Who pays for planned treatment in Germany?

There are no waiting lists in Germany, so that you can be treated in Germany at any time. All you have to do is find a medical professional who offers the treatment which you are seeking. Your healthcare insurer however only has to contribute towards the costs if it is legally obliged to do so. The following information will tell you when this is the case.

Two ways to reach the goal

If you are planning on undergoing treatment in Germany, you have two basic ways to do so:

• a) Obtain prior authorisation from your healthcare insurer. The insurer will issue a form E 112 or S2 for the planned treatment. This enables you to show that you wish to be treated as a patient who has statutory health insurance in Germany and that your healthcare insurer will meet the cost. You will find more information on this in the document and link box below.
• b) If you would like to take up a benefit in Germany for which your healthcare insurer would also pay in your own country under the same conditions, you initially pay the costs incurred yourself and are treated as if you had private health insurance in Germany. You can subsequently apply to your healthcare insurer for a reimbursement. You will find more information on this in the document and link box below.

These two methods differ in terms of the

• legal basis,
• preconditions for your entitlement to treatment,
• payment methods applied by the healthcare provider,
• methods for a reimbursement, and
• co-payments, as well as with regard to several other aspects.

In the first case, at a), your entitlements to treatment are derived directly from the European Regulations on the coordination of social security systems (Regulations (EC) 883/2004 and 987/2009). In the second case, at b), they are derived from the respective implementing provisions of the individual EU States contained in Directive 2011/24/EU.

We would like to give you an overview for both methods and to point to the differences, as well as to the advantages and disadvantages. You should nonetheless always seek the advice of your healthcare insurer in person before deciding between the two methods.