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The expat’s healthcare guide to Germany

To help get you started, we’ve put together a quick introduction guide to some of the basics to think about when trying to navigate healthcare in Germany.

The expat’s healthcare guide to Germany
Photo: Studioclover/Depositphotos
Finding a doctor
 
You should figure out what doctor to go to before you actually need to see a doctor. Luckily this isn’t too hard – every doctor in Germany is listed in the local phone directory (Gelbe Seiten) under Ärzte, so this could be your starting point.
 
If you have an international health plan such as Cigna Global, your insurance company may be able to help you find a doctor who speaks your language – just get in touch with their 24/7 customer service.
 
Naturally you can also find a doctor online – multiple websites list doctors according to their location or their specialty. This website is searchable in English as well. If you do speak German, websites like DocInsider offer ratings and rankings by other patients. Often, however, the best references come from word of mouth – so just ask a friend, neighbor, or colleague.
 
Other good sources are the university clinics (Kliniken) in major cities that provide outpatient services in addition to hospitalization. These clinics are usually staffed by highly skilled doctors who often speak English. You could also contact your embassy or consulate for a list of doctors who speak English or your native language.
 
The opening hours at doctor’s offices vary greatly. Many offices are closed on Wednesday afternoons, so it’s best to call before you visit and make an appointment. 
 
 
Emergency care
 
If you need medical assistance outside of normal doctor office visiting hours, you have a couple of options.
 
If it’s not terribly urgent, but you still can’t wait until the doctor’s office opens, you can take advantage of the Ärztlicher Bereitschaftsdienst (Medical Emergency Service). This is a GP who is on call to handle emergencies after normal office hours. You can reach the service anywhere in Germany by dialing 116 117.
 
You could also try calling your regular doctor. If they’re unavailable, the recording on their answering machine might give you the number of a nearby emergency doctor.
 
In more urgent scenarios, you look up the section called Ärztlicher Notdienst or Ärztlicher Bereitschaftsdienst  in your local newspaper. It lists all physicians on stand-by for emergency duty, numbers of emergency hotlines, and pharmacies with 24/7 service.
 
And if there’s not time for that, take a taxi to the nearest emergency room (Notaufnahme) or call 112 or 19222 for an ambulance.
 
Call '112' for high emergency cases (think life-threatening cases) and call '116 117' for all other emergencies. Both numbers work 24/7.
 
Specialist care
 
Most people have a Hausarzt or Allgemeinarzt (general doctor) as their family doctor, who will make referrals to a specialist if necessary. Most specialists require a referral, called an Überweisung, so don’t just call up any specialist and expect to receive an appointment out of the blue.
 
Pharmacies
 
Pharmacies (Apotheke) are often open as late as 8pm during the week, and may have earlier closing times on Saturdays. They are always closed on Sundays and public holidays, but there will always be at least one in each city/region that provides out-of- hours service. Look for a notice in the window of any pharmacy to find out which pharmacy is on duty, or alternatively, find the addresses in your local newspaper in the section “Apotheken-Notdienst” (pharmacy emergency service).
 
You can also find contact information on the pharmacy emergency service online.
 
Unlike in countries such as the USA or UK, large drugstore chains do not exist in Germany. In fact, a “drug store” in Germany (Drogerie) sells toiletries and other consumer items, but not medicines.
 
However, you can purchase over-the- counter basic medication, such as cough syrup, cold medicine, throat lozenges and nose spray at stores like Rossmann and dm (drogerie markt). 
 
You can only receive prescription medication if you have a written prescription from your doctor – the Medical Products Act in Germany is quite strict.
 
If you have private insurance and your prescriptions are covered, make sure to save a copy of the prescription and a stamp – this will allow you to be reimbursed. You pay for the medicine yourself in the first instance but just send the copy of the prescription and the payment receipt to your insurer and you’ll be reimbursed within a few weeks.
 
Insurance
 
Alright, so how do you pay for it all?
 
If you have German health insurance, your insurance company will give you a plastic ID card (Krankenversicherungskarte) which you need with you when you visit a doctor. This card contains a chip with your personal data, which the doctor's secretary will screen on your first visit. Statutory health insurance accreditation (Kassenzulassung) means that costs will always be covered by the insurer.
 
Generally you have to figure out health insurance, and prove you’re covered, before you get a residence permit in Germany. Many people simply have the state health insurance, while others opt for private global health insurance such as Cigna Global. Hospitals in Germany can be quite expensive, so private health insurance can be a great net to fall back on.
 
If you are state-insured, the doctor will send his bill directly to your insurance company. If you have private insurance, you’ll usually pay the full price up front for both visits and prescriptions, and send the receipts to your insurer for reimbursement.
 
Note that some doctors only treat privately insured clients. Of course that’s not a problem if you already have an international health plan such as Cigna. But if you have state insurance, make sure you check this when making an appointment. Doctors who accept state payments generally display a sign – Kassenarzt or Alle Kassen in their office. If you're treated by anyone other than a Kassenarzt, the state insurance system will not reimburse you.
 
All emergency expenses are automatically covered by your public health insurance in Germany. If you’re a member of public health insurance you don't need to pay anything, whether you go to hospital or call the ambulance.
 
Things to keep in mind
 
Any time you go to a hospital or see a doctor, make sure to bring your health insurance card.
 
Make copies of your bills, for visits and surgeries, particularly if you have private insurance and need to send them off for reimbursement. Exactly how long you wait for reimbursement can vary but it’s usually one to three weeks.
 
Participating in a global private health insurance plan, like that offered by Cigna Global, who specialise in healthcare for expats, ensures you are covered at every level, while having maximum flexibility.
 
 
This article was produced by The Local Client Studio and sponsored by Cigna Global.
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HEALTH

What you should know about Germany’s plans to roll out e-prescriptions

Germany is taking a big step towards a more digital-friendly health system, with plans to roll out e-prescriptions nationwide. Here's what you should know.

A person holds the e-Rezept app in a pharmacy in Oldenburg, Lower Saxony.
A person holds the e-Rezept app in a pharmacy in Oldenburg, Lower Saxony. Photo: picture alliance/dpa | Mohssen Assanimoghaddam

What’s happening?

From January 1st 2022, people in Germany will receive their prescriptions digitally (known in Germany as an ‘e-Rezept’) from healthcare providers.

Patients should be able to get their prescription from their doctor via a QR code sent to an app, which can then be transmitted to a pharmacy. The pharmacy can then let the patient know whether their medicine is in stock (or if they want to order it), and when it is ready for collection. 

This model is to be mandatory for people with statutory health insurance from the start of 2022, replacing the good old paper prescription.

However, the QR code can also be given to the patient by the doctor on a piece of paper if a patient does not have access to or doesn’t want to use a smartphone. 

READ ALSO: The changes around doctors notes in Germany you should know 

How exactly will it work?

In theory this is the plan – you’ll visit the doctor or have a video consultation. After the examination, the doctor will issue you with an electronic prescription for the medication that has been prescribed to you. 

A prescription code is automatically created for each ‘e-Rezept’, which you will need so you can get the medicine at the pharmacy. As we mentioned above, patients in Germany can either open this QR code in the free e-prescription app developed by Gematik and the Health Ministry, or receive it as a printout from the doctor. 

Next, you can take the prescription QR code (either in the app or as a printout) to your pharmacy of choice to get the medication needed.

One of the major differences and timesavers under the new system is that you can also select the pharmacy you want to get the prescription from digitally, order the medication (if needed) and you’ll be alerted when the prescription is ready. You can also arrange to have it delivered if needed. 

A doctor’s signature is not required, as e-prescriptions are digitally signed. 

The aim is that it will save on paperwork, time at the medical office and trips to the pharmacy. 

Some patients have already been receiving digital prescriptions. The ‘e-Rezept’ was tested out successfully in selected practices and pharmacies with a focus on the Berlin-Brandenburg region of Germany. The test phase started on July 1st this year.

Pharmacies and doctors’ offices nationwide have also been given the opportunity to test the new system from the start of December. 

“This will enable practice providers and pharmacy management systems to better prepare for the mandatory launch on January 2022 1st,” said aponet.de, the official health portal site for German pharmacies

The new e-prescription app.
The new e-prescription app. Photo: picture alliance/dpa | Mohssen Assanimoghaddam

READ ALSO: 10 rules to know if you get sick in Germany

There is some leeway though – if there are technical difficulties, paper prescriptions can still be issued in individual cases until the end of June next year.

The National Association of Statutory Health Insurance Physicians estimates that it could take until mid-2022 until all users are equipped with e-prescription applications nationwide.

The obligation does not apply to privately insured people from January next year. Private insurance companies can decide voluntarily to make the preparations for their customers to use the e-prescription.

What’s this about an app?

To be able to receive and redeem prescriptions electronically, people with statutory health insurance need the Gematik ‘das e-Rezept’ app. 

One issue is that the app appears to only be available at the moment in German app stores. We’ll try and find out if there are plans to change this and widen out the access, but it seems likely for that to happen. 

Germany’s Covid-Warn app, for example, was initially only open to German app stores but was gradually widened out to many others. 

As mentioned above though, those who don’t have access to an app will be able to use the paper with the code on it to access their prescriptions. 

READ ALSO: Everything you need to know about making a doctor’s appointment in Germany

Has it all gone smoothly?

As you might expect, there have been a few hiccups. 

Originally, the introduction nationwide was planned for October but was postponed due to many providers not having all the tech requirements set up. 

Now though, more than 90 percent of the practice management systems have been certified by the Association of Statutory Health Insurance Physicians – a prerequisite to issue the e-prescriptions.

The e-prescription is part of Germany’s far-reaching plans to digitise and streamline the health care system.

The head of Gematik GmbH, Markus Leyck Dieken, recently spoke of a “new era” that is “finally starting for doctors and patients” in Germany. 

Useful vocabulary:

Prescription – (das) Rezept

Doctor’s office/practice – (die) Arztpraxis

To order – bestellen 

Pharmacy – (die) Apotheke

Video consultation – (die) Videosprechstunde

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