Hospitalization: How much does it cost?

What to expect from a German hospital

To put your mind at ease, there is no need to worry about the standard of care. Germany is among the biggest spenders on healthcare in the EU and is usually ranked highly in global healthcare statistics.

What hospitals can I go to?

There are three types of hospitals in Germany:

• public hospitals (öffentliche Krankenhäuser) – run by federal or local authorities;
• charitable hospitals (frei gemeinnützige Krankenhäuser) – run by churches or the German Red Cross, and
• private hospitals (Privatkrankenhäuser) – run by private companies.

All types of hospital have an emergency unit (Notaufnahme). If your condition is life-threatening, you will be taken to the nearest available hospital.

If you are referred by your GP, you will need to be referred to a hospital covered by your insurance. ottonova customers can contact us to discuss any preferences they have for their hospitalization via the ottonova Concierge service.<

What forms of hospital treatments are available in Germany?

There are two ways to get a hospital treatment: inpatient and outpatient treatment. So, what's the difference between them?

the key difference lies in the duration and intensity of care. Inpatient treatment involves overnight stays in a hospital or healthcare facility and is typically reserved for more severe or acute conditions. Outpatient treatment, on the other hand, allows patients to receive care without staying overnight, and it is suitable for less severe conditions or follow-up care. The choice between inpatient and outpatient treatment depends on the nature and severity of the medical condition.

The difference between outpatient and inpatient hospital treatment in a nutshell:

Inpatient Treatment:

• Definition: Inpatient treatment, also known as hospitalization or residential treatment, involves patients staying overnight or for an extended period within a healthcare facility.
• Setting: Patients are admitted to the hospital and receive care in a dedicated unit or ward. This setting is more intensive and is appropriate for individuals with severe or acute medical conditions that require constant monitoring and care.
• Examples: Surgeries, serious illnesses, childbirth, mental health crises, and other conditions that demand continuous medical attention and support.

Outpatient Treatment:

• Definition: Outpatient treatment allows patients to receive care without staying overnight in a hospital. Instead, they visit a healthcare facility for scheduled appointments and then return home.
• Setting: Outpatient services can be provided in hospitals, clinics, or specialized treatment centers. This setting is suitable for less severe medical conditions or for follow-up care after an inpatient stay.
• Examples: Routine check-ups, diagnostic procedures, minor surgeries, physical therapy, and other medical services where overnight hospitalization is not required.
  

How long will I have to stay in hospital?

First and foremost, that depends on your condition. You will be discharged when you are fit and well enough to care for yourself.

However, German hospitals tend to take a cautious approach, keeping inpatients for longer than hospitals in the UK or US. New mothers, for example, can expect to spend up to 6 days in hospital following a birth with no complications, compared to just 1 or 2 days in the United States.

Straight talk: How much does inpatient hospitalization cost?
 

Exactly how much a stay in hospital costs depends on what health insurance you have, how long you stay in hospital, and whether you access optional benefits. As with many aspects of the German healthcare system, this depends on whether you have public or private health insurance.
 

Public health insurance & hospital costs:

People with public health insurance do not pay directly for their hospital care, as the costs are covered by their insurance. However, they must make a co-payment of around €10 per day in hospital. 

These co-payments have a maximum limit of €280 per year, but are not charged for pre-admission or post-discharge treatment.

When are you exempt from the €10 co-payment?

• it is not you but your underage child who needs to be hospitalized;
• you have had an accident and your accident insurance will cover the costs;
• you receive treatment on an outpatient, pre-admission, or post-discharge basis, or as a day patient, and therefore do not stay in hospital overnight;
• you are hospitalized to give birth;
• you work for the German Armed Forces and the Federal War Victims Relief Act (BVG) applies, or you receive psychiatric care and go home each day after treatment.

Private patients do not pay anything as only publicly insured people are required to make co-payments.
 

How long will I incur the €10 daily co-payments?

For a maximum of 28 days. If you stay in hospital for longer, you won’t incur further costs.
 

Private health insurance & hospital costs:

By contrast, private insurance providers do not require any additional contribution from the policyholder. People with private health insurance pay hospital fees upfront before applying to their insurance provider for reimbursement or agree with your insurance company a direct payment between hospital and insurance.

As is so often the case, however, the devil is frequently in the details. You need to consider how much a hospital bed will cost if you expect exceptional comfort or hope to undergo special medical treatment.

 

How much does an overnight hospital stay cost for self-payers?

Everyone resident in Germany is required to have health insurance. However, it is quite possible that a publicly insured person with an unusual condition might choose to undergo treatment at a specific private hospital as a self-payer. In addition to room costs of €150–200 per day, they will have to cover the full cost of their treatment. The latter element in particular can be very expensive.


 

Hospital treatment: When do insurers cover the costs?

Whether it’s due to a birth, a appendicitis or for knee surgery, the costs of treatment during hospitalization are counted as “general hospital services”. What treatments are reimbursed depends, once again, on the specifics of your health insurance.
 

Public health insurance: 

• Public health insurance providers cover all medically necessary treatments that a hospital can provide in the course of your inpatient stay. All treatments must be economically justifiable.
• The patient can choose to undergo treatment in any hospital of their choice that accepts publicly insured patients. Public health insurers do not cover treatment in private hospitals. 
• In most cases, public health insurance does not cover novel or alternative medicines. As a result, patients must cover the costs of such treatments and therapies themselves.
  
   

Public health insurance with supplementary hospitalization insurance: 

Supplementary insurance policies can also cover specialist treatments. For example, supplementary policies sometimes allow policyholders to access to new and alternative therapies, use innovative prostheses, and order additional lab tests. However, it is important that all services are listed in the medical fee schedule for private doctors.
 

Private health insurance: 

• Private health insurers also are renowned for being significantly more receptive to innovative treatments. It is therefore entirely possible that private health insurance might cover a hospital treatments or therapy that has not yet been included in the benefits catalog for public health insurance. 
• In addition, as a private patient, you also have access to hospitals that deal exclusively with private insurance providers.
• Unlike public health insurance, private health insurances reimburses chief-physician treatments and double or single rooms depending on the chosen tariff.

Inpatient hospitalization costs: Who pays for a private or double room?

If you’re staying on a large ward, you never know who you’ll have to share it with. It might be an old man who snores all night, or a woman who spends the entire day chatting loudly on the phone. However, some people choose to minimize this risk by opting for a semi-private (double) or private (single) room. But how much does that cost?

Public health insurance:

In most cases, public health insurance only covers hospitalization on wards, often with several other patients. Public insurance providers only cover the costs of private rooms in rare cases, such as when a patient is in obvious need of peace and quiet. So, if you consider a semi-private or private room essential, you will have to pay for it. The exact costs depend on which hospital you choose and what amenities the room has. You could be looking at around €150 per day, or perhaps as much as €200 per day for rooms with extras such as a balcony or telephone.

Public health insurance with supplementary hospitalization insurance:

Supplementary insurance can cover the costs of a private or double room depending on the chosen tariff and health care provider.

Private health insurance:

Depending on the tariff you choose, you will usually benefit from a double or private room when you have to go to the hospital.

What others costs can occur during a stay in hospital?

You can determine the costs of a hospital stay yourself, to an extent. Depending in the hospital, you might be able to access various optional services.

These might include:

• Use of a television or radio
• iPad rental
• Wi-Fi
• Landline telephone for a flat-rate charge
• Headphones rental

How much these services cost and whether they are actually available depend on the hospital you choose.

Optional benefits: When is treatment by a chief physician included?

Chief physicians often have a wealth of experience and extensive qualifications in their field. This is why some patients prefer to be treated by a chief physician, particularly when it comes to serious illnesses or complex operations. That said, it isn’t as simple as saying that chief physicians are always more skilled surgeons, as many also have numerous management responsibilities. Nevertheless, some people just feel more comfortable being treated by a chief physician.

Public health insurance:

Public health insurance only covers treatment by a chief physician in exceptional circumstances. Outside of these cases, publicly insured people have to pay for treatment by a chief physician themselves. Hospitals can charge a maximum of 3.5 times the basic costs of a treatment if a chief physician administers it. It’s important to note that you are liable for all chief physician costs. So, if complications occur during an operation and another chief physician is called to assist, you will have to pay for their services, too.

Public health insurance with supplementary hospitalization insurance:

Treatment by chief physicians can be included in supplementary cover.

Private health insurance:

Most private policies also include chief physician treatment as well as a double or single hospital room.

5 top tips for staying in a German hospital

1. Take your own slippers and gown! Most hospitals will not supply them.
2. Germans tend to be less concerned with privacy than Americans or Brits. Publicly insured people in particular can find themselves sharing rooms with numerous other patients.
3. Visiting hours are usually quite long, from 2pm to 8pm – though this can vary.
4. Children are generally discouraged from visiting, especially if they disturb other patients.
5. Leaving a small token of appreciation for the nurses is customary, particularly after an extended stay in hospital. A card or a basket of fruit always goes down well!