Here we will provide you a general example of what a public health insurance should cover. Each health insurance company has the statutory coverage. Benefits differ from company to company, please check with your choices of insurers.
Expatrio provides the best and fairest rated health insurance fund, Techniker Krankenkasse(TK), and here are some of the statutory treatments provided.
You can simply apply via the Expatrio platform just like you did with the Blocked Account.
- Visits to the Doctor
For visits to the doctor you should—if a possible call to arrange an appointment beforehand. If you do not, you may have to wait a long time in the queue.
You will be treated after a check-in at the receptionist with your EHIC at the doctors or the hospital.
You don’t normally have to pay a bill from the doctor or hospital first and then later be this reimbursed. Contract partners bill the TK directly. However, in some cases, there are co-payments that you must pay directly to the care provider
- How about medical prescriptions? How do I get them?
When a medical prescription is required for treatment, the insured person has to make a co-payment for this. The co-payment charge generally amounts to 10% of the dispensing price, a minimum of 5 EUR and a maximum of 10 EUR
In other words, you will only have to pay 10% of what the prescription costs and it must be in between 5 to 10 EUR. Please note that some medicines are exempt from this co-payment requirement. In exceptional cases, a doctor may prescribe non-prescription medications at the health insurance company’s expense
Once you have received a doctor’s prescription, you must go to a pharmacy, “Apotheke” in German. You can show your prescription there and it should be ready within the day if they have it in stock. If not they will ask you to come back within the following business days.
- Dental Treatment & Prosthesis
If you need to see a dentist for treatment, it is always recommended to call and ask if your treatment is fully or partially covered.
For example: a simple yearly clean is covered but more intensive clean is not and may require a full payment or co-payment.
If a dental prosthesis is required, the dentist will give you an estimated quote on the treatment and prosthesis. It is then submitted to the health insurance company prior to the dental fitting. In most cases, this requires a co-payment based upon pre-checkups of the dental prosthesis fitting.
The dentist will then bill you directly for the amount not covered by health insurance Please not that it may happen that you have to privately pay a little extra for fillings or check-ups because the health insurance companies can only take a specific share of costs for these treatments.
- Emergency Treatment
If hospital treatment is necessary, the doctor will refer you for hospitalization In acute cases, such as an accident or a sudden serious illness, hospital admission is also possible without a doctor’s referral
There are also medical care centers and hospital ambulances accredited for medical treatment that is covered too.
- Hospital stays for up to 28 days
When you are sick and you have to stay in a hospital, the health insurer covers the treatment. You must only pay 10 EUR as a co-payment for a maximum of 28 days per the calendar year.