Singapore relies on insurance, personal savings and co-payments – in Germany, your residence status determines the appropriate cover
Anyone coming to Germany from Singapore to study, undertake a PhD or carry out a research project is already familiar with an efficient healthcare system. Nevertheless, the transition can be confusing at first: medical care in both countries is modern, but is financed and billed in very different ways.
For international visitors, one question is particularly crucial: is the existing cover from Singapore sufficient for Germany? In most cases, the answer is no.
Singapore spreads healthcare costs across insurance, savings and co-payments
Healthcare cover in Singapore consists of several components:
- MediSave is a personal healthcare account. The funds saved in this account can be used for certain medical costs and insurance premiums.
- MediShield Life is the government-provided basic insurance scheme for Singaporean citizens and permanent residents. It provides cover, in particular, against high hospital bills and selected high-cost outpatient treatments.
- Integrated Shield Plans are voluntary private supplementary schemes. They can, for example, cover treatment in private hospitals or higher ward classes.
MediShield Life does not automatically cover the entire bill. Depending on the treatment, excesses, percentage co-payments and costs exceeding the applicable reimbursement limits may remain. These are paid from MediSave or out of your own pocket.
The central principle of the Singaporean system is therefore that government cover, personal savings and private supplementary cover work together.
Germany requires continuous health insurance cover
In Germany, health insurance is generally compulsory. International visitors require suitable cover for the entire duration of their stay. Proof of insurance may be required for a visa, enrolment at a university or a residence permit.
Unlike in Singapore, the focus here is not on a personal health account. The decisive factor is whether a person is insured under the statutory scheme, privately or via a suitable international policy.
Which option is suitable depends primarily on:
- academic status,
- age,
- length of stay,
- any employment status,
- and the specific purpose of the stay.
A student who is duly enrolled may therefore have different insurance options to a scholarship holder or visiting scholar without an employment contract.
MediShield Life does not provide cover for Germany
MediShield Life was designed for medical care in Singapore. Medical treatment abroad is generally not included in the scope of cover.
Even an Integrated Shield Plan does not automatically solve the problem. Although some of these private supplementary policies do include cover for medical emergencies abroad, limited emergency cover is not comparable to comprehensive health insurance for a study or research project lasting several months.
Furthermore, proof of insurance must meet the requirements of the relevant German university, embassy or authority. The IHC article ‘Proof of Insurance for Authorities and Universities’ explains which documents are typically required.
Your residence status determines the appropriate insurance in Germany
Nationality alone does not determine which insurance is suitable – the specific situation during your stay in Germany is the decisive factor.
Students who are duly enrolled can often join the statutory health insurance scheme
Many students who are duly enrolled can take out statutory health insurance in Germany. Exceptions may apply, for example, on the basis of age or student status. It is therefore important to clarify the issue of insurance before enrolment.
Scholarship holders, PhD students and visiting researchers often require an international insurance plan
Those funded by a scholarship or conducting research without a regular employment contract cannot automatically become members of a statutory health insurance scheme.
Special international insurance plans are often available for these groups. However, it is not enough simply to look at the designation ‘student’, ‘PhD candidate’ or ‘visiting scholar’. The length of stay, permanent residence and the type of funding also play an important role.
For employed researchers, the employment contract and income are decisive
Anyone with an employment contract with a German university or research institution is often treated differently under insurance law than someone on a scholarship.
Factors such as income and the type of employment play a role here. Depending on the situation, either statutory or private health insurance may be an option.
IHC offers suitable health insurance solutions for stays in Germany
If students, PhD candidates, scholarship holders or researchers require international health insurance for their stay in Germany, IHC offers various policies depending on the duration of their stay, the desired scope of cover and their personal circumstances:
- ISHCP-STT – Short-term cover for stays of up to 92 days: This plan is specifically designed for short-term study, research, exchange or other temporary stays. It provides cover for urgently required outpatient and inpatient treatment. No medical assessment is required; however, pre-existing conditions are excluded from cover.
- International Science HealthCare Plan (ISHCP) – basic cover for longer stays: This plan is suitable for fixed-term study, PhD and research stays of up to four years. It covers, amongst other things, outpatient and inpatient treatment as well as selected preventive care services and vaccinations. Personal liability insurance is also included. Pre-existing conditions are not covered.
- FlexMed Global Impat – comprehensive cover including pre-existing conditions: This policy is aimed specifically at international researchers and scholarship holders coming to Germany as part of a German scholarship, funding or research programme. Cover is available for up to five years. FlexMed Global Impat offers particularly comprehensive insurance cover, including outpatient, inpatient and dental benefits. Pre-existing conditions are covered; no medical examination is required. Furthermore, you are free to choose your own doctor and hospital.
The plans therefore differ not only in terms of their possible duration of cover, but above all in the scope of the cover provided: ISHCP-STT is intended for short stays, ISHCP offers basic cover for longer, fixed-term stays, and FlexMed Global Impat provides particularly comprehensive cover that also includes pre-existing conditions.
Which IHC tariff is suitable for a stay in Germany therefore depends not only on the duration of the stay but, in particular, on the desired scope of cover, the method of payment and the individual’s personal health situation.
The difference is also evident in the billing process at the doctor’s
People with statutory health insurance normally present their electronic health card at a German doctor’s surgery. The insured services are billed directly to the health insurance fund. Patients do not usually receive a full medical bill.
With private and many international insurance policies, however, the reimbursement principle often applies: the insured person receives an invoice, pays it first and then submits it to the insurer. Invoices, prescriptions and payment receipts should therefore be kept carefully.
The article ‘How the healthcare system works in Germany’ explains how visits to the GP, prescriptions and medical emergencies are handled.
Four points to clarify before entering the country
1. Your residence status limits your insurance options
Are you coming to Germany as a regularly enrolled student, scholarship holder, PhD candidate, employed researcher or visiting scholar?
You should also clarify whether you have an employment contract, who is funding your stay and how long it will last.
2. Proof of insurance must be formally recognised
Is the proof of insurance accepted by the university, the visa office and, where applicable, the immigration authorities?
Existing cover for stays abroad is not automatically sufficient proof for study, research or a residence permit.
3. It’s not just the premium that counts, but the actual scope of cover
Are outpatient and inpatient treatment, medication and medically necessary transport covered? What are the excesses and reimbursement limits?
Dental treatment, pregnancy, psychotherapy and medical aids may also be covered differently depending on the policy.
4. Pre-existing conditions and ongoing treatments must be taken into account
Anyone who requires regular medication or is already undergoing treatment should check how the policy deals with pre-existing conditions and ongoing therapies.
An English-language medical report, a list of diagnoses and a list of medications with the names of the active ingredients will facilitate further care in Germany.
Conclusion – your insurance must be suitable for your stay in Germany
Singapore combines basic state insurance, personal health savings and private supplementary cover. In Germany, on the other hand, you need continuous insurance cover that is appropriate for your course of study, scholarship or employment.
Insurance cover from Singapore should therefore not simply be carried over or terminated prematurely. It makes more sense to consider the two systems separately: cover in Singapore safeguards your personal situation in your home country, whilst a suitable and recognised solution is required for Germany.
When choosing an IHC policy, your academic role is not the only deciding factor. A short research visit, a PhD programme lasting several years and a stay as part of a German funding programme all place different demands on insurance cover. Clarifying this before you arrive will help you avoid difficulties with your visa, enrolment and your first visit to the doctor.
Do you have any further questions? We’d be happy to advise you personally.
