Special case: EU citizens
The following information applies to citizens of EU States, as well as citizens of Iceland, Liechtenstein, Norway and Switzerland, who are spending time abroad:
Those who are insured on a voluntary basis or who are covered by statutory insurance may make use of the health services in other EU States, as well as in Iceland, Liechtenstein, Norway and Switzerland, and have the costs reimbursed by their health insurance scheme. Thus, in respect of ambulant treatment, those insured can choose themselves whether they wish to be treated in Germany or in another Member State. If they consult a doctor or use other medical services within the European Union they initially have to pay the costs of the treatment on the spot and then submit the receipts to their insurance scheme in their own country. The costs will then be reimbursed at the same level as they would if they had been incurred for treatment in Germany; any excess costs must be borne by patients themselves.
In the case of hospital treatment in another State, the agreement of the health insurance scheme must be obtained in advance. This may only be refused if the same or equally effective treatment at the same general standard of medical knowledge could be obtained for the patient in good time at a hospital in Germany.
Extended health insurance cover comes into force if someone covered by statutory insurance and his or her family are only staying in another country on a temporary basis - on holiday or business. In case of illness they are eligible for services that are necessary medically, including hospital treatment.
If a contract for employment in Germany has been signed and you are actually working here, you are subject to compulsory health insurance here.
The European Health Insurance Card
To facilitate treatment during temporary visits abroad, every health insurance scheme is obliged to issue its members with a European Health Insurance Card. In case of illness in another EU country, or in Iceland, Liechtenstein, Norway and Switzerland, medical services are provided according to the laws of the host country and reimbursed according to the charges applying there: by presenting the card, patients are eligible both for services which are free of charge in the host country as well as for free medical treatment. Costs for services which usually incur charges in the host country will be covered by the health insurance scheme on presentation of the insurance card.
However, the European Health Insurance Card only has a limited scope. It is valid:
- for temporary stays abroad
- for necessary medical services
- not for trips abroad specifically for the purpose of treatment
- not for the costs incurred in transporting an invalid home
An extended stay abroad is one that goes beyond a holiday or business trip or a conference visit such as a guest professorship or research trip that lasts a semester or a year. For extended stays abroad within the European Union, as well as in Iceland, Liechtenstein, Norway and Switzerland, instead of the European Health Insurance Card, the following applies:
If you are entitled to statutory health insurance at home, then your domestic health insurance provider will issue Form S1 (formerly E 106) on request. Form S1 entitles you and your family members to register with a German health insurance scheme. The German health insurance scheme will then provide all the services that a German health insurance scheme member is entitled to. The German health insurance scheme will subsequently bill the domestic health insurance provider for their costs.
If you are entitled to statutory health insurance in Germany and some members of your family have remained in your own country then the German health insurance provider will issue Form S1 (formerly E109) on request. Form S1 allows those members of your family who have stayed at home to make use of the services of the statutory health insurance scheme without needing to pay contributions. The domestic health insurance provider will subsequently bill the German health insurance scheme for their costs.
- Useful forms for social security rights
These forms are useful for exercising your rights to benefits as an EU national living and/or working in an EU country other than your own - or having done so in the past. The forms are valid if you legally live in an EU country, irrespective of your nationality.