The German healthcare system: a practical guide

1. How the system is organised

Health insurance funds or private insurers finance most medically necessary care. Outpatient practices, hospitals and pharmacies are separate organisations, so there is no single NHS-style registration point.

You normally choose your own Hausarzt, dentist and specialists. Availability, referral requirements and what is covered can differ by provider, insurance and treatment.

2. GKV and PKV

Statutory insurance (GKV) bases contributions mainly on contributory income up to a ceiling and provides a legally defined core package. Private insurance (PKV) uses an individual contract and risk-based premium; each family member needs cover.

Employees above the annual compulsory-insurance threshold may be able to choose voluntary GKV or PKV. That threshold is different from the lower ceiling used to calculate GKV contributions.

3. Health card and billing

GKV members present the electronic health card (eGK), normally once per practice per quarter. Contracted care is usually billed directly; privately insured patients often receive invoices and claim reimbursement under their policy.

Ask before agreeing to an IGeL or other self-pay service. The practice should explain the service and price; insurance coverage should never be assumed.

4. Pharmacies, prescriptions and out-of-hours medicine

Prescription medicines are dispensed by pharmacies, often through the electronic prescription stored against the health card or a paper/app code. Non-prescription products are usually self-paid.

Outside normal hours, use the local Apotheken-Notdienst search. An emergency pharmacy may charge the permitted night-service fee.

5. Hospitals and co-payments

Planned inpatient treatment usually follows a referral or admission. Emergency departments are for emergencies, not a substitute for a regular practice when routine care is unavailable.

GKV adults can owe statutory co-payments. Medicines, therapies, aids and hospital stays have different rules; exemptions and the household burden limit may reduce them.

6. Digital records and privacy

The electronic patient record (ePA) can hold health information for care. Access and objection controls matter because medical data is sensitive; consult your insurer’s current instructions rather than sharing login details or records with unverified services.

7. Who to contact when care cannot wait

Call 112 for life-threatening conditions or risk of permanent injury. Use 116117 for urgent problems that need attention today but are not life-threatening, especially when practices are closed.

The 116117 telephone service states that its call service is in German. If language is a barrier, arrange a trusted interpreter where safe; in an emergency, do not delay calling 112.