The following tells you what rights and obligations you have towards doctors and your health insurance company.
Best to find out about health insurance benefits and payments in advance
Even though you have a health insurance, it does not mean that the company is responsible for all the costs that arise in respect of your health or medical care. So please check in advance to find out from your health insurance company what benefits and payments you can claim for. The statutory and private insurance companies pay part of the costs for medical and dental treatment, for medication (drugs and medicines), for medical adjuvants and aids, for stays in hospital (in-patient treatment), for treatment by therapists (such as physiotherapy) or rehabilitation measures. Depending on your health insurance company, the benefits and payments that you are entitled to can vary considerably. Often, patients have to pay a personal excess (contribution). In addition, there are adjuvants, aids and forms of treatment that patients have to pay completely themselves. Depending on the financial situation, patients can be exempted from having to pay the personal excess. You have to apply to your health insurance company for such exemption.
Always carry your health insurance card (or police) with you
The health insurance card (Versichertenkarte) is your "entrance ticket" to all medical services and preventative measures covered by your health insurance. You get the card as soon as you become a member of a health insurance company. Every time you go to the doctor, you have to present your health insurance card. The doctor will then settle the payments directly with the statutory health insurance company (sometimes this does not apply to private health insurance companies). As a rule, you have nothing to do with this settlement of costs. However, you do have to pay a medical consultation fee (10 euros) per quarter if you consult a doctor (this applies for persons insured by statutory companies only).
Free choice of a doctor and a hospital
As a rule, you are free in Germany to choose which doctor and which hospital you go to. Exception: If you are insured by a statutory health insurance company, your doctor must be registered with the panel of the German health insurance scheme. If he is not registered as a panel doctor, you will have to pay the costs of treatment yourself.
So when choosing your doctor, please also check the medical specialty and main treatment areas. There are general practitioners (Allgemeinmediziner) or (Hausärzte) in Germany. Normally, you go to these doctors with every day illnesses (such as a cold or upset stomach) or if your illness is unclear. In such cases, the general practitioner will mostly refer the patient for further diagnosis and treatment to a specialist (such as an internist, an ophthalmologist, an orthopedist or a gynecologist). But you can also go direct to a specialist without such a referral and, in this case, you have to pay € 10 every time (this applies for the statutory companies only). All panel doctors settle their payments directly with your health insurance company.
There are state, charitable, denominational, and private hospitals in Germany. As a rule, you are admitted to hospital by a doctor. But, essentially, you have the right to choose your hospital yourself. If necessary, all insured persons have the right to in-patient hospital treatment. Such a hospital stay may be required, for example, when other forms of treatment are not satisfactory.
The health insurance company pays for items required for medical treatment in hospital, such as consultation by a doctor, nursing care, provision of medication, remedies, aids and adjuvants, accommodation and meals. However; during the first 28 days, you have to pay € 10 every day as a contribution to the costs.
Many medicines and drugs only available by prescription
You can obtain medication (medicines and drugs) from pharmacies (Apotheken) and, increasingly, online, too. However, a differentiation is made between non-prescription drugs and prescription drugs (i.e. where you need a prescription issued by a doctor). The statutory health insurance company only pays for prescription drugs. However, patients have to pay a small excess.
Please, note that the German Drugs Act is very strict. Some of the drugs that may be prescription free in your country (for example, antibiotics) have to be prescribed by a doctor here.