A progressive approach to sexual education
Germany is often praised for being open and taking a holistic approach to sexual and reproductive health and recognizing that physical well-being is deeply tied to education, personal autonomy, and access to services.
With early and comprehensive sexual education, Germany strives to ensure that people of all ages and backgrounds can make informed and empowered decisions about their bodies.
This strong educational foundation also helps reduce misinformation, improve safe sex practices, and normalize conversations around health and sexuality—laying the groundwork for a healthier society.
Central to this system is statutory/public health insurance (Gesetzliche Krankenversicherung, or GKV), which covers around 90% of the population.
Reproductive and sexual health services under public health system
So, what does the public health system exactly cover?
1. Contraception
Fully covered up to age 22: pills, hormonal IUDs, vaginal rings, patches, and other medically prescribed contraceptives.
After age 22, contraception is not covered, except in specific medical cases.
Condoms and over-the-counter options are not reimbursed.
2. Preventive gynecological and urological care
Gynecology
Cervical cancer screening at the gynecologist is covered once a year from the age of 20.
The exam includes a check of the external and internal genitalia as well as a Pap smear of the cervix and cervical canal.
From the age of 30, the breasts and armpits can also be palpated (manually examined) during the annual check-up.
From the age of 35, a combined smear test (Pap + HPV test) can be done every three years.
Urology
Every man over the age of 45 is entitled to an annual statutory cancer screening, which includes palpation of the prostate, rectum, external genitalia, and groin region.
3. STD Testing and Treatment
Covered only when medically indicated, such as:
If you show symptoms
If a doctor recommends it during a check-up,
Routine preventive testing without symptoms (especially for men) is not covered unless you're in a high-risk group.
There is one exception: women under the age of 25 can be tested once a year for a chlamydia infection.
4. Pregnancy and Maternity Care
During pregnancy, Germany’s public health system provides a structured and thorough schedule of prenatal care. Certain examinations are routinely carried out throughout the pregnancy to ensure the health of both the mother and the baby.
Standard checkups include:
Weight monitoring – typically once every 4 weeks
Blood tests: hemoglobin level test (to detect anemia), gestational (pregnancy) diabetes, blood pressure checks – usually every 4 weeks
Ultrasound scans – covered once per trimester; more frequent if medically necessary
Screenings for infections – often include hepatitis, rubella, HIV, and syphilis
Determination of the Rhesus factor
Standard consultations with a doctor
In the Final Two Months of Pregnancy:
Checkups become biweekly starting around week 32
The doctor will:
Assess the baby's position
Measure the uterus size and development
Perform a CTG (cardiotocography) to track:
Fetal heart rate
Uterine contractions
From week 36 onwards, further ultrasounds may be carried out if breech position is suspected—these are usually covered by public insurance
All results and medical notes from checkups are recorded in a personal “Mutterpass,” which pregnant individuals are advised to carry with them at all times.
5. Fertility Support
If fertility treatments become necessary, Germany’s public health insurance system (GKV) may help cover the costs—but only under specific legal and medical conditions.
The foundation for this support is outlined in §27a of the Fifth Book of the Social Code (SGB V), which governs insurance coverage for medical interventions aimed at helping couples conceive.
Eligibility Criteria
In order to qualify for financial support, several requirements must be met:
The partners must be legally married
The female partner must be between 26 and 39 years old
The male partner must be between 26 and 49 years old
A medical diagnosis of infertility must be made
The couple must receive a positive prognosis for treatment success
Only the egg and sperm of the married couple may be used (no donors)
Medical or psychosocial counseling must take place before treatment begins
Which Treatments Are Supported?
Germany’s Federal Joint Committee (G-BA) defines which fertility procedures GKV will subsidize. According to current guidelines, coverage may include:
Up to 8 rounds of insemination (IUI) without hormonal stimulation of the women
Up to 3 rounds of IUI with hormonal stimulation of the women
3 cycles of in vitro fertilization (IVF)
3 cycles of ICSI (intracytoplasmic sperm injection)
2 cycles of GIFT (intratubal gamete transfer)
Before any treatment can begin, the doctor must create a detailed treatment and cost plan. This plan must be submitted to the health insurance provider for approval.
Once approved, the plan is typically valid for 12 months, during which the treatments must be carried out.
6. Abortion
Unwanted Pregnancy
The abortion must take place within 12 weeks of conception.
German law requires mandatory counseling before an abortion if it’s by personal choice.
Counseling must be done at a certified center (e.g., Pro Familia).
You must attend the session at least 3 days before the procedure.
The goal is to give time for reflection - not to pressure.
A certificate proving you attended the session is required.
If both conditions are met, the abortion is not punishable by law.
Abortion for Medical or Criminal Reasons
Medical Indication
No counseling is required.
Applies when the pregnancy seriously threatens the woman’s health or life.
No time limit for the abortion.
Counseling Centers
Individuals seeking help can contact the following organizations:
Arbeiterwohlfahrt (Workers' Welfare Association)
Der Paritätische Wohlfahrtsverband (The Parity Welfare Association)
Deutsches Rotes Kreuz (German Red Cross)
Diakonisches Werk (Social Welfare Organization of the Protestant Church)
donum vitae
Gesundheitsamt (Public Health Office)
pro familia
Criminal Indication
Applies when pregnancy results from rape, sexual abuse, or coercion.
No police report is required.
A doctor must confirm it's likely a criminal case.
Abortion must still occur within 12 weeks.
7. What the public health system doesn’t cover
While Germany’s public insurance is robust, there are some limitations:
Elective services (e.g., non-medical contraception after age 22, cosmetic gynecology, Toxoplasmosis, Ersttrimester-Screening)
Some advanced fertility procedures
Routine preventive STI screenings without symptoms
Elective abortions (except in approved circumstances mentioned above)
Those belong in so-called Individuelle Gesundheitsleistungen (IGeL), and will only be covered by the public health system in rare cases and with the recommendation from a doctor. Otherwise they need to be paid out of pocket.