Frequently asked questions
- In which countries the European Health Insurance Card - EHIC or a Provisional Replacement Certificate of the EHIC can be used
EHIC or Provisional Replacement Certificate (PRC) can be used in another Member State of the European Union (EU), European Economic Area countries (EEA - Iceland, Liechtenstein, Norway) or in Switzerland.
- What is covered by the EHIC or PRC?
Based on the EHIC/PRC a person is entitled to necessary healthcare, in regards to the nature and the length of the expected stay, where the necessity is assessed by the attending, contracted, physician in the respective Member state to whom the person has turned to for help.
EHIC or PRC covers the costs of necessary healthcare services that the doctor to whom you have turned to for help deems cannot be postponed until the scheduled return to your native country.
Necessary health care includes also healthcare services provided for chronic or pre-existing illnesses if the aim of the trip is not to receive treatment (for example, control of high blood pressure). It also includes health care in connection with pregnancy and childbirth, providing that the reason for a temporary stay abroad is not childbirth.
Also, necessary healthcare services, include dialysis, oxygen therapy, treatments for asthma. However, to use these services, you must arrange in advance to have them rendered to you with a healthcare institution of the State in which you intend to travel.
- Who is responsible for issuing an EHIC/PRC?
EHIC or PRC shall be issued to you by your competent institution for health insurance.
- When will the PRC be issued?
PRC is issued in the event of theft, loss or EHIC or in the case when you are left without an EHIC for some other reason.
- Can the EHIC/PRC be used in the same manner in case of private stay and, for example, temporary employment in another Member state?
Yes. EHIC or PRC can be used in the same manner regardless of whether you are staying in another Member State of the EU, EEA countries or Switzerland on private business, attending college, business trip, temporary work to which you have referred by your employer or other reason.
- In which health care facilities can EHIC/PRC be used?
EHIC or PRC can be used in contracted healthcare institutions and contracted healthcare workers in the country of temporary stay. These institutions and workers have to be a part of the compulsory health insurance system.
- How do I know which healthcare provider (doctor or hospital) I should contact in case of sudden illness or injury abroad?
The National Contact Point of the country of your stay can provide you with more information on what to do and who to contact in case you get suddenly ill or injured during your stay abroad.
- What should I do if I was charged for healthcare in the country of temporary stay even though I had an EHIC/PRC?
In this case, you need to request from your competent institution for health insurance a refund for the amount paid.
- How can I realize the right to planned medical treatment in the contracted healthcare facility in another Member State of the EU/EEA/Switzerland?
The right to planned treatment in contracted healthcare facilities in other Member States of the EU/EEA/Switzerland has been granted by the European legal regulations on the coordination of social security systems, i.e. Regulation 883/04 and Regulation 987 /09. According to Article 20 of the Regulation 883/2004, the competent institution in one of the Member States of the EU/EEA/Switzerland may issue the approval for planned medical treatment in another Member State.
The insured person shall submit to the competent institution for health insurance in her home country a request for issuing the approval before the planned medical treatment.
- What rights are guaranteed to me under the Directive 2011/24/EU?
Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients’ rights in cross-border healthcare - Directive 2011/24/EU entitles you to receive the necessary healthcare or planned treatments, under the provisions stipulated by the Directive, and with private healthcare providers in another Member State of the EU or the EEA. In order to receive planned medical treatment under this Directive, a person is obliged to file a written request to the competent institution for health insurance and receive prior approval from it. Switzerland is exempted from the application of the Directive 2011/24/EU.
- Am I obliged to cover the cost of the healthcare services utilised under the Directive 2011/24/EU?
Yes, under the provision of the Directive 2011/24/EU you are obliged to cover in full the cost of healthcare services utilised. Upon returning to your home country, you are entitled to request a refund for it from your competent institute for health insurance. The submitted request should contain a copy of the medical documentation and the original invoice in your name, clearly stating which services were rendered to you and that the cost had been covered in full.
- What about a frontier worker’s rights and entitlements to healthcare?
Under EU legislation, a frontier worker is defined as an employed or self-employed person who resides and works in two different EU/EEA Member States or Switzerland and who usually returns to his or her country of residence on a daily basis or at least once a week. Frontier workers are entitled to healthcare both in the country of employment and in the country of residence.
The frontier worker must file for a S1/E106 form with the competent institution for health insurance of the country where he or she is subject to social security legislation (the country of employment). The S1/E106 form must be presented to the institution for health insurance of the country of residence. This way the frontier worker and his or her family members will be entitled to healthcare in both countries, under the respective social security legislation and in each country with the same rights and entitlements as domestic patients with public health insurance.
For more information on your rights and entitlements as a frontier worker, please contact your competent institution for health insurance.