German healthcare in practice: the user manual

The Hausarzt: your front door to everything

German healthcare runs through the Hausarzt (GP/family doctor) - the cornerstone of the system and your first stop for the overwhelming majority of needs:

• Colds, infections, chronic conditions, blood tests, general health questions.
• Prescriptions (and repeat prescriptions).
• Sick notes (Krankschreibung) for work.
• Referrals (Überweisung) to specialists.
• Preventive check-ups and vaccinations.

Register with a Hausarzt near you early - not when you're already sick. You simply pick a practice (a Hausarztpraxis / Allgemeinmedizin) and become a patient; there's no formal "assigned GP" system, but having an established Hausarzt who knows you smooths everything. For finding one who speaks English, see Finding English-speaking doctors in Germany.

At the appointment: the eGK card and no bill

The mechanics that confuse newcomers:

• Bring your electronic health card (elektronische Gesundheitskarte, eGK) - the chip card from your Krankenkasse. Hand it in at reception; it identifies you and your insurance.
• Public patients pay nothing at the desk for the visit - the doctor bills your Krankenkasse directly. You only pay small copays on some things (prescriptions, below).
• Private patients (PKV) get a bill and claim it back from their insurer.
• First visit each quarter: you present the card once per calendar quarter; keep it on you.

Specialists (Fachärzte) and the referral system

For anything beyond general medicine you see a Facharzt (specialist) - dermatologist, orthopaedist, gynaecologist, etc.:

• Some specialists you can book directly; others prefer or require an Überweisung (referral) from your Hausarzt. Bring it if you have one - and it can route the specialist's fee correctly.
• The catch: waiting times. Specialist appointments routinely take weeks to months as a public patient, especially popular fields. This is the system's biggest everyday frustration.

The 116117 guarantee (your weapon against waits)

The rule that saves you: 116117 (the Kassenärztliche Vereinigung's appointment service) is legally required to find you a specialist appointment within four weeks if you can't get one yourself.

• Call 116117 or use 116117.de / the app; in 2026 a code from your Hausarzt often lets you book the guaranteed slot directly.
• It's a legal entitlement, not a favour - use it when a specialist quotes you a two-month wait.
• The same number handles the after-hours on-call service (below).

Prescriptions: the E-Rezept

Germany has gone digital - the E-Rezept (electronic prescription) replaced the old paper pink slip:

• The doctor issues it to your health-card chip (or an app/QR code). Walk into any Apotheke (pharmacy), hand over your eGK, and they retrieve and dispense it.
• Copay: public patients pay 10% of the price, min €5, max €10 per prescription item (under-18s exempt).
• Apotheken are the only place to get prescription medicine (no prescription drugs in supermarkets), and there's always an emergency Notdienst-Apotheke open overnight/weekends (posted on any pharmacy door or apotheke.de).

Sick notes (Krankschreibung / eAU)

Off work ill? The process is now electronic:

• See your Hausarzt (many do phone/video for simple cases), who issues an Arbeitsunfähigkeitsbescheinigung - now transmitted electronically (eAU) straight to your Krankenkasse, which notifies your employer.
• Tell your employer you're sick on day one regardless; check your contract for when a doctor's note is required (often from day 1 or day 3).
• Employer pays full salary for up to 6 weeks, then the Kasse pays Krankengeld (Health insurance in Germany).

Emergencies and after-hours care (know which number)

Getting this right matters:

• 112 - real emergency (life-threatening: chest pain, serious injury, stroke signs). Ambulance/fire; free to call. Go to the Notaufnahme (A&E) for emergencies, or call 112.
• 116117 - urgent but NOT an emergency outside office hours (evenings, weekends, holidays): the Ärztlicher Bereitschaftsdienst (on-call service) connects you to an on-call doctor, a Bereitschaftspraxis (after-hours clinic), or sometimes a home visit.
• Don't use the Notaufnahme for minor issues - it's for emergencies; the Bereitschaftsdienst is the right after-hours route for a fever or a sprain. The full number list is in Emergency numbers in Germany.

The digital layer: ePA and apps

• ePA (elektronische Patientenakte): the electronic patient record, rolled out for all GKV members on an opt-out basis - your prescriptions, findings, and history in one digital file, integrated across practices, hospitals, and pharmacies. You can object/opt out.
• Doctolib and similar apps let you search and book doctors online (and filter by language) - the practical modern way to get appointments.

What's not fully covered (plan for it)

Public insurance covers ~95% of standard care, but some things need extra:

• Dental beyond the basics (crowns, implants, adult orthodontics) - see Dental insurance in Germany.
• Glasses/contacts for adults (little allowance).
• Some preventive/alternative treatments, private-only appointment slots, single hospital rooms - the domain of supplementary (Zusatzversicherung) cover if you want it.

Frequently asked questions