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 those in Iceland, Liechtenstein, Norway and Switzerland, and have the costs reimbursed by their health insurance scheme. With regards to ambulant treatment, those insured can choose 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 health insurance scheme where the person in question is registered must agree to the treatmen 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 you have signed an employment contract in Germany and are working here, you are subject to German health insurance regulations.
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 fee system applicable there: by presenting the card, patients are eligible both for services that are free of charge in the host country as well as for free medical treatment. Costs for services that would otherwise incur charges in the host country will be covered by the health insurance scheme if a European Health Insurance Card is presented.
However, the European Health Insurance Card only has a limited scope. It is valid for:
- temporary stays abroad
- necessary medical service
It is not valid for:
- trips abroad specifically for the purpose of treatment
- the costs incurred in transporting an invalid home.
An extended stay abroad is one that goes beyond a holiday, 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 you Form S1 (formerly E 106) on request. Form S1 entitles you and your family members to register with a German health insurance company. The health insurance scheme will then provide all the services that you would be entitled to covered by your health insurance company at home. The German health insurance company will subsequently bill the domestic health insurance provider for the costs.
If you are entitled to statutory health insurance in Germany and some members of your family have remained in your own country, then your German health insurance provider can issue you 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 there 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.