Statutory health insurance abroad in the EU: Your comprehensive guide for seamless coverage
25 May 2025
Katrin Straub
Managing Director at nextsure
A medical emergency while on holiday in the EU or during a longer stay can quickly become expensive. Although your German statutory health insurance provides basic coverage, there are important details to consider. This article explains what benefits you are entitled to and how you can secure the best coverage.
The topic in brief and concise terms
Your German statutory health insurance is valid with the EHIC in EU countries for medically necessary treatments in the public system, but services and cost coverage are subject to the regulations of the host country.
A medical repatriation to Germany is generally not covered by statutory health insurance and can cost tens of thousands of euros; a private overseas health insurance is essential here.
A private international health insurance closes important coverage gaps, covers costs for private treatments and repatriation, and often costs only a few euros per year.
Quick Facts: Statutory Health Insurance in the EU
Your German statutory health insurance generally also applies in other EU countries. The European Health Insurance Card (EHIC) on the back of your health card is your proof. You receive medically necessary services under the conditions of the respective EU country. This means you are treated as if you were insured there. Importantly, this only applies to the public healthcare system. Private doctors or clinics are often not covered. A medical repatriation to Germany is generally not covered by statutory insurance. For long-term stays, you should inform your health insurer and, if necessary, apply for form S1. These initial points already illustrate that despite the EU-wide protection, gaps may exist.
The European Health Insurance Card (EHIC) in practical use
The EHIC simplifies access to medical care in 27 EU countries, as well as Iceland, Liechtenstein, Norway, and Switzerland. It covers medically necessary treatments that cannot be postponed until returning to Germany. These include doctor visits, hospital stays, and medications. Billing is handled directly between the foreign and your German health insurance providers. However, co-payments may apply, which are common in the host country. You often have to cover these yourself on site. For example: If you have to pay ten percent of the doctor's fees in France, this also applies to you. The EHIC is not a free ticket for free treatments and does not cover planned treatments abroad if the sole purpose of the trip is medical treatment. It's advisable to find out in advance about the healthcare system of the destination country. The EHIC is an important component, but not always sufficient, as the next section will show.
Limits of Legal Protection: When Does It Become Expensive?
Despite the EHIC, there are situations where you may face significant costs. The statutory health insurance covers only those services abroad within the EU that are also part of the benefit catalogue of the local statutory insurance. The level of benefits may be lower than in Germany. The costs for a medically necessary repatriation are particularly critical. These are almost never covered by statutory health insurance and can amount to tens of thousands of euros, depending on the distance and condition of the patient. Treatment in private clinics or by private doctors, which is often available more quickly in other EU countries, is usually not covered or only partially reimbursed. For example: A complicated leg fracture from skiing in Austria can quickly exceed ten thousand euros in a private clinic, with the statutory health insurance covering only a fraction. Here’s an overview of potential cost traps:
Costs for a medically advisable or necessary repatriation (often over 10,000 euros).
Treatment in private clinics or by private doctors (cost differences often amounting to several thousand euros).
Higher co-payments for medication and treatments than in Germany (can quickly add up to hundreds of euros).
Dental treatments that go beyond mere pain relief.
Services that are not standard in the host country (e.g., certain therapies).
These examples show that additional cover is often essential. But what options are available here?
Additional Cover: The Essential Travel Health Insurance
A private international health insurance fills the gaps of statutory health insurance within the EU. It generally covers costs for medically advisable repatriation, treatments in private clinics, and higher medical fees. Many plans cost only a few euros per year, yet offer comprehensive protection. Ensure that the plan covers medically advisable repatriation, not just medically necessary. For example: Even if treatment is possible abroad, repatriation can be beneficial to receive care in a familiar environment and language. A good annual travel health insurance covers all trips within a year, often up to a duration of six or eight weeks per trip. There are special plans for longer stays. Our expert tip: Always take out insurance before starting your trip. The exact terms and benefits can vary, so it's worth looking closely at the contract details.
Recommendations for your next EU trip
To be optimally prepared for medical emergencies when travelling within the EU, we recommend the following steps. Check the validity of your European Health Insurance Card (EHIC). It is usually located on the back of your health card. Familiarise yourself with the healthcare system of your destination country. The standards are not always comparable to those in Germany. Make sure you take out a private health insurance policy for abroad. This should at least cover medical repatriation and the costs of private treatments. Carry important emergency numbers and the contact details of your overseas health insurance with you. Here is a checklist to prepare for your trip:
Check EHIC: Is it up-to-date and undamaged?
Take out health insurance for travel abroad: Pay attention to the coverage (repatriation, private clinic).
Assemble a travel pharmacy: Basic medicines for minor ailments.
Save emergency contacts: Insurance, embassy, local emergency numbers.
Make copies of important documents: Passport, insurance card, policy.
If you have pre-existing conditions: Carry a medical certificate (in English if necessary) for essential medication.
Our expert tip: Save the emergency number of your overseas health insurance directly in your phone. This ensures you can act quickly in an emergency. With these precautions, you can start your journey more relaxed.
Your next step towards worry-free travel
Statutory health insurance provides basic coverage within the EU, but in practice, gaps often appear. Co-payments, costs for private treatments, and especially an uncovered return transport can quickly lead to a financial burden of several thousand euros. A private international health insurance policy is therefore an important addition for every EU traveller, even for short trips. It protects you from unforeseen expenses and ensures you receive the best possible care in an emergency. At nextsure, you will find tailored solutions precisely suited to your needs. We help you find the right coverage for your travels. Contact us now.
Request an individual risk analysis now: Have your insurance situation checked free of charge and receive specific optimization suggestions.
More useful links
Deutsche Verbindungsstelle Krankenversicherung – Ausland (DVKA) provides a leaflet on health insurance abroad, specifically for pensioners.
Federal Ministry of Health offers comprehensive information on health insurance abroad.
GKV-Spitzenverband provides detailed information on the European Health Insurance Card (EHIC).
European Commission offers information on the European Health Insurance Card (EHIC) in the context of EU social security coordination.
Europa.eu explains your rights to healthcare in another EU country.
Federal Statistical Office (Destatis) provides a publication on health insurance based on the microcensus.
European Commission provides an overview of cross-border healthcare within the EU.
German Pension Insurance provides information on receiving a pension and health insurance abroad.
Consumer Centre provides information on health insurance for long stays abroad.
FAQ
Welche Leistungen genau übernimmt meine gesetzliche Krankenversicherung im EU-Ausland?
Ihre gesetzliche Krankenversicherung übernimmt über die EHIC medizinisch notwendige Behandlungen bei Ärzten, Zahnärzten und in Krankenhäusern, die dem öffentlichen System des jeweiligen EU-Landes angeschlossen sind. Der Leistungsumfang richtet sich nach den Vorschriften des Reiselandes. Das bedeutet, Sie erhalten die gleichen Leistungen wie ein dort Versicherter, müssen aber auch die dort üblichen Zuzahlungen leisten.
Was passiert, wenn ich meine EHIC im EU-Ausland vergessen habe?
Sollten Sie Ihre EHIC vergessen haben, kontaktieren Sie umgehend Ihre Krankenkasse in Deutschland. Diese kann Ihnen eine provisorische Ersatzbescheinigung (PEB) ausstellen und oft auch per Fax oder E-Mail direkt an den ausländischen Leistungserbringer oder an Sie senden.
Deckt die gesetzliche Krankenversicherung auch geplante Behandlungen im EU-Ausland ab?
Für geplante Behandlungen im EU-Ausland gelten besondere Regeln. Ambulante Behandlungen sind oft ohne vorherige Genehmigung möglich, sofern die Leistung auch in Deutschland zum Leistungskatalog gehört. Für geplante Krankenhausbehandlungen benötigen Sie jedoch fast immer eine vorherige Genehmigung Ihrer Krankenkasse. Sprechen Sie dies unbedingt vorab mit Ihrer Kasse ab.
Wie verhält es sich mit dem Krankenversicherungsschutz bei einem längeren Aufenthalt oder Umzug ins EU-Ausland?
Bei längeren Aufenthalten (z.B. Sabbatical, Studium) bleibt der deutsche Versicherungsschutz oft bestehen, solange der Lebensmittelpunkt in Deutschland bleibt. Bei einem dauerhaften Umzug oder Aufnahme einer Erwerbstätigkeit im EU-Ausland gelten meist die sozialrechtlichen Bestimmungen des neuen Wohn- bzw. Beschäftigungslandes. Informieren Sie Ihre Krankenkasse rechtzeitig und klären Sie Ihren Status (ggf. Formular S1).
Was ist der Unterschied zwischen einem medizinisch notwendigen und einem medizinisch sinnvollen Rücktransport?
Ein medizinisch notwendiger Rücktransport liegt vor, wenn eine adäquate Behandlung im Ausland nicht möglich ist. Ein medizinisch sinnvoller Rücktransport kann auch dann erfolgen, wenn eine Behandlung vor Ort zwar möglich wäre, aber eine Verlegung in die Heimat aus verschiedenen Gründen (z.B. bessere Heilungschancen, soziale Gründe, Sprache) vorteilhafter ist. Die gesetzliche Kasse zahlt meist keinen von beiden, viele private Auslandskrankenversicherungen decken den medizinisch sinnvollen Rücktransport ab.
Übernimmt die Auslandskrankenversicherung auch Kosten bei einer Pandemie-Reisewarnung?
Das hängt vom jeweiligen Tarif und den Versicherungsbedingungen ab. Einige Auslandskrankenversicherungen leisten auch bei einer Erkrankung (z.B. an COVID-19) im Ausland trotz bestehender Reisewarnung, andere schließen dies aus. Prüfen Sie die Bedingungen genau oder fragen Sie bei Ihrem Versicherer nach. Generell gilt: Eine Reisewarnung des Auswärtigen Amtes ist kein Reiseverbot, kann aber versicherungsrechtliche Auswirkungen haben.
