Using healthcare in another Member State of the EU/EEA/Switzerland
Health care in another Member State of the EU/EEA/Switzerland - Introduction
Temporary stay in another Member State of the EU/EEA/Switzerland
If you are registered under compulsory health insurance with the Croatian Health Insurance Fund (hereinafter: CHIF), during a temporary stay in another Member State of the European Union (EU), the European Economic Area countries ( EEA) or Switzerland, you will be entitled to the same healthcare as persons residing in this country. The cost of this shall be covered by the CHIF.
Temporary stay in another Member State includes staying on account of private business (travelling, visiting relatives, etc.), temporary employment, professional training or education to which an employer headquartered in Croatia referred you, business trip, studying and every other stay of a temporary character.
During a temporary stay in another Member State, you are entitled to necessary and emergency healthcare based on your European Health Insurance Card (EHIC) or a Provisional Replacement Certificate of the EHIC. Based on the above-mentioned documents, you are entitled to necessary/emergency healthcare in healthcare facilities and physicians in the Member state of temporary stay. These facilities and physicians need to have entered into an agreement with the competent institution for health insurance in the country of the temporary stay. Such health care can be utilised on the basis of the Regulation (EC) No 883/2004 of the European Parliament and of the Council of 29 April 2004 on the coordination of social security systems (basic regulation, hereinafter: 883/2004 Regulation) and Regulation (EC) No 987/2009 of the European Parliament and of the Council of 16 September 2009 laying down the procedure for implementing Regulation (EC) No 883/2004 (hereinafter: Regulation 987/09).
In accordance with 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 (hereinafter: Directive 2011/24/EU), it is possible to use healthcare services even in the private healthcare facilities and with private physicians in another Member State of the EU/EEA. However, that kind of health care needs to be paid in full, and you are entitled to seek refund upon returning to Croatia. A refund request has to be submitted with the CHIF regional or branch office, based on the place of your residence in Croatia.
Directive 2011/24/EU does not apply to Switzerland.
Residency/permanent stay in another Member State of the EU/EEA/Switzerland
If you reside/have permanent residence in another EU/EEA/Switzerland and health care is realised at the expense of the CHIF you will be entitled to receive the same healthcare services as other insured persons in country in which you reside/have a permanent residence.
If you receive a pension from Croatia, and you live on the territory of the other Member States of the EU/EEA/Switzerland, you will be entitled to full health care on the territory of the State of residence if the competent regional or branch office of the CHIF, on your the request, issue the stationery E 121 ("Certificate of report of pensioners and members of their families"), or an equivalent S1 form or electronic SED form. The specified document must be delivered to the holder of health insurance in the place of residence in another EU/EEA/Switzerland. The aforementioned document can be issued and the members of your family, under the prescribed conditions.The CHIF will, at your request, issue the EHIC for achieving the necessary health care in other Member States.
Employed and self-employed persons, and frontier workers
If you have a permanent residence in another Member States of the EU, EEA countries or in Switzerland, and are employed by an employer based in Croatia or self-employed in Croatia, the status in compulsory health insurance will be established by the CHIF, i.e. in Croatia as the country of employment/self-employment.
Still, in the case of residence in another Member State, and under the assumption of fulfilling all of the requirements, you will be entitled to full healthcare in the country mentioned above, the cost of which shall be covered by the CHIF. For that purpose, you have to request the issuance of E106 or an equivalent S1 form or electronic SED form from the CHIF regional or branch office (“Entitlement to Benefits in Kind in case of sickness and maternity with residence outside the competent state”). Upon receiving this form, it should be submitted to the health insurance provider in the country of residence. The mentioned form can also be issued for members of your family, under prescribed provisions. CHIF will also, at your request, issue the EHIC to you.
Employees temporarily employed in another Member State of the EU/EEA/Switzerland
Should an employer headquartered in Croatia refer you for temporary employment in another Member State of the EU/EEA/Switzerland, and you have acquired residency in this state, you are entitled to request the issuance of E106 or an equivalent S1 form or electronic SED form from the CHIF regional or branch office, according to your place of residence in Croatia. The specified form has to be submitted to the health insurance provider in the state of temporary employment. Based on it, you will be entitled to full healthcare services in this state. CHIF will also, at your request, issue the EHIC to you.
It is considered that you have taken up residence in the country of temporary employment if you have been referred for temporary work there for a period of minimum a year (minimum 366 days). The documentation you are required to enclose with the request for the issuance of E106/S1/electronic form is a copy of the A1 certificate, issued by the Croatian Pension Insurance Fund, clearly stating that you have been referred to temporary employment in another Member state for a period exceeding a year, a copy of the competent police department’s certificate on temporary departure from Croatia for a period exceeding a year, as well as the written Statement on the actual residence in the CHIF. The mentioned form can also be issued for members of your family, under prescribed provisions.
Planned treatment in another Member state of the EU/EEA/Switzerland
As an insured person with the CHIF, you are obliged to request prior approval for the planned treatment from the CHIF regional or branch office, according to your place of residence in Croatia, in order to qualify for receiving planned treatment in another Member state. Should you receive the approval, you will be entitled to receive the planned treatment in another Member state, under the same conditions that apply to the insured persons in that state.