Abroad cover becomes a question as soon as a semester abroad, an internship or a trip is planned for students in Germany. The cover of statutory health insurance (gesetzliche Krankenversicherung, GKV) abroad is narrower than many expect. This guide explains where a fund reimburses treatment costs, where that stops and which questions to put to your fund before you travel.
Short answer: Within the EU, the EEA and Switzerland, insured persons can use treatment and claim reimbursement from their fund. Reimbursement is capped at the amount the fund would pay for the same treatment in Germany, and the bylaws (Satzung) may deduct an administration fee of up to 5 percent. Other countries are not covered by this rule. Last updated: October 2026.
The most important points
- Reimbursement for treatment abroad under section 13 (4) of the Social Code Book V (SGB V) applies to providers in the EU, the EEA and Switzerland.
- Reimbursement is at most the amount the fund would have to pay for the same treatment in Germany (source: section 13 (4) SGB V).
- The bylaws of your fund may provide for administration deductions of up to 5 percent and may deduct copayments.
- Outside these countries, clarify with your fund before you travel which costs it will cover.
- Extra travel cover can close a gap. How it is built is set out in the terms of each offer.
Where does reimbursement abroad apply?
Section 13 (4) SGB V allows insured persons to use providers in other EU member states, in EEA states and in Switzerland on a reimbursement basis instead of the benefit in kind (section 13 (4) SGB V, accessed October 2026). This applies only if the providers are allowed to practise under an EU directive or are authorised to provide care in the country of stay. For other countries, this provision contains no comparable rule. If you plan a semester overseas, check carefully what your fund pays there.
| Area | What the statutory fund provides | What you should check |
|---|---|---|
| EU, EEA and Switzerland | Treatment possible, reimbursement under section 13 (4) SGB V | Reimbursement at most at the German level, deductions under the bylaws |
| Other countries | No rule under section 13 (4) SGB V | Ask your fund in advance which costs are covered |
| Emergencies abroad | Clarify case by case with the fund | Keep all receipts and inform the fund as early as possible |
The table summarises the rules. Your fund decides individual cases, and its written confirmation is the reliable basis for your planning. Ask for that confirmation before you book flights.
How is treatment abroad billed? A worked example
The figures below are invented to show the arithmetic. They do not describe the cost of any real treatment.
- Assumption: a treatment in an EU country costs 300 euros.
- Assumption: the amount your fund would pay for the same treatment in Germany is 200 euros.
- Reimbursement is capped at 200 euros. If the bylaws provide an administration deduction of 5 percent, that is 10 euros less, so 190 euros.
- Assumption: you pay the bill first. Your own share stays at 300 minus 190, which equals 110 euros.
The example shows why it pays to ask about the German benchmark amount before you travel. The part that is not reimbursed can stay with you.
What role does the health insurance card play?
For trips within the EU, the EEA and Switzerland, the European Health Insurance Card (EHIC) is often mentioned. It is not a separate insurance policy but confirms your entitlement with your fund. Ask your fund whether you need the card and how to apply for it. It generally covers medically necessary treatment, not every service you might wish for.
When extra travel cover can make sense
Some funds offer additional benefits in their bylaws or extra products for trips abroad. Whether a student needs them depends on destination, length and type of stay. A semester in an EU country is often a different situation from a stay overseas. Check the territory, duration, exclusions and maximum amounts of every offer. Private health insurance also differs by tariff. An overview is in our German article on PKV during a semester abroad (in German).
What to take with you before departure
Put together a small folder before you leave. It helps in an emergency and when you later claim costs. The points below have proven useful in practice but do not replace your fund’s advice:
- Your insurance card and your fund’s number, so the treatment can be assigned correctly.
- Proof of enrolment and the length of your stay.
- A list of important medication, ideally with the active ingredient, so doctors can follow it abroad.
- The phone number and the claim form of your fund for reimbursements and questions.
Keep original receipts and photograph them as well. Note date, place and type of treatment while you still remember them clearly. The later claim will be much easier.
Frequently asked questions
Am I automatically insured abroad as a student?
Whether and how you are insured abroad depends on destination and length of stay. Within the EU, the EEA and Switzerland, the reimbursement rules apply. For other countries, ask your fund in advance. Without clarification, a gap can open.
Does the fund pay for transport back to Germany?
That depends on the individual case, the bylaws and any extra cover. Clarify this with your fund before you travel. Keep all documents in case you need to assert a claim.
Can I submit a treatment abroad later?
Yes, usually you submit the bill afterwards and receive reimbursement after review. Clear receipts with diagnosis, treatment and amount are important. Translate key documents if necessary and submit them promptly.
Does a semester abroad change my insurance obligation?
A semester abroad does not automatically replace the obligation. Whether it continues depends on the type of study and the university. Clarify this with your fund and your international office before you confirm the stay.
What to do now
- Ask your fund whether your destination is within the scope of reimbursement.
- Ask about bylaw benefits, administration deductions and the proof you need.
- Check whether extra travel cover is necessary and compare terms and exclusions.
- Keep bills, medical reports and correspondence, and submit them on time.
Related reading
- Health insurance for students in the EU: EHIC and more
- EHIC: The European Health Insurance Card
- Health insurance abroad: what applies to long stays
- Studying outside the EU: health insurance rules
- Health insurance abroad for students explained
Sources: Section 13 SGB V, gesetze-im-internet.de (accessed October 2026); Section 5 SGB V, gesetze-im-internet.de (accessed October 2026).
Last updated: October 2026. This guide is general information, not individual advice.
