Germany’s healthcare access system works differently from many other countries. Understanding when to go to the pharmacy, the GP, or the specialist saves both time and money.
German Pharmacies (Apotheke)
German pharmacies are staffed by trained pharmacists who can advise on and dispense a wide range of medications. Unlike some other European countries, German pharmacies do not simply fill prescriptions — they are a first point of advice for non-emergency health questions. Pharmacists can recommend treatments for: mild infections, cold and flu symptoms, minor injuries, digestive issues, allergic reactions, skin conditions (mild), and pain management. Many OTC medications are available that require prescription in other countries. The limitation: prescription-only medications (Rx) require a doctor’s prescription — but GKV covers the prescription cost (you pay a standard co-payment of €5–10 per prescription).
When to Go to the GP (Hausarzt)
Germany uses a Hausarzt (family doctor/GP) system where the GP is the first contact for non-emergency healthcare. Go to your Hausarzt for: persistent symptoms (over 3 days), conditions requiring diagnosis (not just symptom management), sick notes for work (Krankmeldung — required from day 3 of illness in most employment contracts), specialist referrals (Überweisung — required to see most specialists), prescription renewals, and preventive screenings (Vorsorgeuntersuchungen — many are covered by GKV at intervals). Finding a GP: find one accepting new patients (many have closed patient lists in urban areas) through your health insurer’s online tool or jameda.de.
Specialists and the Referral System
Most specialist visits in Germany require a referral (Überweisung) from your GP. Exceptions: ophthalmologists and gynaecologists can be visited directly. The referral system controls costs and is built into GKV. Emergency specialist access: if you need urgent specialist care and cannot get a GP appointment, the Kassenärztliche Vereinigung (KV, the association of panel doctors) in each region has a duty service — call 116 117 for non-emergency medical advice and out-of-hours referrals. For emergencies: 112 (ambulance) or the hospital emergency department (Notaufnahme).
Sick Leave in Germany
German employment law gives employees the right to paid sick leave (Entgeltfortzahlung) for up to 6 weeks per illness from the employer. After 6 weeks, GKV pays Krankengeld (sick pay, approximately 70% of gross salary) for up to 78 weeks per illness. The sick note (Arbeitsunfähigkeitsbescheinigung, or AU) is required from the 3rd day of illness (some contracts require from day 1). Since 2022, GPs send the AU electronically to the health insurer directly — you only need the patient copy. Employers do not receive detailed medical information — only the fact and duration of incapacity.
