Sick before your flight in Berlin

Sick before your flight — the two most common scenarios

Berlin Brandenburg (BER) handles around 25 million passengers per year. Many of our calls fall into two scenarios. First: a traveller falls ill before the scheduled return flight, is unsure whether boarding is responsible, and wants a medical opinion. Second: a traveller already knows they cannot fly and needs a defensible certificate for the airline, the travel insurer and the employer — with diagnosis, date and a written reason for unfitness. Both are daily business for us.

We do not treat this as a form-filling exercise. A house call lasts 25 to 45 minutes, includes a full clinical examination, rapid tests (influenza, SARS-CoV-2, RSV, streptococcus, CRP) and, depending on findings, mobile ECG, pulse oximetry and otoscopy. Only on that basis do recommendation and certificate follow. Declaring 'fit to fly' with active otitis media, an acute pneumonia at SpO2 < 94 %, or febrile streptococcal angina would not be responsible — and not acceptable to the airline if complications occur in the air.

Typical findings relevant to fitness to fly

Acute otitis media and sinusitis (impaired pressure equalisation, pain on descent, tympanic-membrane rupture risk), febrile infections with unclear trajectory, acute respiratory infections with SpO2 < 94 %, gastroenteritis with dehydration, fresh deep-vein thrombosis or suspicion thereof (absolute flight contraindication), pregnancy complications, migraine with vomiting, lumbago with immobility, post-operative states (pneumothorax risk in the first 14 days after thoracic surgery, recent eye surgery), severe allergies with airway involvement. We know IATA medical criteria and align recommendation and certificate accordingly.

Fit-to-Fly, Unfit-to-Fly, insurance attestation — what the airline really needs

Airlines distinguish between 'Fit to Fly' (for pre-existing conditions or recovery phase), 'Unfit to Fly' (medical certificate of acute unfitness) and rebooking/insurance attestations (for the travel insurer). We know the formal requirements of common airlines (Lufthansa, easyJet, Ryanair, Eurowings, Turkish Airlines, Emirates, United, Delta) and the standards of large travel insurers (Allianz Travel, ERV, HanseMerkur, AXA, Europ Assistance). Each certificate contains diagnosis, examination date, medical justification, anticipated date of resumed fitness and physician's stamp. Bilingual (German/English) on request.

How a pre-flight visit works

You call. We take down symptoms, flight time, airline, destination, hotel or home address, and insurance status. With a tight window (flight in under 6 hours) we prioritise and tell you honestly whether we can make it. The physician calls before arrival. On site, a thorough examination — rapid tests, pulse oximetry, otoscopy, ECG if indicated, clinical assessment. The decision 'fit' or 'unfit to fly' follows the findings, not the wish.

You receive the appropriate certificate (Fit-to-Fly, Unfit-to-Fly, rebooking attestation), prescription, sick note if employed in Germany, and the GOÄ invoice. For Unfit-to-Fly we give a realistic window for resumed travel — typically 3 to 7 days. We arrange a follow-up check before the rebooked flight if needed. For critical findings (suspected DVT, severe pneumonia), we organise immediate hospital referral.

GOÄ, travel insurance, airline reimbursement

All services are billed under the German Medical Fee Schedule (GOÄ) through our Privatärztliche Verrechnungsstelle. Typical cost for a house call including examination, diagnostics and certificate: EUR 240 to 400, depending on time of day, diagnostic scope and certificate type. German PKV reimburses fully. Travel insurers reimburse the visit and accept the certificate as the basis for refunding cancelled flights and hotel costs.

GOÄ certificate codes are billed separately for substantial certificate work and shown transparently. For standardised airline forms (some carriers require their own templates) we complete the fields. For life-threatening emergencies: 112. For low-threshold advice outside our hours: 116117.