Germany’s healthcare system is known for its high standards, strict structure, and mandatory insurance coverage. For international students, understanding how to navigate appointments, family doctors, specialists, and emergency services is essential for receiving proper care and avoiding unexpected costs.
This guide explains how the system functions and what students should expect when seeking treatment.
How the German Healthcare System Works
Germany operates on a dual system of public health insurance (gesetzliche Krankenversicherung) and private health insurance (private Krankenversicherung).
Most students under 30 are required to join public insurance.
Key Principles
• Health insurance is mandatory for all residents
• Patients typically start with a family doctor (Hausarzt)
• Referrals are used to see specialists
• Emergency services treat urgent conditions regardless of insurance type
Public insurance covers most standard treatments with minimal out-of-pocket costs.
Finding and Visiting a Family Doctor (Hausarzt)
The Hausarzt is usually the first point of contact in the healthcare system.
What a Hausarzt Does
• Diagnose common illnesses
• Provide sick notes (Krankschreibung)
• Manage long-term medical conditions
• Issue referrals to specialists
• Handle vaccinations
How to Make an Appointment
• Call the practice directly
• Use the practice’s website (many have online booking)
• Walk-in availability varies but is common in some clinics
Required Documents
• Health insurance card (Versichertenkarte)
• ID or passport for first-time patients
Important Tip
Building a long-term relationship with a Hausarzt makes the system much easier to navigate.
Seeing Specialists (Fachärzte)
Specialists include dermatologists, ENT doctors, cardiologists, neurologists, and more.
When a Referral Is Needed
• Many specialists accept patients without referral
• However, referrals from a Hausarzt can speed up appointment scheduling
• Hospitals typically require referrals for non-emergency visits
Long Waiting Times
In busy cities, specialist appointments may take:
• 2–6 weeks for dermatologists
• 1–3 months for psychologists
• 1–4 weeks for ENT doctors
Priority cases (“dringlich” referrals) are handled faster.
When You Need to Pay Out-of-Pocket
Public health insurance covers most treatments, but some situations require additional payment.
You may need to pay for:
• Certain dental treatments (e.g., crowns, implants)
• Prescription glasses or contact lenses
• Private doctor’s notes (Attest)
• Cosmetic dermatology
• Travel vaccinations (depending on the insurer)
• Some psychological therapy sessions if therapist is not registered with public insurance
Co-Payments (Zuzahlungen)
For medications:
• Typically €5–€10 per prescription
• Some medications are fully covered
Private Doctors (Privatpraxis)
Private-only clinics exist and do not accept public insurance.
Students must avoid these unless they intend to pay full fees.
Emergency Care (Notaufnahme)
Emergency departments treat urgent and life-threatening conditions, such as:
• Severe injuries
• Breathing difficulty
• Acute chest pain
• Major infections
• Persistent bleeding
Important Rules
• Emergency rooms treat you even without an appointment
• Non-urgent cases may wait several hours
• Insurance covers emergency treatment fully
Calling an Ambulance (112)
Use 112 for:
• Life-threatening conditions
• Severe accidents
• Unconsciousness
Ambulance service is covered by insurance when medically necessary.
After-Hours Medical Care
When clinics are closed, patients can use:
Ärztlicher Bereitschaftsdienst (116 117)
• Non-emergency urgent care
• Phone-based triage
• Can arrange out-of-hours clinics
• Free to call
Pharmacies on Duty (Notdienst)
Each city has pharmacies open 24/7 on rotation.
Lists are posted online and at every pharmacy.
Psychotherapy Access for Students
Mental health support is part of the medical system but often has long wait times.
Options
• University psychological services (usually free)
• Publicly insured therapists (Kassentherapeuten)
• Private therapists (self-pay)
Tips for Faster Access
• Contact multiple therapists
• Request “probation sessions” (Probesitzungen)
• Use university support while waiting
Common Mistakes Students Make
Common Mistakes Students Make
• Avoiding doctors due to fear of costs (most treatment is free under public insurance)
• Expecting walk-in appointments for specialists
• Not carrying the insurance card
• Accidentally visiting private-only clinics
• Using the emergency room for minor illnesses
Understanding these points prevents unnecessary stress and delays.
Summary
Germany’s healthcare system is structured, reliable, and highly accessible—once the rules are understood.
By starting with a Hausarzt, using referrals when needed, understanding what insurance covers, and knowing how emergency services operate, students can navigate the system confidently and receive timely care.