1. Regulation 883/04
Necessary healthcare under Regulation 883/04 - the European health insurance card/Substitute Certificate
Any person with a regulated compulsory health insurance status with the Croatian Health Insurance Fund (CHIF) is entitled to necessary healthcare in another Member State of the European Union (EU), the European Economic Area countries (EEA - Iceland, Liechtenstein and Norway), Switzerland or the United Kingdom of Great Britain and Northern Ireland (UK), based on the European health insurance card (EHIC) or a Provisional Replacement Certificate of the EHIC.
Layout of the European Health Insurance Card:
Based on the EHIC/Certificate, persons insured with the CHIF, who during their temporary stay at the territory of another Member State of the EU/EEA/Switzerland/UK, suddenly gets ill, hurt or gets into an accident, have the right to healthcare that cannot be postponed until their planned return to Croatia. The CHIF shall cover the cost of this.
Such health care shall be utilised, by the person insured with the CHIF, at the healthcare facilities or healthcare practitioner that have agreed to provide healthcare services with the healthcare insurance provider in the respective country.
When will a substitute certificate be issued?
The certificate, which temporarily replaces the EHIC will be issued in the event of theft, loss or when a persons do not have their EHIC with them for some other reason. The certificate is used in the same way as the EHIC.
Who will be issuing the EHIC/Certificate?
EHIC/Certificate shall be issued to you at your request, by the CHIF, free of charge.
What is covered by the EHIC/Certificate?
Based on the EHIC/Certificate 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.
The EHIC/Certificate covers the cost of the necessary healthcare, which the physician in the respective country deems cannot be postponed until the scheduled return to Croatia.
Necessary healthcare includes healthcare of chronic or existing illnesses, providing that the purpose of the trip was not to receive treatment (e.g. control of high blood pressure or chronic drug therapies). It also includes healthcare services relating to pregnancy and childbirth, again providing that childbirth was not the aim of the temporary stay abroad.
Moreover, necessary healthcare services that cannot be postponed include dialysis, oxygen therapy, asthma therapy. Still, to utilise these services a person is obliged to make previous arrangements with the healthcare institution in the country where the insured person is travelling to.
What is not covered by the EHIC/Certificate?
The EHIC/Certificate does not cover the cost like the ones incurred by the patient being rescued following a skiing accident, the cost of aeroplane transfer back to his home country, stolen or lost property. Hence, the EHIC/Certificate does not serve as the alternative to travel insurance.
The EHIC/Certificate does not cover participation in the cost of healthcare services utilised (co-payment).
Also, these do not cover the costs of the planned treatment. In this case, a person is obliged to submit a written request for the said treatment with the CHIF, seeking approval for it.
The specified documents do not entitle the person to utilise healthcare services that are not covered by compulsory health insurance in their home state.
How to use the EHIC/Certificate?
EHIC/Certificate can be used directly with the healthcare service provider, under the same conditions as persons insured in the country of stay. This means that the person will have to personally cover the cost of the healthcare services (co-payment), providing it is required from insured persons in the country of stay, and for the same healthcare service.
I have lost the status of the insured person with the CHIF. Am I still allowed to utilise the EHIC?
No, you have return the EHIC to the CHIF.
How long are the EHIC and Certificate valid?
As a rule, the EHIC is valid for three years. The certificate shall be valid for 90 days maximum.