At the hospital

When trying to find out more about a hospital, special search engines (based on hospital quality reports) can help: They provide information about things like which fields of medicine the hospital specializes in or how often certain types of surgery are performed there. On the Bundes-Klinik-Atlas website (run by the German Federal Ministry of Health), you can also see how many nurses a hospital has and what kind of emergency care they offer. And the results can be filtered to see whether the hospital has an interpreting service, staff who speak languages other than German, and signs in Braille or different languages. These two websites are currently only available in German.

You will also find a list of links to healthcare providers in Germany, along with explanations, on the website www.eu-patienten.de. Run by the National Association of Statutory Health Insurance Funds in Germany (GKV-Spitzenverband), this website answers questions about cross-border health care and includes information for EU citizens who would like to have treatment in Germany.

The costs of medically necessary treatments are covered by public health insurers. Then the hospital bills your insurer directly.

Anyone over the age of 18 who has public health insurance will usually have to pay the hospital 10 euros per day for accommodation and meals – but only up to a total of 28 days per year.

Any additional services – such as treatment by a head doctor (Chefarzt) or a room with just one or two beds – will be fixed in a contract with the hospital (Behandlungsvertrag) before the treatment starts. You will then be asked to also sign an extra agreement (Wahlleistungsvereinbarung) listing the services you have chosen. If you don't have supplementary private insurance coverage for those services, you will have to pay for them yourself.

Procedures that are not medically necessary, such as cosmetic surgery, are not covered by public health insurers. If complications arise later and you need treatment as a result, you will have to pay some of the treatment costs yourself.

When a child needs to stay in the hospital, one parent can usually stay there with them, depending on the child's age and medical needs. Public health insurers cover the costs for this. If you can't work because you're looking after a sick child, you may get child sickness benefits (Kinderkrankengeld) from your health insurer under certain conditions.

If you have private health insurance, your hospital treatment bills will be sent directly to you. You can pay these bills first, and are then reimbursed by your insurer afterwards. Alternatively, you can forward the bills to your insurer, who will then pay the doctors and hospital.

The main documents you will need in order to be admitted to the hospital include the following:

• Your electronic health insurance card if you have German public health insurance. If you have German private health insurance: your health insurance card or a statement from your insurer guaranteeing that they will cover the costs. If you don't have a German health insurance provider: Depending on your situation and the country you came from, take along your European Health Insurance Card (EHIC) or Global Health Insurance Card (GHIC), a certificate of entitlement (nationaler Anspruchsnachweis), a medical treatment certificate (Behandlungsschein) from the social welfare office, or your travel insurance or incoming insurance documents.
• Referral from your family doctor or a specialist
• Your passport or national identity card

The following documents and information may also be helpful:

• X-ray images, lab results or medical reports from any previous examinations
• The name, address and telephone number of your family doctor or pediatrician
• The names and telephone numbers of close friends or family who should be contacted in case of an emergency
• Your medication schedule and – as a precaution – enough medication for the first 24 hours in case it's not readily available at the hospital
• If you have them: documentation of allergies, blood group, vaccinations or x-rays, and any other special documentation for things like blood thinners (anticoagulants), a pacemaker or artificial heart valves, or a record of your blood sugar levels if you have diabetes.

Nursing staff will show you to your room and tell you what you need to know about your stay at the hospital. They will ask about any medication you take, and if you have any special dietary preferences or needs.

Mobile phones are allowed in most hospitals nowadays. You may want to double-check whether there are some areas where you're not allowed to use them.

You will come across many people on your ward, including the doctors and nursing staff responsible for your medical treatment and nursing care. Every hospital also has social workers, psychologists, nutritional specialists, physiotherapists, pharmacists and many other medical professionals. It may be difficult to keep track of who everyone is, so do not hesitate to ask who they are if you're not sure.

The first part of your treatment includes a talk with the hospital doctor and an initial physical exam. Because the doctor doesn't know you that well, it's important for you to be open with them and tell them all about your symptoms and medical history. In some hospitals you will also talk to a hospital pharmacist about the medication you take. The ward doctor (Stationsarzt) is the doctor you will have the most personal contact with during your stay in the hospital. Ward doctors regularly talk with the senior doctors (Oberarzt) and the head doctor (Chefarzt).

You will usually have at least one daily visit (Visite) from the doctors, during which they will talk with each other and with you about how you're feeling and how your treatment is going. Nurses will come to take care of you several times a day. They're important contacts, too. They also coordinate everything that happens in the ward.

If your surgery is planned long enough in advance, the hospital will often give you an appointment for a pre-operative assessment (Voruntersuchung). This will usually involve some basic tests, like an ECG (electrocardiogram to check your heart activity) and further x-ray or ultrasound scans. Depending on your health and the type of procedure that is planned, you may be able to donate your own blood. This involves repeatedly giving blood at different times in the weeks leading up to the operation. If you then need a blood transfusion during surgery, doctors can use your own blood for the transfusion.

Before surgery, you will talk about the surgical procedure, the anesthetic and any possible risks with doctors – for instance, the surgeon and anesthesiologist. After they have spoken with you, you will be asked to sign a consent form (Einverständniserklärung) to say that you agree to the procedure and know about the risks.

Ask them to explain medical terms or anything else you don't understand. If you have difficulties understanding German, you may want to bring along someone who can translate for you. It is possible to ask for a professional interpreter, but you will have to pay for this service yourself.

You will need more information before having surgery and will also have to make some preparations. For instance, it's important to know when you need to stop eating and drinking or whether you have to take a sedative a few hours before the procedure. The part of your body where the surgery will be performed often needs to be shaved. It is best to ask beforehand what you will need to know after surgery. Always let someone know if you're in a lot of pain or if something else is worrying you.

Many hospitals offer social services (Sozialdienst) for dealing with personal and legal issues. You might need rehabilitation treatment after surgery, for example, or have to arrange nursing care at home for a while. Older, very ill people may have to go to a nursing home. Social services can then help to gather and fill out the required forms, get a place in a rehabilitation center for you, organize household assistance (Haushaltshilfe) for families, or help find a room at a nursing home. They can also help you apply for financial support from the social welfare office (Sozialamt), federal employment agency (Arbeitsagentur) or nursing care insurance (Pflegeversicherung). Last but not least, you can talk to social services staff about personal problems and they can help you to cope with your condition and its consequences.

Specially trained chaplains offer pastoral care for people facing serious illness or death. They also offer this service to people who belong to a different religion or who are not religious.

Hospitals are required by law to plan their patients' discharge and to ensure that they get enough care afterwards. All of the measures involved in this step must be discussed and agreed upon with you. People close to you can also help here if you like.

After leaving the hospital, you will typically receive further care from your family doctor. You may also need to go back to the hospital for follow-up appointments. You usually won't have to stay overnight in the hospital for this, though.

Before you leave the hospital, you will be given at least a brief letter of discharge (Entlassungsbrief) for your family doctor, with information about your diagnosis, the treatment you had at the hospital, and possible further treatment. A few days or weeks later, you will receive a more detailed medical report in the mail. This will include the results of any special examinations, as well as any x-ray or ultrasound images that were taken.

The hospital staff may also give you (or prescribe) a small amount of medication for you to use in the days after you leave the hospital. In some hospitals, the hospital pharmacy prepares a medication schedule for you to follow. If you need special therapies (Heilmittel) or medical aids (Hilfsmittel) such as physical therapy or crutches, the ward doctors will give you a prescription.

The hospital can also give you a doctor's certificate (Arbeitsunfähigkeitsbescheinigung, or AU-Bescheinigung for short) for up to seven days after leaving the hospital, to inform your employer that you're unable to work during that time. Don't forget to ask if there's anything you need to be careful about or do at home, like avoiding sports or following a special diet.

If you're not yet able to take care of yourself after leaving the hospital and you still need nursing care, the hospital will prescribe at-home nursing care for you (häusliche Krankenpflege). This is also paid for by public health insurers, usually for a period of up to four weeks.

If it's thought that you'll need nursing care for longer than that, the hospital can contact the appropriate nursing care insurance fund (Pflegekasse), with your consent. Your need for nursing care will then be assessed by the German Federal Medical Service (Medizinischer Dienst, or MD) so that further nursing care can be organized.

If you have private health insurance, you can expect to receive one or more bills from the hospital’s head doctors some time after you leave the hospital. You then have to send the bills to your insurer.