Necessary health care
Necessary health care under Regulation 883/04 - the European health insurance card/Substitute Certificate
The insured persons from other Member States of the 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), are entitled to necessary health care in Croatia based on the European Health Insurance Card (EHIC) or a Provisional Replacement Certificate of the EHIC.
Based on the EHIC/Certificate insured persons from another Member State of the EU/EEA/Switzerland/UK who, during their temporary stay in Croatia, suddenly gets ill, hurt or gets into an accident, have the right to healthcare that cannot be postponed until the planned return to their home country, and at the expense of the competent institution for health insurance.
The person receives such healthcare at the physician’s health care practice, or in health care facilities in Croatia that have entered into an agreement with CHIF for the provision of healthcare services.
When will a substitute certificate be issued?
The certificate shall be issued in the event of theft, the loss of EHIC or should a person find themselves without the EHIC for any other reason. Substitute Certificate is to be used in the same manner as the EHIC.
Who issues the EHIC/certificate?
EHIC/certificate shall be issued by the competent institution for health insurance in home country, in which the person is insured under compulsory health insurance.
What does the EHIC/certificate cover?
Based on the EHIC/Certificate a person is allowed to utilise necessary health care services, taking into consideration the nature and the expected length of stay, and the necessity is estimated by the contracted physician in Croatia that you have chosen to visit.
EHIC/Certificate covers the immediate costs of healthcare, i.e. the healthcare for which contracted physician in Croatia, to whom you have turned for help, has determined that it cannot be postponed until the scheduled return to your home country.
Necessary healthcare is the one provided in connection with chronic or pre-existing illnesses if the goal of travel in Croatia is not to receive the treatment for these illnesses, or healthcare services in connection with pregnancy and childbirth if the goal of travel in Croatia is not the planned childbirth.
Also, these health care services include dialysis, oxygen therapy, treatments for asthma, chemotherapy. Still, to use these services, it is necessary to make arrangements in advance with the healthcare institution in Croatia in which you intend to utilise them.
What is not covered by the EHIC/Certificate?
EHIC/Certificate does not cover the cost of the planned treatment in Croatia, the amount of participation in the costs of healthcare utilised, services used in private healthcare institutions or private physicians, as well as services that are not covered by compulsory health insurance in Croatia.
I had to pay for healthcare services despite having the EHIC/Certificate. Do I qualify for cost reimbursement?
If you had to pay for health care services utilised in Croatia, even though you have a valid EHIC/certificate, we kindly ask you to contact your competent institution for health insurance in your home country and request the reimbursement of paid costs. We would also recommend that, for refund, you save and attach all medical documentation when filing the request. Preferably, save the original invoice that clearly stipulates what services were rendered and that the invoice had been paid.
How to use the EHIC/certificate?
EHIC/Certificate is used directly with the contracted providers of healthcare services in Croatia, under the same conditions and at the same price as if you were insured in Croatia. This means that you may have to participate in the costs of healthcare utilised (pay co-payment) if this is mandatory for the persons insured in Croatia for the same health service.
Necessary health care according to the Directive 2011/24/EU
Following 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), the insured person in one Member State has the right to the reimbursement for costs of the necessary health care services provided by private healthcare service providers in another Member State.
If you have utilised the necessary health care in private healthcare facility or with private healthcare workers in Croatia, who have not entered into agreement with the CHIF for providing healthcare services, we kindly ask you to contact your competent institution for health insurance in your home country with the request for reimbursement of cost incurred by utilising health care services.
We recommend that you, for the abovementioned action, save and attach medical documentation, as well as the original invoice in your name stipulating which healthcare services were provided to you and that you paid the cost of it in full.
Last update date: 01.02.2024.
