Diabetes is one of the most prevelant chronic illnesses globally and is increasing in frequency each year due to several causes listed by the World Health Organization.
As you probably already know, there are different types of diabetes: type one, where little or no insulin is produced by the pancreas, and type two, where insulin is used ineffectively by the body.
There are also some women who develop diabetes during their pregnancy, but since this tends to go away after giving birth, it’s generally seen as a part of the pregnancy treatments rather than a chronic illness.
Should I be worried about moving to Germany if I have diabetes?
Not at all, and in this article, we’re going to talk about why that is and what being an expat with diabetes looks like.
First of all, if you’re from the US, you can expect huge changes when it comes to treatments, payments for insulin, and medical devices. While writing this article, insulin in the US costs about 100USD for a single unit while most individuals require two to three vials per month which can range anywhere from two to three units in a single vial, the price in the US is around 400USD to 900USD per month just to survive.
In Germany, this is considerably different with a public healthcare system since you’d be listed as chronically ill. While being listed as chronically ill shocks many people who are worried about their eligibility for health insurance, it’s not actually a bad thing here. It just means you’ll need to be careful about which job you get and for which company because you need to qualify for public health insurance.
So, your first priority as someone with diabetes is to find a full-time job with a German company that can get you on public health insurance.
How much will I have to pay for diabetes medication and treatments in Germany?
Almost everything will be covered by public health insurance. You might see that Germany’s insulin prices are around 11USD, but that’s not actually what you’d pay. Diabetes is considered to be an illness that’s covered by health insurance. Actually, most illnesses that are not self-inflicted (i.e. an infected tattoo), are covered.
You’ll need to find a general practitioner that you get along with. From there, they’ll verify that you’re diabetic either with old medical files from your home country or through a conversation. Since diabetes is so common, most healthcare professionals are pretty familiar with it, and this is just a formality.
From there, you’ll need to file a form with your general practitioner to get a card called the Befreiungsausweis (exemption of payment for medications. Literally translated this is the exemption card). You’ll use this card when picking up your regular medications, and you won’t have to wait for reimbursement because your health insurance provider will receive the bill.
What doesn’t insurance pay?
While German insurance is pretty exceptional, it won’t pay for everything. Germans are notorious for rejecting technology, and when you move here, you’ll most likely be prescribed things like tea for the flu and Silberpuder for skin irritation instead of medication.
For people with diabetes, this means that insulin pumps and better blood testing kits might not be covered by insurance since doctors are not really up-to-date on trending devices. If you have a really good general practitioner, they can prescribe you a specific device. This might be enough to either get it partially or fully covered by your insurance, but since there are only insurance laws and no exact coverage guides, even we can’t say for sure what will be covered and what won’t. Doctors have a much better overview of this.
Another good thing is the digital healthcare act passed by the German government which allows doctors to prescribe apps. If you want a paid app that will track your blood sugar, then show it to your general practitioner and ask them to prescribe its use under the digital healthcare act.
What is it like living in Germany with diabetes?
In Germany, people have more legal protections than in countries like the US. If you’re sick, you generally have three days without a sick note and after that, you just need to go to your general practitioner who will give you a pink piece of paper to give to your employer. They generally write out sick notes for the duration you ask for, so maybe one week for the flu, two for burnout, etc. You also are under no legal obligation to tell your employer why you’re on sick leave.
Companies are also really respectful when it comes to sickness. Most people take a few sick days each year without any problems or coworkers writing to them about things they need to do. That means if you tell someone during an interviewing process that you have diabetes, they’ll generally not think of it in terms of working capabilities, but rather remember it when sending out company gifts like snacks or drinks.
It’s important to remember when moving that Germany’s culture is very much work to live based instead of live to work. And, since public health insurance contributions are based on your income and not your state of health, it means your employer won’t face any negatives for hiring someone who has a chronic illness.
I have diabetes and don’t speak German. Will my experience be different?
Most medical professionals in Germany speak English and will try to help you in whatever way they can. Although Germans are known for being a bit rough, most people have pretty good experiences when it comes to seeing general practitioners (the same isn’t true for the emergency room due to the pandemic and limited capacities. There you can expect to have a somewhat stressful experience).
It’s best to call ahead of time and ask if they speak English over the phone. If you get someone speaking German back to you who sounds frustrated, it’s probably just German confusion. To many people who don’t speak German, German confusion and frustration often sound the same. You can also use the website Doctolib to find medical professionals who speak English.
Want help signing up for public health insurance, or just want to do it online?
🦷 Did you know that public health insurance doesn’t cover dental cleanings for a reason? Most public health insurance companies actually have this as an add-on option for those who are interested. Plans start at €9 per month for basic. Advanced coverage changes depending on your age.
