Healthcare Illness while abroad

When traveling abroad, in addition to their general travel preparations, people should also consider health matters. To obtain assistance quickly in the event of illness, they should find out about medical care in the destination country, potential sources of medical assistance and the local emergency numbers. It is also important to check the cover provided by their health insurance. This includes the question of what types of treatment are covered by the insurance in the applicable country and whether this cover is subject to the fulfillment of certain conditions. Additional travel health insurance can fill gaps in the cover provided by regular health insurance.

Many people contract infections or incur minor injuries while traveling. It is therefore advisable to pack a travel medical kit.

Items that a travel medical kit should contain include:

• Medication for combating common ailments such as pain, high temperatures, coughs, colds and nausea
• A thermometer
• Electrolyte powder for rehydration following diarrhea. On longer journeys, anti-diarrheal medication with the active ingredient loperamide can reduce the frequency of bathroom visits.
• Insect repellent, tick tweezers and itch-relieving gel
• Plasters, bandages and disinfectant for minor injuries
• Sufficient amounts of any medication taken regularly
• When traveling with children: medication suitable for children such as antipyretic (fever-reducing) suppositories, nasal spray and ear drops

Spectacle wearers should also take a spare pair of spectacles as it can be difficult to have new ones made while abroad.

Depending on the destination country, travel medical advice may be useful. This can be provided by family doctor practices or outpatient travel medicine clinics, for example. The consultation assesses whether specific vaccinations are recommended for the country, for example against hepatitis A, rabies or typhus. Doctors also recommend malaria prophylaxis to some people going traveling.  

The Federal Union of German Associations of Pharmacists (Bundesvereinigung Deutscher Apothekerverbände e. V. – ABDA) provides a travel medical kit checklist.

Prior to traveling, people should also find out 

• the local emergency numbers
• the location of local medical practices and hospitals
• how well-equipped these are
• the medical disciplines they cover – for example for children, in relation to specialist disorders and in emergencies.

Information about doctors and clinics in destination countries can be obtained from health insurance funds, tour operators or online, for example.

The German Liaison Office for Health Insurance Abroad (Deutsche Verbindungsstelle Krankenversicherung Ausland – DVKA) provides leaflets for many countries containing important information and links to local health services.

Careful preparations are especially important for people with chronic illnesses. Further information can be found in the article Traveling with chronic illnesses.

Anyone who becomes seriously ill or has an accident while abroad is likely to face high treatment costs. If they do not have suitable insurance, they will have to cover these costs themselves. Prior to traveling, people should therefore always check the extent to which their health insurance covers treatment costs abroad. This partly comes down to whether they have statutory or private insurance.

What applies to people with statutory health insurance?

European Union, Switzerland, Lichtenstein, Norway, Serbia, North Macedonia, Montenegro, Great Britain and Northern Ireland

In the event of accidents or illnesses requiring treatment in one of these countries, statutory health insurance will cover the treatment costs. However, it will only cover the services to which people with statutory insurance in the country in question are entitled. This may mean that people have to contribute co-payments or deductibles for treatment. Treatments which, from a medical perspective, can wait for a person’s return to Germany are not usually covered.

Turkey, Tunisia and Bosnia-Herzegovina

For stays in Turkey, Tunisia and Bosnia-Herzegovina, people must request an international health insurance certificate (“Auslandskrankenschein”) from their health insurance fund prior to traveling. This certificate enables them to obtain medical services in Tunisia and Bosnia-Herzegovina that could not wait until their return to Germany. In Turkey, only services that had to be performed within 24 hours from a medical perspective are covered. 

Other countries outside Germany

In other countries, such as the USA, Canada or Australia, statutory health insurance does not generally contribute toward treatment costs. Medical services and hospital treatment must be paid for independently if no other cover, such as travel health insurance, has been taken out. 

What applies to people with private health insurance?

For people with private health insurance, the scope of cover abroad depends on their specific policy. Generally, insurance cover is provided within Europe, including when traveling for longer periods. Outside Europe, cover is generally limited to one to three months per year. More precise information is provided in the insurance documents or can be requested from the insurance fund.

In many cases, standard health insurance cover does not suffice when abroad. Travel health insurance can close gaps in statutory or private health insurance.

For example, travel health insurance covers the costs of necessary medical treatment in countries that do not accept either the European health insurance card or an international health insurance certificate, such as the USA, Canada or many Asian and African countries. 

In some cases, people with statutory insurance must contribute co-payments for treatments abroad. These are not reimbursed by health insurance funds. In such cases, travel health insurance can be useful as this usually covers such co-payments – including within Europe.

Furthermore, travel health insurance usually covers rescue and recovery costs as well as the costs of medically required repatriation to Germany. These services are not covered by statutory health insurance and are not automatically included in many private policies.

Key considerations when taking out travel health insurance

There are various versions of travel health insurance:

• Private travel health insurance is taken out irrespective of statutory health insurance – with insurance funds or via specialist insurance brokers.
• Some statutory health insurance funds offer contracts at discounted rates via partners from the private insurance industry. However, anyone who chooses such policies is usually tied to their health insurance fund for the duration of the contract.

When taking out travel health insurance, it is often worth comparing various offers with regard to their price and scope of coverage. One important matter for consideration is the conditions under which the costs of repatriation in the event of illness are covered: only in the event of medical necessity or also if medically advisable. Consideration should also be given to whether a deductible has to be paid. This is the part of the cost that insurance holders must pay themselves in the event of illness.

Further information about choosing travel health insurance can be obtained from the consumer advice center (“Verbraucherzentrale”).

In an emergency in any European Union country, people can call the emergency number 112. This will connect them to the local emergency services – 24/7, free of charge and anywhere within the EU.

Different emergency numbers apply in other countries, for example 911 in the USA. 

An overview of important emergency numbers worldwide is provided by the International Telecommunication Union (ITU), a United Nations specialized agency. 

In the event of non-urgent medical situations, people can contact a medical practice or medical center. Tour operators or customer service teams at (travel) health insurance funds can help find these. 

In many countries, it is standard practice for patients to initially have to pay treatment costs themselves. The bill can then be submitted to their insurance when they return home. It is important to retain complete, clearly legible bills and prescriptions.