Here you will find our brochure on trauma-related disorders and post-traumatic stress disorder (PTSD) in German, English, French, Ukrainian, Kurdish, Arabic, and Vietnamese.

Pathways to Healthcare for German Citizens

Since 2009, there has been a general health insurance obligation in Germany, meaning there is mandatory insurance, and all individuals must be insured!

The following groups of people have statutory health insurance entitlement by law, which lasts for a maximum of one month after the end of membership:

  1. Workers, employees, and those engaged in vocational training who are employed for remuneration (§5 Abs. 1 Nr. 1 SGB V). They must be above the threshold for marginal employment. The entitlement starts from the beginning of the employment relationship, i.e., from the actual commencement, earning of remuneration despite non-commencement, or in case of incapacity to work with a duration of the employment relationship of at least 4 weeks or if the person has worked for at least 1 day.
  2. Individuals receiving social benefits, such as SGB III, unemployment benefits I, SGB II, or unemployment benefits II (§5 Abs. 1 Nr. 2, 2a SGB V).
  3. Students/KVdS who are not family-insured (§5 Abs. 1 Nr. 9 SGB V), up to and including the 14th semester and/or the age of 30. An extension is possible in some cases, but in such instances, contributions for the entire semester must be paid in advance. Students on leave have entitlements under SGB II.
  4. Individuals who are long-term sick must report to the JobCenter, appear before the public health officer, and subsequently have entitlement to health insurance through the social welfare office.
  5. Retirees/applicants for retirement have entitlement to health insurance according to §5 Abs. 1 Nr. 11, 11a, 12 SGB V. This includes disability pension, old-age pension, and surviving dependents’ pension. The prerequisite is the fulfillment of the pre-insurance period with a 9/10 rule (since 02/2017, 3 years/child are credited flat. The entitlement begins on the day of the retirement application, and simultaneous notification to the relevant health insurance fund is required! Accident pension and private disability pension are EXCLUDED from entitlement to health insurance coverage.

Mini-jobs and employment contracts below the threshold for marginal employment are generally exempt from insurance!
If you are insured through your employer in Germany but reside in another EU country and wish to receive medical treatment there, you can use the so-called “portable Document” to prove your insurance coverage. The costs will then be covered by the insurance in Germany. Here you can find more information about this.

Private health insurance in Germany is obligated to insure the following groups of people:

  1. Recipients of assistance
  2. Self-employed individuals
  3. Formerly privately insured individuals
  4. Individuals with an annual income of over €54,900

After the age of 55, a switch from private to statutory health insurance is no longer possible! Exceptions include switching to family health insurance (if there is no main self-employment) or taking up employment.
Premiums for private health insurance may be higher than those for statutory health insurance. However, there is a basic tariff for private health insurance whose scope of benefits matches that of statutory health insurance in terms of type, extent, and amount. The premium amount depends on the average maximum contribution rate in statutory health insurance, and there must be officially certified neediness. Refusal by private health insurance is only possible in the case of threat, fraudulent deception, or withdrawal due to intentional violation of pre-contractual disclosure obligations, for example, if the health questionnaire is not submitted. The entitlement exists without a risk assessment. Another disadvantage of private health insurance is that privately insured individuals must advance payments, meaning they must initially pay bills themselves and then reclaim the money from the health insurance fund.

Insurance of spouses and children through family health insurance (FamKV)

If you are an active member of statutory health insurance, it is possible to insure your spouse and children. The requirement is that their residence or habitual residence is in Germany or the EU, and identity documents of those to be insured are necessary (e.g., birth certificate, birth announcement, hospital document with paternity recognition, determination of child benefit entitlement, etc.), as well as a completed and signed family questionnaire and the signed declaration of family insurance. Foreign marriages are also recognized if they correspond to local form. In polygamous marriages, only the first wife is eligible for family health insurance. Here you can find more information about family health insurance.

Information for individuals without health insurance

Individuals who left health insurance between April 1, 2007, and July 31, 2013, are legally regulated to be in a backup insurance since 2009. This means that the last health insurance that insured the person must take them back! Those to be insured have no choice and an obligation to provide information and cooperate! Health insurances require an application from the person to be insured! The backup insurance applies to individuals who have no entitlement to other coverage in case of illness and were last insured under statutory health insurance or have never been insured anywhere but can be assigned to statutory health insurance.

For all individuals who left health insurance after August 1, 2013, there is mandatory continuation insurance. This starts after the insured person leaves compulsory or family health insurance. It takes precedence over backup insurance, meaning no pre-insurance and no declaration of intent is required, as it simply continues with the conditions of voluntary health insurance from the last health insurance. These regulations affect the following groups of people:

  1. Former voluntary insured individuals who were excluded due to payment default,
  2. Former compulsory health insurance or family health insurance individuals who do not meet pre-insurance periods for voluntary membership or have missed continuation,
  3. Returnees from abroad who were in statutory health insurance before the stay, and
  4. Immigrants from outside the EU if the residence or stay permit is valid for more than 12 months.

Exiting backup insurance or mandatory continuation insurance is only possible by providing evidence of re-entry into another health insurance!
Additional information for uninsured individuals who were previously privately insured:

Private health insurances are subject to a compulsory acceptance into the basic tariff (§125 VVG). This means that those to be insured must be accepted without waiting times, unless it is a case of fraudulent deception. To do this, the medical questionnaire (preferably completed with a doctor) must be fully filled out. This questionnaire has no legal relevance regarding whether one is admitted to health insurance. Acceptance of a complete application must occur within 1-2 weeks; otherwise, a complaint should be filed with the private health insurance association. The benefits of the basic tariff of private health insurance correspond to the benefits of statutory health insurance. Co-payments are possible up to the limit of burden. Payment exemption works as with statutory health insurance.

To be admitted to the basic tariff, there must also be an officially proven neediness according to SGB2/12, and current decisions must be regularly submitted. Despite a protected amount of €10,000, one is still considered in need. The treatment of property is regulated locally. Debts (including to the health insurance) and debt repayment are not included in neediness. However, if paying the contribution to private health insurance alone would result in neediness, this must be certified by the JobCenter or social welfare office, and subsequently, the neediness must be reported. The report can initially be informal via fax. Neediness is considered a special hardship, leading to the interest-bearing deferral of accrued premium surcharges.
Admission to the basic tariff is possible with and without a deductible. Under certain circumstances, people can switch to the regular tariff later.

Insurance debts/contribution debts

If you have contribution debts with a health insurance fund, you should immediately seek debt counseling and have the debts broken down.

If you are insured with private health insurance, the debts should always be repaid as the entire amount. However, if there is a special hardship (e.g., declared neediness), you can request a deferral in writing from the private health insurance. If the insured person was already in need at the beginning of the insurance or would have become in need by paying the maximum contribution, the private health insurance can also calculate only half the contributions for the past. If contribution debts have arisen because the JobCenter has not fulfilled its duty to provide advice and information and has not provided sufficient information about private health insurance, you should file an objection and inform the JobCenter that the debts must be paid.

In the case of non-payment of ongoing contributions, the emergency tariff according to §206 VVG comes into effect after two months, resulting in a suspension of insurance. Excluded from this are individuals with officially proven neediness. In statutory health insurance, this emergency tariff is called “suspension of benefits.” These tariffs have existed since 2013. Those who fell out of health insurance before 2013 were/are not insured in the meantime.

Here you can find a strategic roadmap for (re-)acquiring health insurance coverage. It provides an overview of the documents you need and which institutions are responsible. If you want to come to us for advice on this matter, it’s best to bring this document and the documents listed there already filled out.

Pathways to Healthcare for EU Citizens in Germany

How EU citizens can access the healthcare system in Germany depends primarily on their employment status and the nature of their residence status.

Generally, EU citizens have the right to stay in Germany for up to 3 months without conditions (§2 Abs. 5 FreizügG/EU). If you are self-employed, employed, or looking for a job, you are entitled to a residence permit after 3 months. However, you must also prove that you are not staying in Germany solely for job seeking purposes, but also, for example, to live with family members.

EU citizens must obtain insurance within 3 months of coming to Germany. Initially, they must try to obtain coverage from statutory health insurance; if rejected, they must turn to private health insurance. However, private health insurance may also refuse coverage if there is no income or financial means.

EU Citizens Employed in Germany

As employed individuals, if you are legally employed, you are covered by statutory health insurance in Germany. This coverage also extends to your family members, regardless of whether they live in Germany or another EU country. If family members of the person employed in Germany seek medical services in their home country, the German statutory health insurance covers the costs.

The possible insurances are:

  1. Compulsory insurance in statutory health insurance

or upon exceeding the annual income limit: 2. Voluntary insurance in statutory health insurance or

  1. Private health insurance.

Self-Employed EU Citizens in Germany

EU citizens who are self-employed in Germany can either:

  1. Insure themselves through their health insurance in their home country,
  2. Insure themselves with voluntary insurance in statutory health insurance in Germany, or
  3. Insure themselves with private health insurance in Germany.

EU Citizens Whose Right as Employees Persists According to §2 Abs. 3 FreizügG/EU

EU citizens whose right as employees persists are either:

  1. Insured as employees or self-employed,
  2. Statutorily insured when receiving unemployment benefits I, sickness benefits, or parental benefits, or
  3. Statutorily insured when receiving unemployment benefits II.

EU Citizens Seeking Employment/Without Material Residence Right/Freedom of Movement Entitled as Non-Employed or in the First 3 Months of Stay

EU citizens in Germany seeking employment/without material residence right/freedom of movement entitled as non-employed or in the first 3 months of their stay can either:

  1. Insure themselves through their health insurance in the home country,
  2. Insure themselves with voluntary insurance in statutory health insurance, or
  3. Insure themselves with private health insurance.

Lack of Health Insurance Coverage

If there is no statutory health insurance coverage in Germany and health insurance cannot be “brought along” from the home country, there are various ways to still get insured in Germany.

For people engaged in irregular employment in Germany (working “under the table”), it is helpful to consider how work can be legalized to ensure access to statutory insurance. Additionally, there is the option to voluntarily enroll in statutory or private health insurance. The prerequisite for entry into the state insurance system is proof that you were already insured through statutory health insurance in your home country. If you were previously privately insured in another EU country, you must also take out private health insurance in Germany. Furthermore, in some cases, there is the possibility of being insured through the receipt of social benefits in Germany.

You can find a Strategic Roadmap for (Re-)Acquiring Health Insurance Coverage here. It provides an overview of the documents you need and which institutions are responsible. If you want to come to us for advice on this matter, it’s best to bring this document and the documents listed there already filled out.

Right to Medical Care Even Without Documents

In principle, every person residing in Germany has the right to medical care, regardless of gender, ethnic background, religion, or residence status, according to § 1 I No. 5 in conjunction with § 4 AslybLG (Asylum Seekers Benefits Act). In emergencies, doctors and hospitals are obligated to examine and treat you, even in the absence of documents and uncertainty about the cost bearer, and failing to do so constitutes a criminal offense (§ 323 c German Criminal Code)!

Reporting Obligation for Persons Without Valid Residence Status

  • Private individuals – must not report under any circumstances!
  • Public entities (offices, authorities, municipal administrations, police) – must report!
    !! Schools and other educational and childcare institutions such as kindergartens and youth homes are exempt from reporting according to §87 AufenthG and are not required to report!!
  • Hospitals and medical personnel (doctors, dentists, midwives, psychotherapists, pharmacists, nurses, and other medical professionals) are considered public, but are subject to confidentiality! – Hospitals and medical personnel may not report! According to §88 AufenthG, they would be committing an offense if they disclose personal data (e.g., location, date of birth, living situation of the patient).

To assert your right to regular medical care (i.e., all treatments beyond emergency care), you would need to present yourself to the social welfare office, which is obligated to report you to the immigration office as a public entity.
For this reason, in addition to Berlin, there are other facilities providing anonymous and mostly free medical care for people without health insurance.

The Clearingstelle of the Berliner Stadtmission has been working since mid-January 2019 on issuing anonymized medical certificates (AK). This allows people without legal status access to health care according to general standards of statutory health insurance. After examination, the Clearingstelle issues treatment certificates that can be redeemed with specific doctors. This process is anonymous and free of charge!

Nationwide Overview: Medical Assistance for Migrants Without Healthcare

List of Doctors with Language Proficiency, sorted by specialty and districts in Berlin

Application form from the State Office for Refugee Affairs Berlin for cost coverage for language mediation within the scope of healthcare

Take Care Project EU – Phrasebook and self-learning material on health topics for migrants


Pregnancy with an unresolved residence status/no documents: Tolerance arrangement for pregnancy and childbirth

To officially assert your right to prenatal and postnatal medical care, you can visit the Berlin Foreigners’ Office three months before and three months after childbirth. During this period, potential deportation is suspended, meaning you cannot be expelled. However, if you were undocumented before, the Foreigners’ Office will be informed about your stay afterward.

The birth of a child is considered an emergency, and a pregnant woman must not be rejected for childbirth in the hospital. However, the ten recommended prenatal check-ups are part of regular medical services, making them challenging for uninsured women to access.

Family planning, sexual health, abortion

If you decide against a pregnancy, you can seek anonymous and free advice. Unfortunately, the coverage of costs for the abortion itself is often not possible without a regulated residence. The costs of abortion vary depending on the chosen method. During a consultation on abortion, you can weigh potential risks and options for your decision.

The following organizations can provide specialized advice and support on pregnancy-related matters:

Center for Sexual Health and Family Planning Berlin – multiple locations in different districts, offering advice on pregnancy (including unwanted pregnancies), gynecological consultation, coverage of contraceptive costs, sexual health, psychological counseling, and couples counseling, multilingual flyer.
Berlin Midwives Association e.VMultilingual information for expectant parents.
AWO Berlin e.V. – Information on pregnancy counseling, abortion, also available in multiple languages and simple language.
The Maltese also provide nationwide prenatal care.

Psychotherapeutic Help

XENION – Psychotherapeutic Counseling and Treatment Center for Traumatized Refugees and Survivors of Torture

Psychosocial Support

TransVer – Psychosocial Support for People with Migration Background

International Psychosocial Organisation gGmbH (Account must be created) – Psychosocial Online Counseling for Refugees

Specialized Assistance for Individuals with Torture Experience

Zentrum Überleben – Help and Treatment Center for Individuals with Torture Experience, Psychosocial Support, Reintegration, etc.

Resources Specifically for Women

DaMigra – Consulting and Empowerment Projects by and for Women* with Migration Background

LARA e.V. – Specialized Center Against Sexualized Violence on Women* and Support in Crises

SOLWODI – Psychosocial Counseling and Trauma Counseling for Women

S.U.S.I. Intercultural Women’s Center – Multilingual Social and Legal Advice, Psychological Counseling

List of other counseling centers for migrant women, sorted alphabetically

Contacts for Residence-related Questions (Free Consultation)

Contact and Counseling Center for Refugees and Migrants – Consultation on Residence and Asylum, Support for Psychological and Social Issues

Amnesty International Asylum Group Berlin-Brandenburg District – Consultation on Residence and Asylum, Preparation for Asylum Hearings

Refugee Law Clinic Berlin – Legal Advice for Refugees and Migrants

AL Muntada Plus – Consultation on Residence, Asylum, and Migration Law for Refugees from the Arabic Region

Asylum Erstberatung of AWO Kreisverband Berlin-Mitte e.V. – Consultation on Residence and Asylum, Family Reunification (English, Somali, Tigrinya, Russian, Farsi, Kurdish)

Multilingual Leisure and Sports Offerings

Sportbunt – Search Engine for Sports Offerings (German, Arabic, English, Farsi)

Overview of current healthcare regulations for refugees in Berlin:

The electronic health card

In 2016, the electronic health card for asylum seekers was introduced in Berlin, eliminating the use of green certificates since 2017. The four health insurance companies AOK Nordost, DAK, BKK Siemens, and BKK VBU are involved in the process, with asylum seekers randomly assigned to them.

For newly arriving individuals in Berlin seeking asylum, the first stop is the Arrival Center at Oranienburger Straße 285 in Reinickendorf.

There, a transitional accommodation and a registration area are available. You will undergo initial medical examinations and vaccinations. While the registration process is ongoing, you will be accommodated in the Arrival Center for a few days.

For more information, visit the State Office for Refugee Affairs website.

Information about Medical Care under the Asylum Seekers’ Benefits Act can be found on the Berlin Senate Administration’s website.

Validity and Entitlements

Newly arriving refugees are registered for the electronic health card by the LAF. Upon registration, they receive a copy of the registration letter to the health insurance company. The card is issued by the health insurance company and sent to the individuals’ accommodation. During the transitional period until the eGk is sent, the copy of the registration letter serves as proof of insurance coverage.

Even after the introduction of the eGK, the scope of services still adheres to the provisions of §4 and §6 of the Asylum Seekers’ Benefits Act.

According to §4 of the Asylum Seekers’ Benefits Act (AsylbLG), there is a right to treatment if an illness is either acute or painful. This also applies to chronic illnesses, if the omission of treatment could lead to the illness becoming acute and endanger the individual (e.g., hypertension, diabetes).

There is entitlement to all officially recommended vaccinations and all medically necessary preventive examinations, such as dental care, child examinations, cancer screenings, etc. (§4 Abs. 1 Satz 2 AsylbLG). During pregnancy and childbirth, there is entitlement to all services, including midwifery assistance and preventive examinations.

We especially recommend checking and, if necessary, completing the vaccination status.

Pregnant women have the same entitlements as those insured under statutory health insurance (all preventive examinations, childbirth, midwifery assistance, etc.).

The documents gathered here for printing are intended to assist you in organizing and conducting volunteer consultations effectively when needed. We draw on several years of experience in our work in shelters as well as collaboration with medical practices and clinics.

Organization of the Consultation:

Information; Organization of Consultation – Procedures

Information; Organization of Consultation – Lists

Medical Supplies – On-Site Consultation

Confidentiality Declaration

Treatment and Findings:

Anamnesis Forms in Multiple Languages

Medical Report Form – Dental

Medical Report Form – Psychological

Medical Report Form – Somatic


Information; Prescription of Medications

Medication List for Pediatric Consultations

Medication Intake –
ME (English)
ME (Français)
ME (Arabic)
ME (Dari)
ME (Persian)
ME (Serbo-Croatian)

Brochure by the German Medical Association – Patients without Legal Residency Status in Hospitals and Practices

Brochure by the Office for Medical Refugee Aid Berlin, ProAsyl, and IPPNW Germany – Possibilities and Limits of Medical Care for Patients without Legal Residency Status

Health for Refugees: Information Portal by Medibüros / Medinetzen – The Model of the Anonymous Health Insurance Card

Effective communication between healthcare professionals and patients is crucial in healthcare. However, language assistance in the healthcare sector is not considered a healthcare service and, unfortunately, is not reimbursed by health insurance. Therefore, the costs can be covered by the relevant authority responsible for the individual. To initiate this, a request for cost coverage must be submitted by the healthcare professionals or the hospital.

  • An interpreter or language assistant must always be approved in advance.
  • If patients receive services from the LAF (local social welfare office), the application for cost coverage can be submitted before the treatment online with the LAF. (In emergencies, applications can also be submitted retroactively.) Upon receipt of the application, ideally, a confirmation and a declaration of cost coverage are provided. The language assistance service must be confirmed after the treatment.

If other authorities are responsible for patients, please direct the application there. Costs for language assistance can be requested in advance from the social welfare office or, in the case of receiving benefits from the job center. The following legal regulations may apply:

  • Language assistance services according to §73 Paragraph 1 SGB XII: Cost coverage as atypical needs.
  • Language assistance costs according to §21 SGB II: When receiving benefits from the job center, language assistance costs can be covered as additional needs.
  • Information and sample applications for > 18 months, < 18 months, after a positive asylum application:

> 18 Months Residence & Receipt of Benefits according to § 3 AsylbLG

  • If they have been in Germany for less than 18 months, the cost coverage for language assistance costs applies according to § 4 Abs. 1 S. 1 AsylbLG, when entitled to psychotherapeutic services, and if communication and thus treatment are not possible without an interpreter.
  • Cost coverage for language assistance costs according to § 6 Abs. 1 AsylbLG, “when consultation is essential for health security in individual cases or necessary to meet special needs of children.”

< 18 Months Residence & Receipt of Benefits according to § 3 AsylbLG:

  • If they have been in Germany for more than 18 months and receive social benefits, language assistance costs can be granted according to § 2 AsylbLG (analogous to SGB XII, social welfare). There is no legal basis for the reimbursement of language assistance costs in statutory health insurance. In outpatient treatment, patients must bear the costs of an interpreter themselves.
  • However, according to §73 S. 1 SGB XII, services “can be provided in other life situations if they justify the use of public funds.” This provision allows for assistance in cases not covered by the social welfare system.
  • Or language assistance costs according to §21 SGB II: If patients receive benefits from the job center, language assistance costs can be covered as additional needs.

Further information on the topic:

Lengthy Processing Times by Authorities

After 6 months, an action for failure to act can be filed. In cases of urgent medical necessity for patients and the resulting need for interpreters, an expedited application can be submitted.

Question of Responsibility for Refugees

It must be clarified in advance who is responsible for the individual (LAF, job center, social/welfare office).

Shortage of Interpreters

Interpreters are mostly internally employed, and there are few freelance, mobile interpreters who are increasingly in demand. Therefore, expect long waiting times and/or the absence of the desired language for interpretation. Many interpreters are not trained for specialized language assistance. The fees for language assistance are sometimes too low, and precarious working conditions for this professional group make the field unattractive for newcomers.

The application for language assistance costs is often very time-consuming. The processing time is often several months, and applications are frequently rejected.

Telephone Interpreting:


A non-profit organization offering 24-hour telephone translation services for hospitals and medical practices. Convenient for brief translations in medical emergencies—call the number and select the language by pressing a key.

Language Mediation Pool Berlin UG

Fee-based interpreters, direct booking on the website possible. Telephone interpreting is also available. Cost coverage can be requested from LAF.

Face-to-Face Interpreting:

Community Interpreting Service

Freelance fee-based interpreters, direct booking on the website.

Integration Guides

Support for daycare/school, language course, and financial and insurance matters.

Language Mediation Pool Berlin UG

Fee-based interpreters, direct booking on the website possible. Telephone interpreting is also available. Cost coverage can be requested from LAF.

Each One Teach One

Languages of the African continent, support in discrimination cases, detailed information on the website.

Pros and Cons of Face-to-Face Interpreting:

  • + Affected individuals can communicate problems in a natural, personal atmosphere
  • + Body language and facial expressions are used in translation, resulting in higher translation quality
  • – Requires significant coordination effort, relatively high costs
  • – Appointments are often not kept, leading to treatment delays

Search Engine for Language Mediators:

Federal Association of Interpreters and Translators

Database and search engine for qualified language mediation services.

Video Interpreting:


Video or telephone interpreting service with secure video conferencing software, after determining the need and registration.


Video or telephone interpreting service with secure video conferencing software, after online registration.

Global Voices

Video interpreting service with special computers. Online price inquiry possible.

Pros and Cons of Video Interpreting:

  • + In addition to the voice, body language is perceived, ensuring a better understanding of the matter
  • + Greater trust of affected individuals in the language mediator
  • – Anonymity, as in telephone interpreting, is not present

Video interpreting is becoming increasingly popular as it combines elements of telephone and face-to-face interpreting. Video interpreting is flexible, allowing for requests from any location. It saves travel costs and is independent of appointment commitments.