Sick on vacation – from travel health insurance to sick notes
Nobody wants to fall ill or have an accident while on vacation. Spending the most beautiful time of the year ill is not a nice idea. Especially not when it happens far from home.
We have here important tips and advice to prepare your trip and also in case the use of travel health insurance becomes necessary.
Public and private health insurance in other European countries
For temporary travel in the European Economic Area (EEA) or Switzerland, legally insured persons are entitled to all necessary medical services. This also applies to the chronically ill and to illnesses with a prolonged course that require long-term care.
For emergency treatments, because of accident or sudden illness, and further treatments, because bspw. a chronic illness is present, you only need the European Health Insurance Card, which is issued by your health insurance company.
Within the EEA and Switzerland you have free choice of doctor, provided that the doctor is authorized to bill in the health insurance system. In order to be able to settle the costs, you must submit the invoices with detailed information on the treatment to the health insurance company.
The maximum reimbursement level is the cost that would have been charged for the same treatment in Germany. Here it can happen that the treating physicians settle more expensively than it is usual in Germany and thus costs remain for you.
In addition to the treatment costs, you have to reckon with the usual own contribution (co-payments) and a lump sum for the increased administrative expenses (7.5 – 10%).
Additional costs and administration fee are also incurred for prescription payments for medications.
Return transports to Germany are not reimbursed by the health insurance companies. Additional travel health insurance would absorb these costs.
If you are privately insured, you should check to what extent your health insurance also covers you abroad and for repatriation. Missing benefits can also be compensated here with travel health insurance.
Public and private health insurance in non-European countries
If your destination is not part of the EEA and is not covered by the social security agreement, you must have travel health insurance. Because then there is no support from the health insurance companies.
Those with private insurance should also read the plan terms more closely here. Many tariffs lack the so-called world validity. Especially the return transport is very important. Not all tariffs include this benefit.
Travel safely with a travel health insurance
A travel health insurance is an emergency insurance. It pays for in-patient and out-patient treatment (including X-rays and operations) necessitated by sudden illnesses and accidents. Also medicines, remedies, dressings, etc. will be reimbursed by the travel health insurance.
Transport to the emergency doctor or clinic as well as accommodation and necessary services during a hospital stay are covered by travel health insurance.
The return transport to Germany, if it is medically justifiable and reasonable, is one of the most important benefits of travel health insurance. The repatriation of deceased persons is also included in many offers.
Many companies have significantly improved their service over the years, advising if necessary on alternative medications (if the usual ones are not available in the country of travel), on choosing a doctor or on obtaining lost documents.
It is important to emphasize that the benefits of travel health insurance are focused on emergency care. The aim is to restore the health status to such an extent that further treatments can be carried out in Germany. Long-term planned treatments, cures and therapies are not covered by travel health insurance.
For example, teeth that have been knocked out are only provisionally treated and broken dentures are repaired as far as possible. The complete treatment will then be continued in Germany.
How are benefits reimbursed by travel health insurance?
For smaller treatments you usually have to pay in advance yourself. The money spent will be reimbursed by your insurance company. If more extensive treatments are necessary, the insurers take over the settlement with the clinic or the doctor after consultation.
When traveling in the EEA, Switzerland and countries with social security agreements, your insurer may insist that you first settle the bill with the statutory health insurance company and submit the rest of the bill only afterwards. However, some insurers also take care of this quite straightforwardly on their own. You should definitely clarify this before the trip.
You should always keep the bills you receive and check them for important points:
The doctor's invoice should contain the date of the invoice, the name and address of the doctor and the name of the patient. of the hospital, your name and date of birth, the diagnosis made and individually listed medical services and their data. In the case of dental treatment, the teeth treated must be listed and also how they were treated. You have to get a receipt for the payment you have made.
Prescriptions must also contain certain mandatory data. Name and address of the issuer, the medication, the costs, receipt notes and the person treated must be listed.
Incomplete data cause a lot of frustration later on. It may then happen that your bill is not recognized or you have to seek corrections from Germany. It is also important to pay attention to the language in which the bills must be submitted. If the insurer insists on correct German, you must have invoices and receipts translated by sworn interpreters. It is often not worth it for smaller amounts. Therefore, be sure to check the insurance conditions.
Important information about travel health insurance abroad:
Have the free choice of doctor confirmed. Inform yourself about doctors in the vacation region and clarify briefly with the insurance company – in case of emergency also via the hotline, whether they are in cooperation with certain doctors or hospitals or can recommend someone. If possible, ask the doctor treating you about the cost of the treatment so that you do not receive an excessive bill.
In case of pre-existing conditions, you should have your fitness to travel certified. You should also clarify whether your travel health insurance covers further treatment, such as minor check-ups u.a. reimbursed. If necessary, you must inform yourself about import conditions for medicines and remedies.
If the insurer refuses, you can contact your own health insurance company, presenting the refusal or. of the exclusion make an agreement. Many insurance companies provide, if there is no possibility of private coverage, even in non-European countries and without social security agreements.
The terms and conditions of travel health insurance policies change regularly. Therefore, it is worthwhile to review existing annual policies and possibly take out a new travel health insurance policy.
Incapacity for work and sick leave during vacation
Depending on the contractual regulations, a certificate of incapacity for work must be submitted no later than on the 4th day of work. The employer must be notified of the date of the sick leave. This also applies if you are on vacation. Whether at home or on a trip.
You should therefore inform your employer in good time.
During a stay abroad, you must provide your employer with a foreign certificate of incapacity for work. Within the EEA, Switzerland as well as within the social security agreement, the corresponding health insurance of the country can provide your statutory health insurance with all the necessary information. Your health insurance company will then inform your employer about your inability to work. You should still inform your employer.
When sending the certificate of incapacity for work – especially in countries not covered by the above agreements – you must ensure that the form is clear:
- it must be clear that you are unfit for work – a mere statement of illness is not sufficient
- the duration of the inability to work
- if the inability to work continues, also a corresponding extension
If you have informed your employer in good time and if the sick note is available in due time, you have not forfeited your entitlement to vacation and can make up for the vacation. Before you do this, however, you should talk to your employer again and not just extend your vacation on your own.
If you are ill before the vacation or. cannot take the vacation for similar reasons, the vacation is not used up and can be reapplied.