary (terms you’ll actually see)
| Krankenkasse | A statutory health insurance fund/provider |
| GKV / SHI | Statutory (public) health insurance |
| PKV / PHI | Private health insurance |
| Hausarzt | Family doctor / GP (often your first stop) |
| Facharzt | Specialist doctor |
| Apotheke | Pharmacy (where prescriptions are filled) |
| eGK | Electronic health card used in statutory insurance |
| Pflegeversicherung | Long-term care insurance linked to the system |
FAQ
Is healthcare “free” in Germany?
Not exactly. Most costs are covered through your insurance contributions, and some services include regulated co-payments. The practical upside is that you usually don’t face surprise pricing at the doctor’s office.
Can my family be covered with me?
In statutory insurance, certain family memebers may be included under family coverage rules (depending on income and status). Private insurance typically requires separate coverage per person.
Do I need a referral for a specialist?
Sometimes you can book directly, and sometimes a referral helps. A Hausarzt can be a shortcut to the right specialist path—especially when your issue isn’t obvious.
What should I do if I’m sick after hours?
For urgent but non-life-threatening issues, the out-of-hours medical service number is 116 117. For emergencies, call 112.
Sources
- German Federal Ministry of Health (BMG) – Statutory health insurance (SHI)
- German Federal Ministry of Health (BMG) – Electronic health card (eGK)
- Make it in Germany (official portal) – Health insurance overview
- DAAD – Health insurance for studying in Germany
- gesund.bund.de (public health information) – Medication costs & co-payments
- European Commission – EHIC: How to use the card in Germany
- Hochschule Darmstadt (University) – Healthcare information for exchange students
