Health Insurance Abroad: Your Comprehensive Guide for Optimal Coverage While Travelling and During Long Stays
22 Jun 2025
11
Minutes
Katrin Straub
CEO at nextsure
A medical emergency abroad can quickly become expensive and spoil the joy of travel. Learn how to protect yourself from unexpected costs and what insurance solutions are available for short and long stays, so you can enjoy your time abroad without worries.
The topic in brief and concise terms
Statutory health insurance (GKV) often only provides basic coverage abroad; a private international health insurance is essential for comprehensive protection and repatriation costs.
The European Health Insurance Card (EHIC) facilitates medical treatment in EU/EEA countries, but does not replace private travel health insurance, as it does not cover repatriation, for example.
For long-term stays exceeding 56 days, special long-term international health insurance policies are required, which must be taken out before departure.
Immediate Overview: Important Facts About Health Insurance Abroad
When travelling abroad, having the right health insurance coverage is crucial to safeguard against high costs. The statutory health insurance (GKV) covers medically necessary treatments in EU countries as well as countries with social security agreements, often through the European Health Insurance Card (EHIC). However, costs are usually reimbursed only up to the amount of German rates, and repatriation is generally not included. For more comprehensive protection, especially outside of Europe or to cover repatriation costs, which can quickly amount to tens of thousands of euros, a private international health insurance policy is indispensable. This 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 reverse side of your German health card, provides you access to medically necessary services from public healthcare systems in the 27 EU countries, as well as Iceland, Liechtenstein, Norway, Switzerland and the United Kingdom. This means you will be treated under the same conditions and costs as the insured residents of that respective country. However, it is important to note: the EHIC is not a travel insurance. It does not cover private healthcare services, planned treatments abroad, or the costs of a medically necessary return transport. In countries with a social security agreement outside the EU, such as Turkey or Tunisia, you often need a special international health certificate from your insurer. Keep in mind that treatment costs abroad may exceed the German reimbursement rates; without a supplementary insurance, you must cover this difference yourself. A private international health insurance is therefore a sensible addition, even within Europe.
Private Health Insurance (PKV): What coverage do you have abroad?
Privately insured individuals often benefit from more comprehensive overseas coverage than those with statutory insurance. Within Europe, insurance coverage is typically provided in full according to the tariff, often even for longer stays. Worldwide, coverage frequently applies for at least one month, with many tariffs extending to three months or longer. However, always review your contract terms carefully. Not every private health insurance contract, for instance, covers a medically necessary repatriation, or the cost coverage may be limited to German fee schedules, which can lead to coverage gaps abroad. If you are permanently relocating to an EU or EEA country, private health insurance can often be continued. Outside these regions, coverage usually ends, although individual agreements can sometimes be made. An additional travel health insurance can also be beneficial for privately insured individuals to avoid deductibles or not to jeopardise premium refunds.
The indispensable addition: Why international health insurance is worth its weight in gold
Travel health insurance is essential for almost every trip and fills the coverage gaps of statutory health insurance and often private health insurance. It usually covers the full costs of outpatient and inpatient treatments abroad, including in private clinics, and pays for necessary medications. A key advantage is the coverage of costs for a medically advisable return transport to Germany, which can quickly reach five or six figures – an air ambulance flight from Australia can cost up to 200,000 euros. Statutory health insurance does not cover these costs as a rule. Good policies often provide coverage from ten to 30 euros per year and should always be taken out before departure. Look out for benefits such as:
Coverage of costs for medically necessary treatments.
Cost coverage for a medically advisable return transport.
Pain-relieving dental treatments and repairs to dentures.
Rescue and recovery costs up to a certain amount.
No or only low deductible.
Organisation and coverage of costs in the event of death or repatriation.
This protection ensures that you are well taken care of worldwide in an emergency without worrying about immense costs. Travel health insurance for 30 days is often available at a very affordable rate.
Long-term stays abroad: Features and important considerations
If you are planning an extended stay abroad, for example, for studies, work & travel, or as a retiree, special conditions apply to your health insurance coverage. Standard travel health insurance usually only covers trips up to 56 days. For stays lasting from two months to five years, you will need a special long-term travel health insurance. This must be taken out before leaving Germany and often requires a German residence. Make sure to clarify the following points in advance:
Duration of coverage and maximum insurance period (e.g., up to 24 months or five years).
Possibility of extension from abroad (often only once and before expiration is possible).
Conditions for early cancellation and premium refund if returning early.
Rejoining the German public or private health insurance upon your return.
If you relocate your residence permanently to a non-EU country without a social security agreement, your entitlement from the German public health insurance usually pauses (§ 16 SGB V). A comprehensive long-term travel health insurance then becomes your primary coverage. Also, find out whether travel health insurance is tax-deductible.
Expert Knowledge: Social Security Agreements and Legal Aspects
Germany has entered into social security agreements (SSA) with many countries, which also include health insurance. These agreements apply to EU/EEA countries, as well as countries like Turkey, the USA, Canada, Australia, and Japan. These agreements ensure that you are entitled to medical services in the respective country, often upon presentation of the EHIC or a foreign health insurance certificate. The services are governed by the host country's laws. Our expert tip: Check with the German Liaison Office for Health Insurance Abroad (DVKA) for the specific regulations for your destination country. In countries without an SSA (“non-contractual foreign countries”), there is generally no entitlement to benefits from the statutory health insurance (GKV). According to § 16 SGB V, the entitlement to benefits from the GKV is suspended during a stay abroad, unless there are alternative arrangements (such as EU law or an SSA). For business-related assignments abroad, the employer initially bears the costs, which can be reimbursed by the health insurance fund (§ 17 SGB V). Recent rulings repeatedly confirm the importance of clear contract terms, especially regarding repatriation. For instance, the Higher Regional Court of Hamm ruled that an insurer must cover the costs of a medically necessary repatriation if local care is insufficient.
Recommendations for Action: How to Be Optimally Insured Abroad
To be best insured while travelling and during extended stays abroad, there are several steps you should consider. Check your existing insurance coverage through statutory or private health insurance at least four weeks before departure. Determine which services are covered in the destination country and whether the EHIC or an overseas health certificate is needed. Always take out a private foreign health insurance that covers treatment costs beyond German rates and a medically reasonable return transport. Compare offers in terms of coverage and costs – a good annual policy is often available for less than 30 euros. For long-term stays over 56 days, a special long-term foreign health insurance is necessary 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 foreign health insurance immediately. Carefully keep all invoices and receipts. With the right preparation, you are ready for an emergency and can enjoy your time abroad without worries. Also consider additional protections like travel cancellation insurance.
Your next step to worry-free travel
More useful links
The Deutsche Verbindungsstelle Krankenversicherung – Ausland (DVKA) provides a detailed PDF leaflet about health insurance abroad specifically for retirees.
The Deutsche Verbindungsstelle Krankenversicherung – Ausland (DVKA) offers important information on health insurance for students and interns abroad.
The Federal Ministry of Health provides comprehensive information on the regulations for health insurance during stays abroad.
The Federal Ministry of Health offers support and information on health and long-term care insurance during stays abroad via its citizen telephone service.
The Federal Ministry of Health provides an informative flyer (PDF) on health insurance abroad.
The Federal Ministry of Health informs about the impact of Brexit on international health policy and insurance coverage.
FAQ
Which health insurance do I need for a world trip?
For a world trip or any other long-term stay (usually over 56 days), you will need a special long-term overseas health insurance. This must be taken out before the trip starts and covers medical treatments as well as usually worldwide repatriation.
Is my German health insurance valid in the USA?
The German statutory health insurance (GKV) generally does not provide coverage in the USA, unless there is a social security agreement covering this (which is the case for the USA, but often only means limited benefits). The cost of treatment in the USA is extremely high. A private travel health insurance policy with sufficiently high coverage is absolutely essential for trips to the USA.
What happens if I fall ill abroad and don't have travel health insurance?
Without foreign health insurance, you will have to bear all costs that your statutory health insurance or private health insurance does not cover yourself. These can be treatment costs that exceed German rates, costs for private clinics, or the very high costs of a medical repatriation. This can lead to significant financial burdens.
Can I take out international health insurance after the start of my trip?
As a rule, travel health insurance must be taken out before departure. A few providers allow for it to be arranged from abroad, but this is the exception and often involves waiting times or higher premiums. Don’t rely on this and make sure you arrange your coverage in good time.
What does "medically advisable repatriation" mean?
A medically advisable repatriation means that a transfer back to the home country is recommended for medical reasons, even if treatment on-site is theoretically possible. This may be the case, for example, if healthcare is better in the home country, language barriers complicate treatment, or a prolonged treatment abroad would be unreasonable. Many GKV/PKV tariffs only cover "medically necessary" repatriation, which poses a higher hurdle.
Does the international health insurance also cover chronic illnesses?
Good overseas health insurance also provides coverage in the event of an unexpected worsening of an existing chronic condition abroad. However, planned treatments or treatments whose necessity was already determined before departure are usually excluded. Check the exact conditions of your policy.
