Health Insurance for Refugees

In Germany, everyone is required to have health insurance, whether it is private or statutory. Health insurance covers accrued medical costs. These include doctor visits, hospital stays, as well as payments when ill.


Refugees usually only have a temporary residence permit. Therefore, they cannot immediately take out a health insurance policy. Nevertheless, they are also covered for medical treatment. Here you’ll learn that


  • You, as an asylum seeker, will need a certificate of medical treatment from the social services department or an electronic health insurance card to be able to visit the doctor.
  • You must always first go to the doctor in order to receive special treatments or medication
  • You will have to obtain statutory health insurance after a residence period of more than 15 months and that you can select the insurance company yourself.

Refugees Are Entitled to These Benefits


Many refugees suffer physical and psychological trauma from war or while taking refuge. There is also the risk of becoming infected with contagious diseases. This is when medical treatment is absolutely necessary.  

Since you do not have a permanent residence in Germany, you are fundamentally not medically insured. Your medical treatment is regulated by the Asylum-Seekers’ Benefits Act (Asylbewerberleistungsgesetz). According to §4 of the Asylum-Seekers’ Benefits Act, you are entitled to the following benefits:


  • Medical treatment for acute illnesses and pain, including necessary medication
  • Medical and nursing assistance as well as care for pregnant women and women who have recently given birth
  • Recommended vaccinations and check-ups


This applies to the first 15 months of your residence and is called Wartezeit (waiting period). When you are sick or require other medical treatment, you must first go to your social services department. There it will be determined if you urgently require treatment. If so, you will receive a Behandlungsschein (certificate of medical treatment). With this, you will then be able to go to the doctor.

The Electronic Health Insurance Card for Refugees


In some federal states in Germany, as an asylum seeker you will receive an elektronische Gesundheitskarte (electronic health insurance card) right from the start. With this, you will not have to first go to the social services department to receive a certificate of medical treatment. Instead, you can go directly to the doctor. The health insurance card will also simplify the billing. The health insurance company will receive payment for the medical treatment from the municipality. The health insurance company responsible for your coverage will be assigned to you.

Important: This regulation does not apply to all regions in Germany. Whether and how you receive an electronic health insurance card before the first 15 months of your residence are up depends on:


  • The federal state
  • The municipality
  • Participating health insurance companies

The federal state of Bremen is a pioneer of electronic health insurance cards for refugees. Since 2005, asylum seekers in Bremen receive their health insurance cards directly after arrival from AOK. Thus, this regulation is also known as the “Bremer Modell” (Bremen Model). Hamburg, Nordrhein-Westfalen, Schleswig-Holstein, and Thüringen have also begun issuing electronic health insurance cards to asylum seekers (as of 2017).


You can find further information about the regulations applicable in each federal state here (link only available in German).

How Does the German Health Care System Work?


The German health care system consists of doctors, pharmacies, and hospitals. Your first point of contact is the doctor. If you don’t have an acute illness, you’ll have to first make an appointment to see the doctor in most cases. For critical or very specialised ailments, the doctor will refer you to a specialist or hospital. If no further treatment is necessary, you may receive a prescription for medication. You can then use this prescription to obtain your medication from a pharmacy.

In order to receive treatment in a hospital, you’ll need a referral from a doctor. Important: go to the hospital without first seeing a doctor only for emergencies. Examples of emergencies are:


Acute shortness of breath, pain, or dizziness

Accident or injury

Pregnancy complications

Health hazards caused by drugs and poisons

Suicide risk

Allergic shock

Disturbance of consciousness


In these urgent cases, it’s best to go directly to the hospital. Alternatively, you can call a Notarzt (emergency medical physician) by dialling 112.


Do you speak only a little German? Many doctors in Germany also speak English. It would be best to have someone with you who can interpret for you. This will help you avoid misunderstandings.

Which Costs Are Covered by Health Insurance?


Generally, health insurance companies in Germany will cover the costs of medical treatment. This includes most prescription drugs, vaccinations, and medical treatment costs. These will automatically be transmitted to the health insurance company with the electronic health insurance card. Should this not be the case or you don’t have an electronic health insurance card, the doctor will issue an invoice to your social services department or health insurance company.

If residing in Germany for longer than 15 months and you have not had an electronic health insurance card till now, you will no longer need a certificate of medical treatment before going to the doctor. You can instead get statutory health insurance coverage. You can also choose the health insurance company yourself.


Some costs won’t be covered even if you do have health insurance or aren’t covered by all health insurance companies. Examples of such costs are:


  • Non-prescription drugs
  • Dental prostheses, cleanings, etc.
  • Alternative medicine
  • Visual aids such as glasses or contact lenses
  • Contraception


For these you will need a special insurance policy, e.g. supplemental dental insurance, or cover the costs out of your own pocket.



At this current point in time there are unfortunately no uniform regulations for the electronic health insurance card in Germany. In some federal states, you’ll need a certificate of medical treatment before being able to see the doctor. Thus, it’s important to first check what regulations are applicable in your region. This will help save you time and energy in case of illness.


You can find further information at your local Gesundheitsamt (health authority) or Migrationsberatung (migration advisory service).