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The subtle ways living abroad in Europe can affect healthcare costs

Living in Europe can be a life-changing experience, with many different cultures and ways of life to immerse yourself in. Additionally, healthcare is of a consistently high standard when it comes to coverage and quality - so that’s more good news!

The subtle ways living abroad in Europe can affect healthcare costs
March and April are still a prime seasons for colds and flu. Photo: Britanny Colette / Unsplash

Working and living in Europe, the odds are that your host country’s government will mandate health insurance. They will deliver a very high standard of care through their health system, usually funded by your contributions. The thought of an ambulance ride won’t fill you with dread – they’re covered. 

That doesn’t mean that healthcare costs can’t snowball, however. Together with AXA – Global Healthcare, we examine some of the ‘gaps’ that can emerge in healthcare when you’re living overseas and how costs can rapidly increase. 

Communication difficulties

As much as you plough through lessons on Duolingo or attend night classes to come to grips with the local language, it takes years to build any kind of fluency close to what you have with your native tongue. 

This can cause issues when it comes to overseas healthcare. While finding a doctor may be reasonably straightforward, locating one who can understand exactly what you are describing is another matter. While English is often widely understood, the linguistic complexities presented by the doctor’s office mean that a visit can be stressful at the very least. 

This can pose two problems. First, you may delay a visit to a healthcare professional, as the discomfort of seeking medical attention may outweigh the actual physical symptoms. Prevention is better than a cure; however, some health conditions, such as hypertension (high blood pressure) can become chronic before you are fully aware.

The second problem is that a lack of language fluency can mean symptoms are either incorrectly described or understood. While it can be challenging to describe your symptoms in your native language, it can become far more complex when two languages are involved. This could mean misdiagnosis or the wrong medication is prescribed. 

With the Virtual Doctor service from AXA, you can book a medical consultation with a real doctor on the phone or by video chat – at a time that suits you – from anywhere in the world

Cultural differences 

While you can expect a very high standard of healthcare when living in Europe, there are times when a difference in cultural attitudes may prove challenging. 

An example cited by some who come to German-speaking countries to work is a marked difference in how pain medication is prescribed. Following an operation, you can expect to be prescribed a few ibuprofen and then sent on your
way.

While not precisely world-ending, such differences in how different cultures address healthcare can be unwelcome and can also add to the stress that comes with suffering from an illness. And as we now well know, stress can make you even sicker.

Think of private health insurance as a peace of mind, so you can go on experiencing all that your new home offers. Photo: Getty Images

The effects of isolation

Stress also plays a significant role in other areas. While living abroad can help you forge lifelong friendships – you might even meet the love of your life – sometimes it can be overwhelming. 

AXA’s 2023 Mind Health Report indicated that more European working populations consider themselves ‘getting by’ rather than ‘languishing’ or ‘struggling’, but there’s still considerable room for improvement. 

There’s also a significant gap in mental health outcomes between men and women, with women more susceptible to poor mental health due to a range of financial and cultural factors.

Combined with the sense of disconnection felt by international workers, as previously reported by The Local, the conditions become conducive for several mental health issues, such as anxiety and depression, to manifest. 

Again, while mental healthcare in Europe is generally good and continuously improving, that doesn’t mean that missed work and therapeutic costs can’t sometimes escalate over a reasonably short period of time. Depending on the severity, not every visit or medication may be covered.

Sometimes, being away from home can be difficult. AXA – Global Healthcare offers the Mind Health service, so you can talk to friendly faces who understand and can help guide you through

A solution that equals peace of mind

While healthcare in Europe is of a very high standard, that doesn’t mean that the very nature of living and working in another country won’t cause healthcare costs to add up if you get sick or have an accident. 

International private health insurance can often be an option. Not only will you receive the same world-class treatment, but you will often have more choices regarding treatment and medical professionals. This can help offset or eliminate those additional costs. 

The most significant benefit of private health insurance for internationals is the rapid access it gives you to medical professionals who speak English and several other languages.

AXA – Global Healthcare, for example, offers a Virtual Doctor Service, which will connect you with a medical professional, via video or telephone call, at a time that is convenient for you. They can diagnose,
prescribe medication, and answer any questions you have.

The Mind Health service is also provided to AXA – Global Healthcare policyholders. This connects you with a qualified psychologist who can help you navigate the challenges of being away from home and your regular support networks. This can make all the difference in how you deal with stress and worry. 

Think of a private health insurance plan as an investment as you make a new home. It will give you the peace of mind you need if you are ever faced with accident or illness.

Explore AXA – Global Healthcare’s range of plans today and discover one that’s right for you

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HEALTH

How to find available therapists in Germany

It’s no secret that mental health care can be particularly tricky to access in Germany. Here are some helpful tips for anyone who is struggling to book an appointment for therapy.

How to find available therapists in Germany

The process to find psychotherapy in Germany’s urban centres is arduous – licensed therapists often have impossibly long wait times, and private practices don’t accept public health insurance.

A major reason that public insurance funded mental health care is hard to find in Germany comes down to regulations. Specifically the ‘coverage plan’ (Bedarfsplanung) that basically limits the number of licences available for publicly insured therapists in a region.

Germany’s maddening bureaucracy probably won’t be fixed any time soon. So residents in need of therapy will need to find a way through the system as it is.

So here are a few helpful tips for finding therapists, as well as how publicly insured patients can have private practice therapy costs reimbursed.

Look for therapists enrolled at academies

You’ll probably have a better chance getting an appointment with therapists who are currently in training, because not everyone knows that this option exists.

You can search for “Akademie für Psychotherapie”, to find one in your location. The Berliner Akademie für Psychotherapie, is one in the capital city, for example.

If you arrange an appointment this way, you can expect to be connected with a grad student therapist in training who needs to complete their supervised practice hours. In this case, you would see your therapist as usual, and they will be going through your session with an experienced therapist afterward.

The main advantages to seeking a therapist in training is that it may be cheaper and you can probably more readily find an appointment. A potential disadvantage is that the therapist you’ll be seeing is less experienced. 

But according to a Stockholm University study, student therapists who receive regular feedback from supervisors may be just as effective as licensed therapists at treating patients.

How to get reimbursed for going to a private practice

As mentioned above, therapists covered by public health insurance are few and far between, especially in many urban centres, and therefore regularly come with long wait times. But for those willing to do battle with the bureaucracy, there is an option to have your costs reimbursed for seeing a private practice therapist.

Specifically, public insurance providers are obligated to provide full reimbursement of costs in the event of a “supply emergency”. 

Waiting times of more than three months are considered unreasonable. So generally, patients can claim a supply emergency if they have contacted several therapists, and none of them offered available appointments within that time frame.

But you’ll want to make sure that your process is properly documented so that you won’t be stuck with the out-of-pocket costs.

First, you’ll need to document your need for psychotherapy. To get this, make an appointment for a psychotherapeutic consultation with a practice in your area, and be sure to collect a written recommendation for treatment (a PTV 11 form). 

If you don’t know where to start with this, look to the Association of Statutory Health Insurance Physicians (Kassenärztliche Vereinigung) for a database of therapists. You can also call 116 117 or use the 116 117 App.

After you’ve got your PTV 11 certificate, you’ll need to document your futile search for a licensed therapist. To do this, contact at least three to five therapists that have public health insurance approval. Keep a list of the names of therapists you contacted, as well as dates and times of contact and how long the waiting list for treatment is. 

Additionally, you should try to arrange treatment through the aforementioned Association of Statutory Health Insurance Physicians, and receive confirmation if it’s not possible. So you’ll need to call 116 117, or use the 116 117 App again. But this time go through the process to have them try to find you placement with a therapist. This should take a maximum of four weeks, but rarely happens.

Finally, if you have documented all of the above and have still not found a readily available therapist, then you can seek out a private practice. You’ll need to enroll as a self-paying patient initially, but then you can submit an application for an outpatient reimbursement (Kostenerstattungsverfahren) along with the previously collected certificates and proof of your search. Private practice therapists are usually familiar with this process, and may be able to help you with the application as well.

READ ALSO: What are the main reasons internationals in Germany turn to therapy?

Free phone consultations for students

Students in Berlin can also take advantage of a free 50-minute conversation with a therapist through StudierendenWERK.

For students elsewhere, it’s worth checking what kind of mental health support services your school offers. Many German universities offer mental health support to some extent, and if school counsellors can’t provide the care that you need, they may be able to offer helpful information about where such services are available in your area.

READ ALSO: Here’s how you can get mental health help in English in Germany

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