জার্মানিতে সবার হেলথ ইনস্যুরেন্স থাকা বাধ্যতামূলক। কিন্তু কীভাবে আপনি তার সুবিধা নিতে পারেন? এই আর্টিকেল থেকে কিছুটা ধারনা পাওয়া যাবে। ধন্যবাদ।

Hello everyone. If you are reading this article, this would mean you are interested to know how the medical system in Deutschland works/ what you should do if you are feeling sick, where to pay, how to pay, etc. Here I will be talking about only Govt. health insurance (Gesetzliche Krankenversicherung [GKV]) because I have no idea how a private health insurance (normally for the Language Course Students) works. In this article I will be using the Detusch terms in parallel with the English terms so that you get acquainted with the terms. This article is written on personal experience and in February 2014. A lot might have changed by the time you are reading this.

  • Health Insurance Card (Krankenversicherungs/Gesundheitskarte):

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It is good to have your Gesundheitskarte with you at all time. You never know when you need it. Don’t get panicked if you don’t have it and you need it in case of emergency. If you are paying a visit at the hospital it is alright if you give them your Name, Date of birth, and may be sometimes address. But if you are visiting a Doctor you should be carrying your Gesundheitskarte or a billing slip (Abrechnungsschein) from your insurance with you.

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  • Hausartz (House Doctor):

Don’t get scared whenever you are asked the name of your house doctor (Hausartz). It is very usual in Deutschland. Normally wherever you move in, find a medicine doctor near to your house. Visit him once or twice whenever you are sick. It does not matter how little sick you are. Just pay your Hausartz a visit. Write down his name and address where you have access to at all time.

  • Hospital (Krankenhaus):

You don’t want to go to a Krankenhaus unless it is an emergency (i.e. you are very sick and it’s a Govt. holiday/ you don’t have any other option). If you need to get admitted to a hospital, you doctor (Hausartz) will advise you to go to one. But in case of emergency, you go directly to Hospital Emergency (Notfallambulanz), explain your problems there and they will take necessary steps. In worse cases you can also call 110. Remember, teeth and eyes usually not treated in Emergency.

Here the doctor will want to know the name of your Hausartz. Tell them the name and address if you have it. Let them know if you don’t have one.

N.B: Here you will be asked for your Gesundheitskarte. If you don’t have it, give them a proper ID (Ausweiß) and they will do the rest.

  • Drugstore/ Pharmacy (Apotheke):

We all know that an Apotheke is the store where you buy your medicine from. The fact that we don’t know is, not all the Apothekes are equipped/allowed to sell all kinds of medicine.  For example, you won’t get medicine and a doctor prescribed special kind of bandage for your knee/hand at the same Apotheke. For bandages you might have to visite the Sanitionhaus, which is a different kind of Apotheke. The co-workers of the Apotheke will guide you to the nearest Sanitionhaus.

  • Costs: 
  • Health Insurance: around 80€
  • Medicine and others:
  1. If the color of your Prescription is Red, you pay a 5€ or 10% of the total Medicine cost (whichever is higher). Normally the name of your Health Insurance Institute is printed on this prescription.
  2. If the color or your prescription is White or Green you pay the full money for the medicine. (So, if your doctor gives you a White or Green prescription, ask him to give you a red one)
  • Hospital: 10€ per night/day. You will be provided with necessary medicine and meals.
  • Problems you might face:
  1. You have special kind of pain (back pain, knee pain, tooth ache, etc.) and you need to see a specialist, depending on which city you are living in it might take weeks to get an appointment. You should be able to get an early appointment if your Hausartz refers you to a specialist.
  2. Many of us have no idea that the regions of Health Insurance Institute are divided into many Zones (i.e. AOK Nordwest, AOK Rheinland/Hamburg, etc.). Even though you are insured by AOK, if you are to get a costly Doctor-prescribed-Medicine/Bandage in a different Zone (i.e. you live in Nordwest zone and you need to get treated in Rheinland zone) it is going to have to wait. The process goes as following:

You go to a Pharmacy (Apotheke) in a different zone to buy a costly Medicine/Bandage. The Apotheke will send a request to the Regional office of the Insurance Institute. The regional office will then forward the request to the regional office of where you actually live/ you are insured from. Once everything is checked out, your Apotheke will let you know if you are allowed to take your product with/out getting paid by the insurance.