Health Insurance & Health Care

If you fall ill far from home, your coverage determines comfort, cost, and, in a worst case, whether you get repatriated. Members of German statutory health insurance have basic coverage within the EU through the EHIC — but it really is only basic coverage. For longer and non-European stays, there is no way around additional travel health insurance. This guide explains what applies where and what to look for in your coverage.

The EHIC: what it covers — and what it does not

The European Health Insurance Card (EHIC) — on the back of your German insurance card — is valid for temporary stays in the EU, the EEA, Switzerland, and the United Kingdom. Even after Brexit, an EHIC issued by a German statutory health insurer still works in the UK. It covers medically necessary care in the public healthcare system under the rules of the country you're staying in — including any local co-payments. But it is explicitly not a substitute for travel insurance: medical repatriation, private clinics, and planned treatments are not covered.

Valid in the EU, EEA, Switzerland, and the UK (also post-Brexit for German statutory insurance members)
Medically necessary care in the public system — under local rules and co-payments
No medical repatriation, no private clinics, no planned treatments
Does not replace travel/international health insurance

International health insurance: strongly recommended outside the EU

Once you leave the EU/EEA/Switzerland/UK, or travel for longer, German statutory health insurance generally no longer applies. This applies in countries with no agreement, such as Thailand, and equally where a social security agreement exists but does not cover health insurance — such as the US (the agreement covers pensions only). Private international health insurance is not required by German law; it only becomes mandatory where entry or visa rules require it. Without it, though, you can quickly be left unprotected in case of a claim. Employees have a special rule: if you fall ill while employed abroad, under § 17 SGB V your employer generally provides the benefits, and your health insurer reimburses the employer up to the amount that would have been incurred in Germany. This mainly applies outside the EU and agreement countries — costs above German rates and repatriation remain a gap. So ask in advance whether your employer has a group international health policy. The most important element of good international health insurance is medically sound repatriation. Also check how pre-existing conditions are handled, possible sports exclusions, and surcharges for the US/Canada. For stays of several months, you need a genuine long-term policy, not standard travel insurance.

Outside the EU / without an agreement covering health insurance (e.g. US, Thailand): statutory insurance generally does not pay for private trips
Not legally required — but strongly recommended; mandatory only where entry/visa rules require it
Employees: if you fall ill while employed abroad, your employer generally pays (§ 17 SGB V), reimbursed by the insurer up to German rates
The most important element: medically sound repatriation coverage
Watch for pre-existing conditions, sports exclusions, and US/Canada surcharges
For several months: a dedicated long-term policy instead of standard travel cover

Vaccinations: personal or work-related?

The German Standing Committee on Vaccination (STIKO), together with the German Society for Tropical Medicine, publishes country-specific travel vaccination recommendations based on actual exposure risk. An often-overlooked point: for stays abroad required for work or training, statutory health insurance can cover travel vaccinations (based on § 20i SGB V, Book V of the Social Code, and the Federal Joint Committee's Vaccination Directive) — usually not for purely private trips. For individual advice, a tropical medicine institute or a travel-medicine practice is your best bet; the Federal Foreign Office's medical advisories give a first overview per country.

STIKO publishes country-specific travel vaccination recommendations based on exposure risk
For work-related stays abroad, statutory insurance can cover travel vaccinations
Get individual advice from a tropical medicine institute or travel-medicine practice
Check the Federal Foreign Office's medical advisories for the destination in advance

The clauses where policies fail

Whether an international health insurance policy fits your workation is in the small print. Many cheap annual policies only cover six or eight weeks per trip; stay longer and you are uninsured from the next day on. Some also cap your total time abroad per year, for example at 60 days. Work itself can be a problem too: some terms exclude benefits if you are gainfully employed abroad. For individual workations of four to eight weeks, an annual policy with a suitable maximum duration is usually enough. If you are away more than three months a year or stay longer in one go, look at long-term, expat, or nomad policies. These often apply worldwide (the US and Canada sometimes excluded or at a surcharge), allow longer stays, include telemedicine, and can be cancelled flexibly. As a rule they complement German health insurance rather than replace it; check with your fund how long your statutory membership continues during long stays.

Check the maximum duration per trip (often only 6 or 8 weeks)
Check any cap on total time abroad per year
Exclusion for working abroad? Read the wording carefully
Repatriation must be explicitly included
From about 3 months a year: long-term, expat, or nomad policy

Liability, laptop, and cancellation

Besides health insurance, three other policies are worth a look. Many German personal liability policies apply abroad, but often only up to a certain duration, for example twelve consecutive months. Household contents insurance often covers devices on the road only through its outside-the-home cover and with a limited sum; for an expensive laptop, separate electronics insurance can make sense. Trip cancellation insurance is mainly worthwhile if you book accommodation and flights far in advance without free cancellation.

Personal liability: check validity abroad and maximum duration
Laptop: outside-the-home cover of household insurance or separate electronics insurance
Trip cancellation for long-term, non-refundable bookings
Before departure: save the EHIC, policy, and insurer's emergency numbers offline

Sources

Verified, mostly official sources. Reflects the state of research as of the writing date — please double-check with the source directly before making important decisions.

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