If you receive money from the jobcentre, you are insured in the statutory health insurance system. Just like everyone else who is covered by the statutory health insurance system, you are entitled, under Book V of the Social Code (Sozialgesetzbuch), to a range of services, especially medical treatment, pregnancy and maternity services, and services for the prevention and early detection of diseases.
If you receive social assistance (Sozialhilfe), you are not compulsorily insured in the statutory health insurance system. However, you will receive a health insurance card from a statutory health insurance fund, and this allows you to access healthcare services if you need them, in line with the services provided by statutory health insurance. The costs will be covered by the welfare office (Sozialamt).
If you receive benefits under the Asylum Seekers Benefits Act (Asylbewerberleistungsgesetz), you are only entitled to the medical and dental treatment required for the treatment of acute illness or pain during the first 18 months of your stay in Germany. This includes the provision of medicine and dressings, as well as other benefits required for recovery, improvement or alleviation of illness or its consequences.
Officially recommended vaccinations and medically necessary preventive examinations for the prevention and early detection of diseases or the consequences of diseases are also covered, among other things.
Expectant mothers and mothers in the first few weeks after a birth are entitled to medical and nursing care as well as support, midwife assistance as well as medicines, surgical dressings and therapeutic products.
Further benefits can be granted if they are essential to ensure health in the individual case. This regulation makes it possible for the competent authorities providing benefits to meet special needs in the individual case. The law does not provide for any restrictions for the type of illness, which means that treatment for mental health problems can also be included.
You can find more information about medical care at medmissio Institute for Global Health. Its MedBox aid library offers a for Ukrainian refugees with answers to urgent questions about their medical care.
If you are unable to work for health reasons, you must get an official certificate confirming your incapacity for work from your doctor. On 1 January 2023, the electronic certificate of incapacity for work replaced the paper certificate.
Now, your doctor sends your incapacity for work certificate in digital form to your health insurer. Your employer is obligated to contact your health insurer to access your electronic certificate. This means that you no longer need to worry about submitting your incapacity for work certificate to your employer. This applies to all workers, including people in marginal employment.
However, you still need to inform your employer about your sick leave so that they can start the process of contacting your health insurer and accessing your certificate.
Doctors in private practice
In general, illnesses are diagnosed and treatment is prescribed by doctors working in individual or group practices (niedergelassene Ärztinnen und Ärzte). These doctors also issue prescriptions for medicines and can refer their patients for admission to a hospital for further treatment.
Doctors in private practice may bill the social services office (Sozialamt) or a statutory health insurance provider (Krankenkasse) for their services, or patients can pay for their treatment at the doctor’s office themselves. If you do pay yourself, you cannot be reimbursed afterwards.
Important: Most doctors see patients by appointment. You should therefore make an appointment, preferably by telephone. You can also make appointments online, for example on the website (in German only). Make sure you keep to the agreed date and time! Patients without an appointment can usually expect waiting times.
Doctors must keep medical confidentiality. They are not permitted to disclose the information they are entrusted with to third parties. Certain infectious diseases, such as tuberculosis, must be reported to the public health authority. This is the only way to prevent the spread of infectious diseases. This notification does not affect the processing of an asylum claim.
Important: Many doctors speak English or another language in addition to German. Please ask about this. If you do not speak German well, it is a good idea to take a person you trust and who speaks German to the doctor with you. If you are in Berlin, (in German) provides an overview which also indicates which languages are spoken in which medical practice.
You will be treated in a hospital only if treatment at a doctor’s office is not sufficient. A stay in hospital (Krankenhaus) must be approved in advance. In an emergency, you can go to a hospital without a prior appointment.
In Germany, many medicines may only be dispensed to patients by pharmacies (Apotheke). You can get certain medicines (verschreibungspflichtige Arzneimittel) from a pharmacist only if you present a doctor’s prescription. There are also many medicines that can be bought freely without a prescription. The costs of these will not be reimbursed by the relevant government agency.
The pharmacist will inform you about how to take the medicine correctly.
At least one pharmacy near you will be on duty at all times of the day and night. You can find out which chemist near you operates an emergency service at (in German) as well as from the emergency hotline 22 8 33.
Medical confidentiality means that patients can rely on doctors to maintain silence about everything that is entrusted to them. This also applies beyond the death of the patient.
The duty of confidentiality also fundamentally applies with respect to other doctors, members of the patient’s family and the doctor’s own family members. Conversations with your doctor, patient data concerning your illness or financial circumstances therefore have to be kept secret.
If your doctor violates the medical confidentiality obligation, in addition to measures under occupational law or professional disciplinary measures, he or she may also be subject to claims for damages and even criminal consequences.
- In some cases, there are exceptions to medical confidentiality - for example, if you have a notifiable disease such as tuberculosis. In this case, your doctor has to inform the health authorities so as to protect the health of everyone. Important: As a patient, however, you do not need to fear any negative consequences. The notification of the health authority also has no effect on your residence title.
You can also voluntarily release your doctor from medical confidentiality at any time. To do so, you as the patient need to give your consent expressly or by means of conclusive behaviour (implied consent).
List of documents you will need to see a doctor
To see a doctor in Germany, you should take the following documents with you to ensure that your visit can take place without difficulty:
- Medical treatment certificate (you can get this from the authority, the city or the municipality, generally from the social welfare office) or health insurance card
- If necessary, questionnaire (to be completed, e.g., via in Ukrainian and printed out in advance)
- When seeing a specialist doctor, a note issued by a general practitioner (if available) (referral)
- Vaccination certificate, record of x-rays taken, test results (for example, x-ray films, blood test results)
- List of medications (to identify any pre-existing health conditions)