Germany (DE)

Germany is Europe's largest economy and most populous country — a federal parliamentary republic of 16 states (Bundesländer) celebrated for its engineering prowess, rich cultural heritage from Beethoven to Bauhaus, world-famous Oktoberfest and Riesling wines, and one of the most comprehensive social safety nets in the world.

Capital: Berlin

Region: Europe

Language: German

Currency: EUR (€)

Cost of living: Moderate (index 68)

Emergency: 112

Healthcare in Germany

Germany has one of the world's oldest and most comprehensive healthcare systems, dating back to Otto von Bismarck in 1883. It is a multi-payer Bismarck-model system with compulsory health insurance. Coverage is nearly universal, quality is excellent, and waiting times for routine care are short — though specialist appointments can take 3–6 weeks.

Consistently ranked among the top 10 globally. One of the highest per-capita healthcare spenders in Europe (2026), with near-universal coverage and no gatekeeping for specialist care.

Public healthcare: GKV — Gesetzliche Krankenversicherung

Statutory Health Insurance

Eligibility:Mandatory for employees earning below €77,400/year (2026 JAEG). Self-employed and freelancers can voluntarily enrol. Students under 30 have special student rates. Nearly 90% of the German population is covered by GKV.

Monthly cost:Total 14.6% of gross salary + average supplementary rate ~2.9% = ~17.5% (varies by Krankenkasse). For employees: split equally with employer (you pay ~8.75%). For self-employed: you pay the full amount, minimum ~€200/month. Income ceiling: €69,750/year (2026; beyond which contributions cap).

What's included:

GP and specialist visits (no copay, no deductible)
Hospital stays (€10/day for first 28 days per year)
Prescription medication (€5–10 copay per prescription)
Pregnancy, childbirth and postnatal care (100% covered)
Preventive check-ups (annual for adults, U1–U11 for children)
Dental check-ups 1–2× per year, basic treatment
Mental health care (psychotherapy with approved therapists)
Physiotherapy with doctor's prescription

Not included (or co-pay required):

Glasses and contact lenses (adults) — usually private pay
Premium dental work (crowns, implants) — 50–80% out-of-pocket
Private hospital rooms and senior doctor treatment
Alternative medicine (homeopathy, acupuncture — some plans cover)
Cosmetic procedures

Co-payments:Small copays apply: €10/day for hospital stays (first 28 days/year), €5–10 per prescription, €10 per physiotherapy session. Annual copay cap: 2% of household income (1% if chronically ill). Children under 18: no copays.

How to enrol:Employees: your employer enrols you automatically with the GKV of your choice when you start work. Self-employed/freelancers: apply directly to any GKV (TK, Barmer, AOK, etc.) — most have English-language support. You need your Anmeldebestätigung, passport, and a completed application. Coverage starts on the day you register.

Waiting period:None for GKV — coverage starts immediately on registration.

Private healthcare: PKV — Private Krankenversicherung

Who can use it:Open to: employees earning above €77,400/year (2026 JAEG), self-employed, freelancers, civil servants (Beamte). Not open to employees below the income threshold. Once you switch to PKV as an adult, returning to GKV is difficult — plan carefully.

When it makes sense:Best for: single high-earners under 35 in good health (premiums are lower than GKV). Civil servants (Beamte) receive a 50–70% subsidy (Beihilfe), making PKV much cheaper than GKV. Avoid if: you want to have children (PKV premiums per child add up; GKV covers family free), you expect to earn less later in life, or you have chronic conditions (harder to get good PKV terms).

Monthly cost:€250–700/month for basic coverage. Scales with age, pre-existing conditions, and chosen coverage level. Premiums rise with age (unlike GKV which is income-based).

Major providers:

DebekaDKVAllianzHUK-CoburgSignal IdunaAXAContinentale

Accessing care

GP system

You choose your own Hausarzt (GP) freely — no catchment area. You are NOT required to register with a specific practice, but building a relationship with one Hausarzt is the norm. First visit: bring your health insurance card (Gesundheitskarte). Appointments typically available within 1–2 weeks; walk-ins accepted at many practices for acute issues.

Specialist referral

You can usually go directly to specialists (Facharzt) without a GP referral (Überweisung), but some GKVs offer discounts if you always start with your Hausarzt (Hausarztprogramm). Specialists typically have 3–6 week waitlists. For faster access, the 116 117 "Terminservicestelle" can help find slots.

Emergency care

Call 112 for life-threatening emergencies (free, works without SIM). Drive yourself or take a taxi to the nearest Notaufnahme (A&E) for serious but non-critical issues. A&E co-pay: €10/day. Expect long waits (2–6 hours) in urban A&E for non-urgent cases — use 116 117 or Notfallpraxis for these instead.

Out of hours

Call 116 117 (Ärztlicher Bereitschaftsdienst) for non-life-threatening medical issues outside GP hours — evenings, weekends, public holidays. They will direct you to an on-call duty doctor (Notfallpraxis) or arrange a home visit. 116 117 is free.

Prescriptions

Prescriptions (Rezept) are issued electronically (eRezept) via your insurance card. Take your card to any Apotheke (pharmacy) — pharmacist scans the card and dispenses. Standard co-pay: €5–10 per prescription. Some medications are exempt; some require you to pay the full price difference if a cheaper generic exists.

Dental

Basic check-ups and cleanings 1–2× per year are covered by GKV. Major work (crowns, implants, orthodontics) requires high co-pays: 50–80% out-of-pocket. Consider a Zahnzusatzversicherung (dental top-up insurance, €10–30/month) if you expect dental work. Keep your Bonusheft — annual check-up stamps increase your GKV coverage for later major work.

Mental health

Psychotherapy is covered by GKV if performed by an approved therapist (Kassenzulassung). Waiting lists are long: 3–9 months for non-urgent cases in cities. Acute crisis: call 116 117 or your insurer's urgent help line. Many expats use online therapy services (Selfapy, HelloBetter) which some GKVs cover. Private therapy costs €80–130/hour.

Maternity

Pregnancy and birth are fully covered by GKV with zero copay. Mutterpass (maternity passport) is issued at first prenatal visit. Choice of hospital, birthing centre, or home birth. Midwife (Hebamme) care is 100% covered (pre- and post-natal). Maternity leave: 6 weeks before + 8 weeks after birth (14 weeks total, paid at 100%). Then parental leave (Elternzeit) up to 3 years per parent.

Expat-specific advice

First steps on arrival:

Within 14 days: complete Anmeldung (address registration) — required for GKV enrolment
Within 30 days: enrol in a GKV (TK, Barmer, AOK recommended for English support)
Await arrival of your Gesundheitskarte (health insurance card) — arrives by post in 2–3 weeks
Find a Hausarzt (GP) in your neighbourhood using doctolib.de, jameda.de or neighbour recommendations
Register with a Zahnarzt (dentist) for the Bonusheft to start accumulating
If you have children: find a Kinderarzt (paediatrician) — long waiting lists in cities

Finding English-speaking doctors:Use Doctolib.de and filter by language. Most urban GPs speak conversational English; specialists vary. Cities with large expat populations (Berlin, Munich, Frankfurt, Hamburg) have many English-speaking practices. If language is a concern, bring a bilingual friend or use Google Translate during appointments.

International insurance:Not recommended long-term. Short-term visitors (under 3 months) can use EHIC (EU citizens) or travel insurance. Non-EU expats arriving before their GKV starts should get private "expat starter" insurance (e.g. Cigna Global, Allianz Care) for their first weeks.

Emergency card info:Keep your Gesundheitskarte (health insurance card) in your wallet at all times. Memorise 112 (emergency) and 116 117 (non-emergency medical). Note your Hausarzt's phone number. If you have allergies or chronic conditions, consider a medical ID bracelet.

EHIC notes:EU/EEA citizens: your EHIC (European Health Insurance Card) covers short visits to Germany before you become a resident. Once you register (Anmeldung) and start work, you must switch to German GKV. EHIC alone is not sufficient for residency.

Pharmacies (Apotheke)

Hours:Monday–Saturday 8am–6:30pm typically. Closed Sundays and public holidays. Larger cities have 24h central pharmacies.

After-hours / emergency:Every area has a rotating Notdienst (emergency duty) pharmacy open outside normal hours. Check the list posted on every Apotheke door, or search "Apotheke Notdienst" + your postcode online. Night surcharge applies (€3–5 per prescription).

Prescription rules:Prescription-only medication (Rezeptpflichtig): requires an eRezept from a doctor. Over-the-counter (Apothekenpflichtig, rezeptfrei): available without prescription but you must ask the pharmacist — not self-service. Freely available (Freiverkäuflich): supermarkets only sell a very limited range.

Available over-the-counter:

Pain relief: Ibuprofen, Paracetamol (smaller doses)
Cold & flu remedies: ACC, Wick MediNait, Grippostad
Allergy relief: Cetirizine, Loratadine
Digestive aids: Bepanthen, Pantoprazol, Iberogast
Vitamins and supplements
Basic first aid: bandages, disinfectant, wound care
Throat lozenges, cough syrups

Typical costs

GP visit (with insurance)	€0 (GKV) or direct-bill (PKV)
GP visit (private pay)	€35–80 (private consultation)
Specialist visit	€0 (GKV) / €60–150 (private pay)
Emergency visit	€10/day (GKV) / €150–500 (private pay)
MRI scan	€300–600 (private pay); free with GKV referral
Prescription average	€5–10 (GKV copay); actual prices vary by medication
Dental check-up	€0 (GKV, 1–2× per year)
Baby delivery	€0 (GKV); €3,000–8,000+ (private)

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