Doctor's Fees in Germany: What Health Insurance Pays — and What It Doesn't

€0 patient share on GKV standard outpatient care; private Incoming covers 100% GOÄ tariff for recognised acute care — Care Expatriate from €58/month covers outpatient without deductible.

Yes on private Incoming (direct access to specialists); GKV requires GP referral for most specialists under § 76 SGB V but many funds waive it in practice.

Individuelle Gesundheitsleistungen (IGeL) are extras (e.g. eye pressure test) not covered by GKV or Incoming — patient pays €20–€200 out of pocket.

Yes on private Incoming: pay the doctor, submit invoice to insurer, refund within 2–3 weeks — Care Expatriate reimburses 100% GOÄ — overview.

Private Incoming: Care Expatriate Premium tier includes up to €1,000/year for Heilpraktiker; Basic and Comfort exclude it. GKV: usually no.

Statutory health insurance (GKV) covers virtually all medically necessary treatments: GP visits, specialists, lab tests, prescriptions (with 5–10 EUR co-pay), and preventive care. Incoming insurance like Care Economy (from 30 EUR/30 days) covers acute treatments but typically excludes preventive care.

A general practitioner visit costs 30–80 EUR, a specialist 80–300 EUR. X-rays, lab work, or emergency treatment can easily reach 500–1,000 EUR. Care Expatriate (from 58 EUR/month) provides comprehensive coverage for long-term stays.

In statutory insurance (GKV), most specialists require a referral from your GP. With private or incoming insurance like Care Expatriate (from 58 EUR/month), you can typically visit any specialist directly without a referral – just bring your insurance certificate or PDF confirmation.