Health insurance abroad: Your comprehensive guide to optimal cover for travel and long stays
22.06.25
5
Minutes
Katrin Straub
Managing Director at nextsure
A medical emergency abroad can quickly become expensive and cloud the joy of travelling. Find out how to protect yourself from unexpected costs and which insurance solutions are available for short and long stays, so you can enjoy your time abroad with complete peace of mind.
The topic in brief and concise terms
Statutory health insurance (GKV) often only provides basic cover abroad; private overseas health insurance is essential for comprehensive protection and repatriation costs.
The European Health Insurance Card (EHIC) makes treatment easier in EU/EEA countries, but it does not replace private travel health insurance abroad, as it does not cover repatriation, for example.
For long-term stays of over 56 days, special long-term international health insurance policies are required, which must be taken out before travelling.
At a glance: Key facts about health insurance abroad
When travelling abroad, the right health insurance cover is crucial to protect you from high costs. Statutory health insurance (GKV) covers medically necessary treatment in EU countries as well as in countries with social security agreements, often via the European Health Insurance Card (EHIC). However, costs are usually reimbursed only up to the level of German rates, and repatriation is generally not included. For more comprehensive cover, especially outside Europe or to cover repatriation costs, which can quickly amount to tens of thousands of euros, private international health insurance is essential. It often costs only a few euros per year.
Statutory health insurance abroad: What does the EHIC really cover?
The European Health Insurance Card (EHIC), usually found on the back of your German health card, gives you access in the 27 EU Member States as well as Iceland, Liechtenstein, Norway, Switzerland and the United Kingdom to medically necessary treatment provided by the public healthcare system. This means you are treated under the same conditions and at the same cost as insured persons in that country. However, it is important to note: the EHIC is not travel insurance. It does not cover private healthcare services, planned treatment abroad or the cost of a medically necessary repatriation. In countries with social security agreements outside the EU, such as Turkey or Tunisia, you often need a special overseas sickness certificate from your health insurance provider. Bear in mind that treatment costs abroad can exceed German reimbursement rates; you will have to cover this difference yourself without additional insurance. A private overseas health insurance policy is therefore a sensible addition even within Europe.
Private health insurance (PKV): What cover do you enjoy abroad?
Privately insured people generally benefit from more comprehensive cover abroad than those insured under the statutory scheme. Within Europe, cover is usually provided to the full scope of the policy, often even for longer stays. Worldwide, cover is often valid for at least one month, and with many tariffs even for three months or longer. However, always check your policy conditions carefully. Not every private health insurance policy, for example, covers medically appropriate repatriation, or reimbursement is limited to German fee schedules, which can lead to gaps in cover abroad. If you move permanently to an EU or EEA country, private health insurance can often be continued. Outside these regions, cover usually ends, but individual arrangements are sometimes possible. Additional travel health insurance abroad can also be worthwhile for private health insurance policyholders, in order to avoid excesses or jeopardising any premium refunds.
The essential add-on: Why overseas health insurance is worth its weight in gold
Travel health insurance is essential for almost any trip and fills the cover gaps of statutory health insurance (GKV) and often also private health insurance (PKV). It usually covers the full costs of outpatient and inpatient treatment abroad, including in private clinics, and pays for necessary medication. A key benefit is the cost coverage for a medically sensible return transport to Germany, which can quickly amount to five- or six-figure sums – an ambulance flight from Australia can cost up to 200,000 euros. Statutory health insurance generally does not cover these costs. Good policies are often available from as little as ten to 30 euros per year and should always be taken out before travelling. Look out for benefits such as:
Coverage of the costs of medically necessary treatment.
Cost coverage for a medically sensible return transport.
Pain-relieving dental treatment and repairs to dental prostheses.
Recovery and rescue costs up to a certain amount.
No or only a small excess.
Organisation and cost coverage in the event of death or repatriation.
This cover gives you the reassurance that, in an emergency, you will receive the best possible care worldwide, without having to worry about immense costs. A travel health insurance for 30 days is often available at a very reasonable price.
Long-term stays abroad: special features and key considerations
If you are planning a longer stay abroad, for example for study, Work & Travel or as a retiree, special conditions apply to your health insurance cover. Standard international travel health insurance policies usually only apply to trips of up to 56 days. For stays of two months to five years, you need a special long-term international health insurance policy. This must be taken out before leaving Germany and often requires a German place of residence. Be sure to clarify the following points in advance:
Period of cover and maximum insurance duration (e.g. up to 24 months or five years).
Option to extend from abroad (often only once and before expiry).
Conditions for early cancellation and premium refund if you return early.
Reinstatement in German statutory health insurance (GKV) or private health insurance (PKV) after your return.
If you move your place of residence permanently to a non-EU country without a social security agreement, your entitlement under German statutory health insurance (GKV) is generally suspended (§ 16 SGB V). Comprehensive long-term international health insurance is then your primary cover. Also find out whether international health insurance policies are tax-deductible.
Expert knowledge: social security agreements and legal aspects
Germany has concluded social security agreements (SVA) with many countries, which also cover health insurance. These include EU/EEA states, but also countries such as Turkey, the USA, Canada, Australia or Japan. These agreements stipulate that you are entitled to medical treatment in the respective country, often on presentation of the EHIC or a medical certificate for treatment abroad. Benefits are governed by the law of the host country. Our expert tip: Find out about the exact regulations for your travel destination from the German Liaison Office for Health Insurance – Abroad (DVKA). In countries without an SVA (“non-contractual foreign countries”), there is usually no entitlement to benefits from statutory health insurance (GKV). Under Section 16 of the German Social Code Book V (SGB V), the entitlement to benefits from statutory health insurance is suspended during a stay abroad, provided that no differing regulations (such as EU law or an SVA) apply. In the case of work-related assignments abroad, the employer initially bears the costs, which they can have reimbursed by the health insurance provider (Section 17 SGB V). Recent court rulings repeatedly confirm the importance of clear contractual terms, especially in the case of repatriation. For example, the Hamm Higher Regional Court ruled that an insurer must cover the costs of medically necessary repatriation if local care is not sufficient.
To be as well protected as possible when travelling and on longer stays abroad, you should follow a few steps. Check your existing insurance cover through GKV or PKV at least four weeks before departure. Clarify which benefits are covered in the destination country and whether the EHIC or an overseas medical certificate is required. Always take out private international health insurance that covers treatment costs beyond German rates and medically appropriate repatriation. Compare offers in terms of scope of cover and cost – a good annual policy is often available for under 30 euros. For long-term stays of over 56 days, special long-term international health insurance is required and must be taken out before departure. Always carry important emergency numbers and your insurance details with you. In the event of a claim, contact the emergency service of your international health insurance provider immediately. Keep all invoices and receipts carefully. With the right preparation, you will be equipped for the worst case and can enjoy your time abroad without worry. Also consider additional cover such as trip cancellation insurance.
Your next step towards worry-free travel
Proper cover in the event of illness is a fundamental part of every travel plan. With an understanding of how your German health insurance works abroad and the benefits of supplementary overseas health insurance, you are well prepared. nextsure supports you in finding the right solution for your individual needs. We provide transparent information and digital application processes for your optimum protection. This allows you to focus fully on the positive experiences of your time abroad, knowing that you are well covered in an emergency. Get in touch now for individual advice.
Request an individual risk analysis now: Have your insurance situation checked free of charge and receive concrete suggestions for improvement.
More useful links
The German Liaison Office for Health Insurance – Abroad (DVKA) offers a detailed PDF fact sheet on health insurance abroad specifically for pensioners.
The German Liaison Office for Health Insurance – Abroad (DVKA) provides important information on health insurance for students and interns abroad.
The Federal Ministry of Health provides comprehensive information on the rules governing health insurance during stays abroad.
The Federal Ministry of Health offers support and information via its citizen hotline on health and long-term care insurance during stays abroad.
The Federal Ministry of Health provides an informative flyer (PDF) on health insurance abroad.
The Federal Ministry of Health provides information on the impact of Brexit on international health policy and insurance coverage.
FAQ
What health insurance do I need for a trip around the world?
For a round-the-world trip or another long-term stay (usually over 56 days), you need a special long-term international health insurance policy. This must be taken out before you depart and usually also covers medical treatment as well as repatriation worldwide.
Is my German health insurance valid in the USA?
The German statutory health insurance (GKV) generally does not provide cover in the USA unless there is a social security agreement that covers this (which is the case for the USA, but often only means limited benefits). Treatment costs in the USA are extremely high. Private international travel health insurance with a sufficiently high level of cover is absolutely essential for trips to the USA.
What happens if I fall ill abroad and don’t have travel health insurance?
Without international health insurance, you must cover all costs that your statutory or private health insurance does not pay for yourself. These can include treatment costs that are higher than German rates, costs for private clinics or the very high cost of medical repatriation. This can lead to a significant financial burden.
Can I also take out international health insurance after my trip has started?
As a rule, overseas health insurance must be taken out before travelling. A few providers allow policies to be arranged from abroad, but this is the exception and is often associated with waiting periods or higher premiums. Do not rely on this and make sure you arrange your cover in good time.
What does "medically advisable repatriation" mean?
A medically advisable repatriation means that a transfer back to your home country is recommended for medical reasons, even if treatment on site would theoretically be possible. This can be the case, for example, if care in the home country is better, language barriers make treatment more difficult, or a longer course of treatment abroad would be unreasonable. Many GKV/PKV tariffs only cover "medically necessary" repatriation, which sets a higher threshold.
Does the overseas health insurance also cover chronic illnesses?
Good overseas health insurance policies also provide cover in the event of an unexpected worsening of an existing chronic condition abroad. However, planned treatment or treatment whose necessity was already established before departure is usually excluded. Check the exact terms and conditions of your policy.
