What cover is provided for trips abroad under statutory health insurance and private health insurance?

As a rule, you are only entitled to benefits from your statutory health insurance within Germany. The only exceptions are temporary stays in EU countries and countries with which Germany has concluded a social security agreement.

Medical treatment there is charged via the European Health Insurance Card (EHIC), which ensures access to healthcare in the following countries:

• all 27 EU member states,
• the United Kingdom,
• three EEA member states (Iceland, Liechtenstein, Norway),
• three convention states (Macedonia, Montenegro, Serbia) and Switzerland.

Additional country-specific information as well as "holiday leaflets" (Urlaubsmerkblätter) with further information can be obtained, for example, from the German Liaison Office for Health Insurance – Abroad (Deutsche Verbindungsstelle – Ausland – DVKA).

Persons insured through German statutory health insurance receive the European Health Insurance Card automatically: it is printed on the back of their health insurance card.

This usually entitles you to medical treatment within the local public health system in line with the standards there. However, these standards may be much lower than in Germany and usually only emergency care is provided. This means that if you can reasonably be expected to continue the treatment at home, you may, for example, only be given painkillers or, in the case of dental problems, a temporary prosthesis.

In some cases, you will even have to pay for treatments that are covered by statutory health insurance in Germany, or you will have to pay the usual local co-payment. Moreover, one important service is generally not covered by your statutory health insurance: return transport to Germany in case of illness.

As a rule, statutory health insurance only pays for unplanned medical treatments. If you are travelling abroad for the express purpose of obtaining medical treatment and want this covered by your statutory health insurance in Germany, you must first obtain the insurer’s approval.

In any case, you must be able to present the European Health Insurance Card (or a substitute document) at the point of treatment. Otherwise you will usually have to pay for the treatment.

In summary: With the European Health Insurance Card, you have access to the local public healthcare system and (basic) healthcare in countries in which the card is valid according to the standards applicable there.

There is no insurance cover at all for persons insured under statutory health insurance in countries that do not accept the European Health Insurance Card. In these countries, you must therefore pay all costs for medical care yourself – depending on the country, you may even have to pay directly. A hospital stay can thus quickly lead to very high costs.

If you have taken out private health insurance, your cover abroad depends on your premium tariff and the underlying contractual conditions. Before starting your trip, you should therefore check what benefits are included in your tariff and whether there are any restrictions (for example, with regard to the maximum period of validity abroad or restrictions on certain treatments, etc.). If necessary, your health insurer will also provide you with an insurance certificate in the language of your destination country.

As a general rule, if you pass through or have stopovers or connections in other countries when travelling to your holiday destination, you may also need health insurance cover for these countries. You should therefore also check what coverage your insurance provides in countries you are passing through or in which you are only staying for a short time.

When is additional private foreign travel health insurance advisable?

The European Health Insurance Card provides persons insured under the statutory health insurance system with access to (basic) medical care according to the local standards of the respective healthcare system in the countries in which the card is valid.

If you want to have access to private medical practitioners, hospitals or treatment in your holiday destination beyond the local standards of care, you must take out private foreign travel health insurance. Alternatively, you will have to pay for such services entirely out of your own pocket – without any reimbursement.

Some statutory health insurers cooperate with private insurers and offer their members foreign travel health insurance at reduced rates.

The scope of cover abroad for persons insured with comprehensive private health insurance depends on the premium tariff they have chosen. Before you start your trip, contact your insurer or your contact person in insurance matters for information about the benefits that are covered in your destination country. Depending on the scope of cover included and the travel arrangements, foreign travel health insurance may also be advisable for those with comprehensive private health insurance.

Health insurance for travel abroad is usually relatively inexpensive. Policies with a term of one year are sometimes offered for as little as around 10 euros.

Check your existing insurance cover

Roughly one in three Germans already has private foreign travel health insurance. However, not all insured persons are aware that they have already taken out this cover, which may be provided in the form of additional benefits for foreign travel offered by credit card providers and automobile clubs.

Before taking out a separate foreign travel health insurance policy, it is therefore advisable to make sure that you have not already obtained the desired coverage elsewhere.

You should, however, also verify the scope of benefits provided under any existing contracts and check whether coverage is subject to certain conditions (such as booking the trip with a specific credit card).