After an accident abroad, the cost question runs across several pots: health insurer or EHIC for acute treatment, private policies for repatriation and disability, the party at fault for damages. Who is responsible for what – and where expensive gaps yawn without private provision – we clarify here.
The Social Code V is clear: "The entitlement to benefits is suspended as long as insured persons are abroad" – unless otherwise provided (source: Section 16 SGB V, gesetze-im-internet.de, translated). The most important exception is Europe: with the European Health Insurance Card (EHIC), you are treated in EU/EEA countries and Switzerland like a person insured there – at local standards, with local co-payments and only at public providers. Outside Europe, the fund pays (apart from a few treaty states) nothing.
Medical repatriation to Germany is never a statutory health insurance benefit – not even within the EU. Air ambulance flights cost 15,000 to over 100,000 € depending on the region. Only (long-term) international health insurance closes this gap; look for the wording "repatriation when medically reasonable" instead of "necessary". Details in the guide Long-Term International Health Insurance.
For work accidents during a posting, German statutory accident insurance applies with its full benefits package – see the main page Accident Insurance for Germans Abroad.
Disability benefits and pensions from private contracts flow worldwide – independent of treatment costs.
If someone else caused the accident, they are liable under the law of the accident country – from the opponent's motor liability insurer to private liability. Legal protection with foreign coverage helps with enforcement.
German missions abroad are legally called upon to grant Germans abroad "advice and assistance" (source: Section 1 Consular Act, gesetze-im-internet.de, translated) – they refer doctors, inform relatives and help in emergencies. However, they do not cover treatment costs.
Ensure emergency call and treatment · present EHIC or proof of insurance · contact the international health insurer's emergency line (before major procedures!) · document the accident, witnesses, police report · collect receipts · inform the accident insurer within the deadlines – disability usually has to be medically determined and reported within 12–18 months. Best report accidents immediately via /schadenmeldung.
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Often yes, especially outside the EU. With international health insurance, the emergency line often arranges direct billing with the clinic – so always call there first.
No, the EHIC only applies at providers of the public system. In tourist regions you are often taken to private clinics – without a private policy, you pay yourself.
Good international health policies cover travel and accommodation costs for visits during longer hospital stays as well as the return of children.
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Sources: Section 16 SGB V – Suspension of entitlement, gesetze-im-internet.de · Section 1 Consular Act – Duties of consular officers, gesetze-im-internet.de · Updated: 2026
