Statutory health insurance abroad in the EU: Your comprehensive guide for seamless protection
25 May 2025
10
Minutes
Katrin Straub
CEO at nextsure
A medical emergency during a holiday in the EU or while staying for an extended period can quickly become expensive. Although your German statutory health insurance provides basic coverage, there are important details to consider. This article explains which benefits you are entitled to and how you can best protect yourself.
The topic in brief and concise terms
Your German statutory health insurance is valid abroad within the EU with the EHIC for medically necessary treatments in the public system, but benefits and cost coverage are determined by the rules of the host country.
Repatriation to Germany after illness is not typically covered by statutory health insurance and can cost tens of thousands of euros; a private international health insurance is essential in this case.
A private international health insurance covers important gaps, covers costs for private treatments and repatriation, and often costs only a few euros per year.
Quick Facts: Statutory health insurance coverage in the EU
Your German statutory health insurance is generally valid in other EU countries as well. The European Health Insurance Card (EHIC) on the back of your health card serves as proof. You will receive medically necessary services under the conditions of the respective EU country. This means you will be treated as if you were insured there. It is important to note that this only applies to the public healthcare system. Private doctors or clinics are often not covered. A medical repatriation to Germany is usually not covered by the statutory fund. For long-term stays, you should inform your health insurance provider and possibly apply for Form S1. These initial points already illustrate that despite the EU-wide coverage, there may be gaps.
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 the return to Germany. This includes doctor visits, hospital stays, and also medications. The billing is handled directly between the foreign and your German health insurance. However, co-payments that are common in the host country may apply. These often need to be paid by you on the spot. For example: If you have to pay ten percent of the doctor's fees yourself in France, this applies to you as well. The EHIC is not a free pass for free treatments and does not cover planned treatments abroad if the sole purpose of the trip is medical treatment. It is advisable to inform yourself 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. Public health insurance in the EU only covers services that are included in the healthcare catalogue of the respective country's statutory insurance. The level of service may be lower than in Germany. Particularly critical are the costs for a medically necessary repatriation. These are almost never covered by statutory insurance and can amount to several tens of thousands of euros, depending on the distance and the patient's condition. Treatment in private clinics or by private doctors, who are often more readily available abroad, is usually not covered or only partially reimbursed. For example, a complicated leg fracture while skiing in Austria can easily cost over ten thousand euros in a private clinic, with public insurance perhaps covering only a fraction. Here is an overview of potential cost traps:
Costs for a medically sensible or necessary repatriation (often over 10,000 euros).
Treatment in private clinics or by private doctors (difference costs often several thousand euros).
Higher co-payments for medications and treatments than in Germany (can quickly add up to hundreds of euros).
Dental treatments beyond mere pain relief.
Services not standard in the host country (e.g. certain therapies).
These examples show that additional insurance is often essential. But what options are available?
Additional Protection: The Essential Travel Health Insurance
A private international health insurance fills the gaps of statutory health insurance outside the EU. It generally covers the costs for medically advisable repatriation, treatments in private clinics, and higher medical fees. Many policies cost only a few euros per year but offer comprehensive protection. Ensure that the policy covers medically advisable repatriation, not just medically necessary repatriation. For instance, even if treatment is possible abroad, repatriation might be beneficial to receive care in a familiar environment and language. A good annual travel health insurance covers all trips within a year, often for up to six or eight weeks per trip. Special policies are available for longer stays. Our expert tip: Always take out insurance before commencing your journey. The exact terms and benefits may vary, so it's worthwhile to look closely at the contract details.
Expert Knowledge: Legal Fundamentals and Special Cases
The legal basis for health insurance coverage in other EU countries is formed by the EU Regulation 883/2004. It coordinates the social security systems. For hospital services abroad within the EU, prior approval from your health insurance provider is often required, except in cases of acute emergencies. If you become employed in another EU country, you are generally subject to the social security regulations of the employment country. The S1 form (previously E106) certifies your entitlement to benefits in your country of residence if you work and are insured in another EU country. Retirees who move their residence to another EU country usually remain insured in Germany but receive benefits in their country of residence through the S1 form. Our expert tip: Always clarify the details in advance with your health insurer for planned treatments or long-term stays. The German Liaison Office for Health Insurance Abroad (DVKA) can also assist with complex questions. These regulations are complex, but good preparation protects against surprises.
Recommendations for your next EU trip
To be optimally prepared for medical emergencies abroad in the EU, we recommend the following steps. Check the validity of your European Health Insurance Card (EHIC), which is usually located on the back of your health card. Familiarise yourself with the healthcare system of your destination country. Not everywhere has a standard comparable to Germany. Make sure to take out private foreign health insurance. This should at least cover the costs of medically necessary repatriation and private treatments. Carry important emergency numbers and the contact details of your foreign health insurance with you. Here is a checklist for your travel preparation:
Check EHIC: Is it current and undamaged?
Take out foreign health insurance: Pay attention to the scope of services (repatriation, private clinic).
Assemble travel pharmacy: Basic medications for minor ailments.
Save emergency contacts: Insurance, embassy, local emergency numbers.
Make copies of important documents: Passport, health insurance card, insurance policy.
If you have pre-existing conditions: Carry a medical certificate (possibly in English) for necessary medication.
Our expert tip: Save the emergency number of your foreign health insurance directly in your mobile phone. This way, you can act quickly in an emergency. With these precautions, you can start your trip more relaxed.
Your next step to worry-free travel
The statutory health insurance provides basic cover in EU countries, but in practice, gaps frequently appear. Copayments, costs for private treatments, and especially an uncovered repatriation can quickly lead to a financial burden of several thousand euros. A private international health insurance is therefore an important addition for every EU traveller, even for short trips. It protects you from unforeseen expenses and ensures the best possible care in emergencies. At nextsure, you will find tailor-made solutions precisely suited to your needs. We help you find the right cover for your travels. Get in touch with us now.
Request an individual risk analysis now: Have your insurance situation reviewed free of charge and receive specific suggestions for optimisation.
More useful links
Deutsche Verbindungsstelle Krankenversicherung – Ausland (DVKA) provides a leaflet on health insurance abroad specifically for pensioners.
Bundesgesundheitsministerium provides comprehensive information about health insurance abroad.
GKV-Spitzenverband offers detailed information on the European Health Insurance Card (EHIC).
Europäische Kommission provides 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.
Statistisches Bundesamt (Destatis) provides a publication on health insurance based on the microcensus.
Europäische Kommission offers an overview of cross-border healthcare in the EU.
Deutsche Rentenversicherung provides information on pensions and health insurance abroad.
Verbraucherzentrale gives information on health insurance for long-term stays abroad.
FAQ
What exactly does my statutory health insurance cover in other EU countries?
Your statutory health insurance covers medically necessary treatments through the EHIC with doctors, dentists, and hospitals that are part of the public system in the respective EU country. The coverage depends on the regulations of the destination country. This means you receive the same services as someone insured there but will also have to pay the usual co-payments applicable there.
What happens if I forget my EHIC while abroad in the EU?
If you forget your EHIC, contact your health insurance provider in Germany immediately. They can issue you a provisional replacement certificate (PEB) and often send it directly to the foreign service provider or to you by fax or email.
Does statutory health insurance also cover planned treatments abroad in the EU?
Special rules apply to planned treatments abroad within the EU. Outpatient treatments can often be undertaken without prior approval, provided that the service is also included in the catalogue of services in Germany. However, for planned hospital treatments, you almost always need prior approval from your health insurer. Ensure you discuss this in advance with your insurance company.
What happens to health insurance coverage during a longer stay or move to another EU country?
For extended stays (e.g., sabbaticals, studies), German insurance coverage often remains in place as long as your main residence is in Germany. In the case of a permanent move or taking up employment in another EU country, the social security regulations of the new country of residence or employment usually apply. Inform your health insurance provider in good time and clarify your status (if necessary, with form S1).
What is the difference between a medically necessary and a medically appropriate repatriation?
A medically necessary repatriation occurs when adequate treatment is not possible abroad. A medically advisable repatriation can also take place if local treatment is possible but relocation to the home country is more advantageous for various reasons (e.g. better chances of recovery, social reasons, language). The statutory health insurance usually covers neither, but many private travel health insurances cover the medically advisable repatriation.
Does international health insurance also cover costs in case of a travel warning due to a pandemic?
This depends on the specific plan and the terms and conditions of the insurance. Some travel health insurances provide coverage even in the event of an illness (e.g. COVID-19) abroad despite existing travel warnings, while others exclude this. Carefully check the conditions or inquire with your insurer. Generally, it is important to note that a travel warning from the Foreign Office is not a travel ban, but it can have legal implications for insurance.
