Treatment in Germany: from the visa to the discharge letter

Why do Georgian patients choose Germany?

Germany is usually chosen when a case is complex and price becomes secondary. The most common areas are complex cancer treatment, neurosurgery, cardiac surgery, paediatrics and clarifying a rare or unclear diagnosis when tests done in Georgia contradict each other. The country's strength is its network of university hospitals, where research, advanced equipment and joint review by doctors from several specialties are everyday practice.

Germany has its drawbacks too. Treatment here is usually more expensive than in Turkey or India, international offices sometimes reply slowly, and contact with doctors is formal and strictly scheduled. For a standard, well-established operation, going to Germany is not always justified: for comparison, see the Turkey guide. The choice of country and method is for your treating doctor to make; this text only describes the organisational route and does not give medical advice.

Do you need a visa for treatment in Germany?

Since 28 March 2017, Georgian citizens with a biometric passport have not needed a visa for short-term, non-work visits to the Schengen area. According to the list of the German Federal Foreign Office, a visa-free stay must not exceed 90 days in any 180-day period. This rule also covers treatment: a consultation, diagnostic tests or a hospital stay of several weeks usually fits within this limit.

• The 90 days are counted across the whole Schengen area, not just Germany. If you were in Italy or Austria in the last six months, those days are deducted from your remaining allowance.
• For treatment longer than 90 days, you must obtain a national visa before departure. On the website of the German Embassy in Tbilisi, medical treatment for more than 90 days is listed as a separate category, and the application is submitted on paper. Do not count on extending your stay on the spot after a visa-free entry.
• When travelling on an official passport, a visa is required: the European Commission suspended the visa-free regime for holders of Georgian diplomatic, service and official passports from 6 March 2026 to 6 March 2027. This suspension does not apply to ordinary biometric passports.
• At border control, you may be asked about the purpose of your visit and your financial means. Have to hand the clinic's letter with the date of the visit, your return ticket, proof of accommodation and your insurance policy. Ordinary travel insurance usually does not cover planned treatment, so read the policy exclusions in advance.

EU rules also allow such a suspension to be extended more widely, and an electronic travel authorisation, ETIAS, is planned for visa-free travellers. So check the current rule in an official source before buying your ticket. When a visa is needed and how the embassy application package is prepared is explained on the medical visa page.

How do you choose and check a German clinic?

In Germany you will come across three types of institution: university hospitals (Universitätsklinikum), large public and municipal hospitals, and private clinics, often narrowly specialised. A university hospital is the natural choice for a complex or rare case, although its international office is often overloaded. A private clinic replies quickly but cannot cover every field to the same depth.

Most German hospitals do not hold JCI accreditation, and this should not be seen as a weakness: here quality is monitored by the national system. Hospitals are required by law to publish an annual structured quality report (Qualitätsbericht) describing their departments, staff, volume of services and quality indicators. In oncology, an additional benchmark is a certificate from the German Cancer Society (Deutsche Krebsgesellschaft) for a specific tumour centre.

Ask the international office in writing:

1. how many patients with your diagnosis or procedure the department treats each year;
2. who will draw up the plan and who will operate: the head of department (Chefarzt) or another doctor on the team;
3. what is included in the cost estimate (Kostenvoranschlag) and what may be added during treatment;
4. whether repeat tests are needed on site and whether they are included in the price;
5. who will be your contact person before arrival and during your hospital stay.

If you write to several clinics at once, compare the replies in a single table, item by item. The clinic search service does this work for you, starting the selection from the diagnosis, not from advertising.

Remote assessment before you travel

Many German clinics issue a written assessment based on translated documents, sometimes for a fee. Such an assessment answers two questions: whether travelling is medically justified, and what treatment the department proposes. If the answer matches the plan already offered in Georgia, you may not need to travel at all. If it does not, show both opinions to your treating doctor and work out the reason for the difference together. First confirm the price and timeframe of the assessment in writing, then send the documents as a single file so that the doctor does not have to piece together photos sent in instalments.

What language should the documents be in, and when is a sworn translator needed?

A German doctor reads the medical history in German. Many international offices also accept an English translation for a preliminary assessment, but at a tumour board and when planning surgery a German text works faster and raises fewer questions. So first ask the clinic which language it prefers: one complete translation is better than two half-finished ones.

For the clinic, a good-quality medical translation without notarisation is usually enough. The situation changes when the document goes to a German state authority: the embassy, the foreigners' authority (Ausländerbehörde), a court or an insurance company. In Germany, an official translation is often certified by a translator sworn in or authorised by a court (allgemein beeidigt or ermächtigt). The official database of such specialists, set up by the justice authorities of the federal states, is at justiz-dolmetscher.de and can be searched by language and city.

A German authority may or may not accept a translation made and notarised in Georgia: the decision is up to the recipient. So before translating, ask who should do the translation and whether the Georgian original needs an apostille. The apostille and legalisation tool will answer this question, and the translation options are on the medical translation page. The translation calculator shows an indicative price based on volume.

Which documents should you prepare, and by when?

For the first enquiry, the clinic needs a complete but well-organised history. A single file works best, in chronological order, with a date and a short title for each document:

• the latest discharge summary or an extract from the medical record, with the diagnosis and current medication;
• recent laboratory test results, with reference ranges and units;
• the CT, MRI or PET report and the scan itself in DICOM format;
• histology and immunohistochemistry reports, if the case concerns oncology;
• a copy of your passport, so that the clinic issues the invitation and cost estimate in exactly your name.

Where and how these documents are requested in Georgia, and what a complete package includes, is described in our guide to documents for treatment abroad. The timeframes below are indicative and depend on how quickly the clinic replies.

How does payment work at a German clinic?

A patient coming from abroad without German health insurance is considered a self-payer. In this case the clinic usually sends you a written cost estimate in advance and, on that basis, asks for an advance payment, either before arrival or on the day of admission. After treatment is completed, a final invoice (Schlussrechnung) is drawn up: if the actual cost turns out lower, the excess is refunded to you; if higher, you pay the difference.

When reading the cost estimate, pay attention to a few details. In Germany, doctors' fees are calculated under the official fee schedule, the GOÄ, and are sometimes invoiced separately from the hospital costs. Personal treatment by the head of department is often an additional, optional service. Ask separately about intensive care days, expensive medicines, accommodation for a companion and an on-site interpreter. Transfer money only into the clinic's official account, against an invoice; refuse to pay into an intermediary's personal account.

If you are applying for state or municipal assistance with part of the costs, you will need the cost estimate translated into Georgian. Which authority needs what is explained in the guide to funding treatment abroad.

Travel and living during treatment

• Tickets: buy them after the clinic has confirmed the admission date in writing. Keep the return date flexible, as discharge is often delayed by a day or two.
• Accommodation: during an outpatient course, such as radiotherapy, the patient lives near the clinic and attends every day. In this case a flat with a kitchen is more practical than a hotel.
• Companion: the same visa-free rule and 90-day limit apply to them. Some clinics offer the companion a place in the ward for a fee.
• Language on site: accurate interpreting is essential at consultations and when signing the consent form. How a Georgian interpreter works at the clinic is described on the interpreter service page.
• Medicines: take your regular medicines in their original packaging with a translation of the prescription. Carrying narcotic and psychotropic medicines is subject to additional rules, so ask about them in advance.

The daily routine in a German hospital is strictly scheduled: the doctors' ward round takes place in the morning, planned tests at pre-booked times, and visiting hours are set by the department's rules. Write down your questions the evening before so that you miss nothing during the round. Keep every receipt, test result and doctor's letter in one folder: on your return, both your Georgian doctor and the funding body will need exactly these papers.

After you return: the discharge letter and follow-up care

On discharge, the German clinic gives you a discharge letter (Entlassungsbrief or Arztbrief) setting out the diagnosis, the treatment given and further recommendations. The final letter often arrives by email a few days later, especially when the final histology result is pending. For a Georgian doctor, this document must be translated into Georgian, with medicines given by their international non-proprietary names so that the pharmacy can find the right product. The discharge summary translation service does this.

Follow-up tests are often done in Georgia and the results are sent, translated, to the German clinic. Agree in advance whom you will contact with questions and how quickly the department replies. If you need special care at home, equipment or a medicine not registered in Georgia, the post-operative care team arranges this. To compare the route in a neighbouring country, read Treatment in Austria.

Frequently asked questions about treatment in Germany