In the wake of the European refugee crisis, Germany has received over a million new applications for asylum in the last two years. The health care system is struggling to provide asylum-seekers with access to essential medical services and facilitate their longer-term integration. In this article, we report on the morbidity, utilization and costs of care for a sample of asylum-seekers as compared to a matched group of regularly insured. Using administrative data, we found that asylum-seekers had more hospital and emergency department admissions, including more admissions that could be avoided through good outpatient care or prevention. Their average expenditures were 10 percent higher than for the regularly insured, mostly because of higher hospital expenditures, although there was substantial variation in expenditures by country of origin. Facilitating access to the health care system, especially outpatient and mental health care, could improve asylum-seekers health status and integration, possibly at lower costs.