General Health Insurance Issues in Germany

When you work in Germany, you must make arrangements for health insurance. The German system works on the basis of insurance based cover and a bill is raised for everything.

I have met many British ex-pats working in Germany who decide that they will gamble on reliance on the British NHS system to take care of them.

You should be aware of the following though: If you are working outside the UK and no longer paying British National Insurance, you are not entitled to cover from the British NHS. Nor are you entitled to cover overseas via the EU reciprocal treatment schemes.

Of course, suppose that you keep an address in the UK and come back every now and then to visit then who is going to know that you are not entitled to treatment if you make occasional trips to see your GP when you are back? But, a greater problem could arise if you fall seriously ill. Consider the following situation:

Suppose that you work for three years in Germany, paying Swiss national insurance through some management company. One day, you realise that you have been feeling a little under the weather for a while and you resolve to stay off the beer until it passes but the next thing that you know is that you are waking up in hospital.

The doctor explains that you have suffered from kidney failure and that you will be OK but you are going to need dialysis for the rest of your life and he asks about your insurance details.

You say that, as a Brit, you are covered under the reciprocal scheme but, when he follows this up, he is told by the NHS that this is not so as you have not paid UK contributions while working in Germany. You bite the bullet and work out that by digging into your savings, you can just about pay for the treatment to date and the cost of an air ambulance to get you back to the UK.

So, this you do only to discover, on arriving in the UK that British citizens returning to the UK from overseas are not entitled to NHS care if the primary purpose for their return was to obtain medical treatment. Now how are you going to fund a lifetime's dialysis?

OK, that is very unlikely to happen but it could and the consequences are pretty dire.

Another thing to consider is that when you register in Germany, you are required to have medical cover. You may only be asked to tick a box on a form but some parts of Germany will ask you to produce evidence of medical cover.

See the links on the healthcare page for the different coverage options available.

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