B1 · intermediate #KRANKENKASSE

Health insurance

die Krankenkasse

Health insurance (die Krankenkasse) is the system that pays for medical treatment in Germany; most employees belong to the statutory scheme (GKV).

If you are ill for more than three calendar days, you need an AU sick note — it is what your employer recognises, and some employers ask for it from day one. And unlike in many countries, where your employer simply hands you a plan, in Germany you pick your own fund, and the procedure depends on which one it is.

Contents

Right now: two systems, one choice

This builds on

German at the doctor’s Your payslip

This page explains the Krankenversicherung line that is deducted from your payslip. What to say in the doctor’s office has its own page.

ShortcutAlmost every employee is in the statutory system (gesetzlich). You choose the fund, and the basic cover of every fund is set by law — the differences are in extra services and a small part of the premium.

System	In German	Who
Statutory	gesetzliche Krankenversicherung (GKV)	most employees — the default
Private	private Krankenversicherung (PKV)	high earners, civil servants, self-employed

gesetzlich means “statutory / public”, not “legal” in the everyday sense. In the statutory system family members can be covered for free (die Familienversicherung) — in the private system every person pays separately. For families arriving from abroad, this is the biggest difference.

Your card and your fund

When you sign up, a card arrives by post: die elektronische Gesundheitskarte, eGK for short. In everyday life everyone calls it die Versichertenkarte. It is the first thing asked for at every doctor’s visit.

Term	In English	Where you meet it
die Krankenkasse	health insurance fund (the insurer)	the sender of your letters
die Versichertenkarte	insurance card	the doctor’s reception desk
die Versichertennummer	insurance number	on every form
der Beitrag	premium (contribution)	on your payslip and in letters
die Zuzahlung	copay	at the pharmacy
die Befreiung	exemption	once you hit the copay limit
die Familienversicherung	family cover	for spouse and children

Switching funds is possible and costs nothing: Ich möchte die Krankenkasse wechseln. The new fund usually handles the paperwork with the old one for you.

You’re ill: who expects which paper

Being ill in Germany means two separate steps: telling your employer and seeing a doctor. They are not the same thing, and the order matters.

Step	To whom	When
1 · Tell	your employer	on day one, before work starts — by phone or email
2 · Get the note	from the doctor	die Arbeitsunfähigkeitsbescheinigung (AU)
3 · The note travels by itself	the doctor sends it to the fund, your employer retrieves it there	electronic since 2023 (eAU) — on statutory insurance you carry no paper

From which day a note is required depends on your contract — some workplaces want one from day one. Read the clause that mentions Krankmeldung or Arbeitsunfähigkeit once; don’t go by memory.

Guten Morgen, hier ist Yıldız. Ich bin heute krank und kann nicht zur Arbeit kommen.

Good morning, this is Yildiz. I’m ill today and can’t come to work.

Ich gehe heute zum Arzt und sage Ihnen dann, wie lange ich krankgeschrieben bin.

I’m going to the doctor today and will tell you afterwards how long I’m signed off.

Trap 1

“I’m sick” is not enough

In Germany, reporting an illness has two parts: telling them (die Krankmeldung) and the doctor’s document (die Arbeitsunfähigkeitsbescheinigung; since 2023 the doctor sends it to the fund electronically). Someone who does the first and skips the second can end up counted as absent without leave.

Ich habe angerufen, das reicht doch?

I called, isn’t that enough? → No, the document is needed too.

The document is called AU everywhere. As you leave the doctor, it is enough to ask “Brauche ich eine AU?” — everyone knows what you mean.

At the pharmacy: Zuzahlung

Prescription medicine in Germany is not completely free: you pay a small copay — die Zuzahlung. The insurance covers the rest.

Situation	Phrase	In English
Handing over a prescription	Ich habe ein Rezept.	I have a prescription.
Asking about cost	Muss ich etwas zuzahlen?	Do I have to pay anything extra?
Exemption	Ich bin von der Zuzahlung befreit.	I’m exempt from the copay.
Cheaper equivalent	Gibt es ein günstigeres Medikament?	Is there a cheaper medicine?

If the copays you pay in a year pass a certain limit, you can get an exemption (die Befreiung). For that you have to keep your pharmacy receipts and apply to your fund — nobody reminds you.

Trap 2

Throwing away receipts

The exemption does not come by itself. Your fund does not automatically add up what you paid in copays over the year — you document it. Whoever throws away the pharmacy receipt loses the entitlement.

Ich möchte eine Zuzahlungsbefreiung beantragen.

I’d like to apply for a copay exemption.

Welche Unterlagen brauchen Sie dafür?

Which documents do you need for that?

The part nobody tells you: when a letter arrives, a clock starts

Letters from your fund are written in a friendly tone, but they often hide a deadline inside. Textbooks don’t teach you these words, yet this is usually the only line of the letter that matters.

What you see in the letter	What it means	What to do
innerhalb von zwei Wochen	within two weeks	the clock is running — put it in your calendar
bitte reichen Sie … ein	please submit …	a document is being requested
andernfalls	otherwise	a consequence will follow — pay attention
Rückmeldung	feedback / reply	an answer is expected
der Bescheid	official decision letter	there may be a deadline to object

Most of these phrases are built with the passive and the genitive — the backbone of official German. Those two pieces of grammar are enough to understand the letter.

The second unspoken thing: not answering a letter you don’t understand is the worst option. Writing to your fund to ask for more time or an explanation is completely normal, and your German does not have to be perfect:

Ich habe Ihr Schreiben vom 12.08. erhalten, aber nicht ganz verstanden. Könnten Sie es mir bitte einfacher erklären?

I received your letter of 12 August but didn’t fully understand it. Could you please explain it more simply?

Könnten Sie mir bitte mehr Zeit geben? Ich muss die Unterlagen noch besorgen.

Could you please give me more time? I still have to get the documents.

Practice now

What you just learned

die ___ (or Gesundheitskarte)
Show the answer
Versichertenkarte, Krankenversichertenkarte — It is the chip card you have to carry with you when you go to the doctor.
Ich bin in die AOK versichert.
Show the answer
False — To say you are insured with a health insurance fund, you use the preposition bei der: bei der AOK.
What is the first step when you are ill?
Show the answer
Tell your employer before work starts. — Tell your employer first. The verbal notice (Krankmeldung) is made before work starts; the doctor’s note (AU) comes after. They are two separate steps.

What to do this week

This topic sinks in when you go through your own documents. Five minutes:

Get out your insurance card: what is the fund called, and where does the Versichertennummer appear?
Find the Krankenversicherung line on your payslip — that figure is what this page is about.
Write your sick-call sentence now and keep it ready by the phone: Guten Morgen, hier ist … Ich bin heute krank …
Set aside an envelope for pharmacy receipts — that is the only requirement for an exemption application.
Open the latest letter from your fund and find the date and the deadline in it. If you don’t understand it, write back with the sentence above.

The full conversation in the doctor’s office is on the German at the doctor’s page; the phrases for booking are on the appointment page.

07Build

Build the sentence yourself

Tap the words and put them in order. This is the hardest part of German — and there are no options to pick from, you build it.

tap the words
tap the words

Tips

Know this before the test

The core of the topic in three lines, then the mistakes people make most often.

Statutory and private insurance
gesetzliche Krankenversicherung charges by income and can cover your family; private insurance prices by risk. Most employees are in the statutory system.
Ich bin bei der AOK versichert.
When you’re ill, the order is: tell → doctor → eAU
First tell your employer (before work starts), then see the doctor. The doctor sends the AU to the fund electronically (eAU) and your employer retrieves it there — you carry no paper. By law you need it if the illness lasts more than three calendar days (weekends count), at the latest on the next working day; your employer may ask for it from day one.
die Arbeitsunfähigkeitsbescheinigung (AU)
No card, no appointment
die Versichertenkarte is handed to reception at every visit. Without a card, the visit can be billed privately.
Haben Sie Ihre Versichertenkarte dabei?
Zuzahlung and exemption
You pay a small copay (die Zuzahlung) on medicine and treatment. If the total passes a set share of your yearly income, you apply to your fund with the receipts and get an exemption.
die Zuzahlungsbefreiung

Ich bin in der AOK versichert.
Ich bin bei der AOK versichert.
Being insured with a fund is expressed with bei + dative.
I’ll get the AU once I’m better.
You get the AU from the doctor within the deadline.
If you get it too late, the absence can count as unexcused. The deadline in your contract is binding. You don’t deliver it yourself: since 2023 your employer retrieves it electronically from the fund (eAU).
At the doctor’s, “Überweisung” is a bank transfer.
At the doctor’s, “Überweisung” is a referral to a specialist.
The same word means a transfer at the bank; in medicine it means a referral.
When I’m ill I go to the doctor first and call my employer later.
You tell your employer first, then go to the doctor.
The duty to report arises before work starts; a doctor’s appointment does not postpone it.

0706:20

Test yourself

Tap an answer — we will look at why together.

What does gesetzliche Krankenversicherung mean?

Statutory / public insurance. gesetzlich = regulated by law. Most employees are in this system; the private one is called privat (PKV).

What is the first step when you are ill?

Tell your employer first. The verbal notice (Krankmeldung) is made before work starts; the doctor’s note (AU) comes after. They are two separate steps.

What does AU stand for?

Arbeitsunfähigkeitsbescheinigung. The written note the doctor gives you. Saying “Brauche ich eine AU?” to the doctor is enough; everyone understands.

What is the small fee you pay at the pharmacy called?

die Zuzahlung — the copay. der Beitrag is the monthly premium deducted from your pay, a different thing.

How do you get a copay exemption?

By applying. The exemption does not come by itself; you document what you paid. Whoever throws away the receipt loses the entitlement.

A letter from your fund says innerhalb von zwei Wochen. What does that mean?

A deadline is running. innerhalb von … sets a cut-off. This is usually the most important line of the letter — if you don’t understand it, ask for an extension instead of not replying.

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Worksheet