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Frequently Asked Questions about accessing medical treatment in other countries in Europe
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The rules and procedures to access medical treatment in another Member State differ depending on the purpose and duration of your stay there.  You may be on a temporary stay, for example, a holiday or business trip.  You may have gone to that country specifically for medical treatment because that treatment was not available in Ireland or there are long delays to obtain the treatment in Ireland or you may have taken up residence there.

See below for Frequently Asked Questions on:

Accessing medical treatment during a temporary stay - the European Health Insurance Card

The European Health Insurance Card makes it easier for people from the European Union’s 27 Member States plus Iceland, Liechtenstein, Norway and Switzerland to access health and medical care services during temporary visits abroad.

If you are going on holiday, a business trip or a short break or are heading off to study abroad, remember to make sure that you have obtained a card. It will help save you time and money if you fall ill or suffer an injury while abroad.

What are the practical benefits of the card?

The card ensures that you will get the same access to necessary medical treatment under public sector health care (e.g. a doctor, a pharmacy, a hospital or a health care centre) as nationals of the country you are visiting. If you have to receive medical attention in a country that charges for health care, you will be reimbursed either immediately, or after you go home to your own country. The idea is that you are given the care you need to allow you to continue with your stay.

However, it is important to note that the card does not cover your health care costs while abroad if you are travelling in order to obtain treatment for an illness or injury that you had before travelling. Nor does the card cover you for private sector health care providers.

June plans to go to Spain for a short holiday. While she is in good health, she is worried about healthcare if she becomes ill while abroad. As a citizen of the EU, does she have any entitlement to healthcare in Spain or in any other Member State of the EU?

As a national of an EU Member State, June and members of her family are entitled to free or reduced cost necessary medical treatment in any EU country as well as Iceland, Norway, Liechtenstein and Switzerland.  If she falls ill, she should present at the nearest public hospital with her European Health Insurance Card.  She will be given the same medical treatment as a Spanish national would receive.

Only publicly funded treatment is included in the European Health Insurance Card scheme – each country operates its own rules for medical provision. In some countries, medical treatment is free, in others you pay part of the cost; in others you pay the total cost and then claim a refund.

Does every public hospital recognise the European Health Insurance Card?

There have been repeated complaints from EU citizens holidaying in Spain that certain public hospitals there refuse to recognise the European Health Insurance Card.  Apparently, in some cases, travellers have been incorrectly advised that their European Health Insurance Card is not valid in Spain if they have travel insurance.  This is not the case.  The European Health Insurance Card holder has the right to receive necessary medical treatment in the host Member State’s public healthcare system on the same terms and conditions as nationals of that country.  In Spain, public healthcare is generally free of charge.  Holders of the European Health Insurance Card should also be treated free of charge where Spanish nationals would receive free treatment irrespective of whether they hold travel insurance.  This matter is currently under investigation by the European Commission.

Where can I obtain a European Health Insurance Card?

You have the following options in applying for your European Health Insurance Card:

  • You can apply online at www.ehic.ie if you already have either a medical card or a Drugs Payment Scheme (DPS) card

  • You can apply in person by completing an application form at your local Health Office

  • To apply by post, ask for an application form at your local Health Office, Community Care office or Health Centre. An application form can be posted to  you from these offices or you can download it from www.ehic.ie.  Return the completed forms to your local Health Office.

If I am resident outside Ireland but receive my pension from Ireland, where do I apply for my European Health Insurance Card?

Due to a change in European law, from the 1st May 2010 responsibility for issuing the EHIC will no longer rest with a person's state of residence.

Under the new law the Competent State (the State where a person is paying to or benefiting from the Social Security System) will be responsible for issuing the EHIC for persons resident in another EU/EEA State.

In practice this means that the HSE will have to issue the EHIC for all Irish insured persons or pensioners and their dependant’s resident in other member States, e.g. a retired person receiving a contributory pension from the Department of Social Welfare but who lives in Spain would up to now have their EHIC issued by the Spanish authorities. From 1 May 2010 the EHIC will be issued by the Irish authorities.

If a person within another EU/EEA State who is linked to the Social Security System in Ireland wishes to apply for the EHIC they will find all the necessary information at the following web address www.ehic.ie.

For further information please contact euregulations@hse.ie

Is it necessary to obtain travel insurance in addition to the European Health Insurance Card?

It is advisable to take out travel insurance in addition to the European Health Insurance Card. Few countries pay the total cost of medical treatment even under reciprocal health service arrangements. Illness or accident abroad may mean extra travel, accommodation and repatriation costs for which you should be insured. Certain travel insurers will only honour a travel insurance claim for medical costs if the policy holder can produce evidence of the European Health Insurance Card.

Who should I call in case of emergency?

112 is the single European emergency number, reachable everywhere in the EU, from landlines and mobile phones, free of charge. 112 links the caller to the relevant emergency service (local police, fire brigade or medical services) and is available 24-hours a day. 112 is now operational in all EU member states alongside existing national emergency numbers (like 999 or 110). 112 is also being used in a few countries outside the EU, such as Croatia, Montenegro and Turkey.

For further information go to: http://ec.europa.eu/information_society/activities/112/index_en.htm

What if I have a pre-existing medical condition requiring weekly medical treatment e.g. diabetes.  Is it possible to visit a doctor in another State and who is responsible for the cost?

The cover provided by the European Health Insurance Card is no longer limited to emergency treatment.  You should produce your European Health Insurance Card to the hospital to obtain the treatment. You may require supporting evidence from your GP of your condition and as a consequence, you are recommended to bring a letter from your doctor confirming your condition.

Does a student undertaking studies in another Member State have an entitlement to healthcare there?

Students are entitled to all health care benefits in kind e.g. healthcare and medicine during their studies in another Member State. To ensure that students can avail of these benefits, they should obtain a European Health Insurance Card from the health authorities in their home State prior to departure.  Students are regarded as retaining their habitual residence in their home State and students are treated as “staying” in the country of study.  In these circumstances, the Commission has taken the view that the EHIC issued to students by their home State is valid and it guarantees to students as persons insured in another Member State “any benefits in kind which become necessary on medical grounds during their stay, taking account of the nature of the benefits and the expected length of stay”.

When returning the application form, it should be accompanied by a letter from the student’s college confirming that the overseas semesters are part of a registered course.

If the student becomes ill while abroad, he should produce the European Health Insurance Card to the medical staff he consults at his local public hospital.

Where can I obtain further information on the European Health Insurance Card?

Further information on the European Health Insurance Card can be obtained from the following website:  http://ec.europa.eu/social/main.jsp?catId=559&langId=en

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Accessing Planned Healthcare in another State

I am aware that the Cross Border Healthcare Directive has recently come into force.  What does this Directive do?

On 25th October 2013, the Cross Border Healthcare Directive 2011/24/EU came into force throughout the EU.  This Directive clarifies the rights of patients to access and obtain reimbursement for safe, good quality healthcare treatment in another EU Member State.

If you travel to another EU Member State from Ireland for medical care, you will enjoy equal treatment with the citizens of the country in which you receive the treatment.  If you would be entitled to that treatment in Ireland, then you will be reimbursed through the HSE in Ireland.  The amount reimbursed will be the cost of the treatment in Ireland.  In certain cases, you will require prior authorisation from the HSE before travelling for treatment to another Member State.  This authorisation will be required in Ireland if your treatment requires an overnight stay at a hospital or highly specialised or cost intensive healthcare.

The implementation of the Directive should make it easier for you to access information on healthcare in other EU Member States.  It should also result in national health authorities working closer together and exchanging relevant information on quality and safety standards in healthcare.  The Directive supports the development of "European Reference Networks" bringing together, on a voluntary basis, specialised centres of expertise already recognised in Europe. It also promotes co-operation between EU countries to help deliver the considerable potential benefits of Health Technology Assessments and eHealth.

For further information on the Cross Border Healthcare Directive in Ireland, click on the following website:  http://www.hse.ie/eng/services/list/1/schemes/cbd

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Accessing Health and Medical Care during residence in another State

What is my entitlement to health and medical care if I take up residence in another State?

You have the right to receive sickness benefits in kind, e.g. healthcare and medicines, in your country of residence, regardless of where you are actually insured. You are entitled to exactly the same treatment as nationals of that country.

If you are insured in a different country than the one where you reside, you should register with  the local healthcare institution of your place of residence. To do so you may need to ask the healthcare institution where you are insured for an S1 form that you will then present to the institution where you live. This is typically the case of pensioners retiring to a different country than the one that pays their pension and where they are insured.  It is not necessary for temporary stays.

Can I transfer benefits accrued in the country I have just left to my new country of residence?

The country where you are insured is always responsible for paying your sickness, maternity or paternity benefits in cash, i.e. benefits that replace a wage that has been suspended due to sickness. These benefits will be paid according to the rules of the country where you are insured, regardless of where you are living or staying.

Whenever certain conditions have to be fulfilled before you become entitled to benefits, the institution examining your claim must take account of periods of insurance, residence or employment completed under the legislation of other countries. This is a guarantee that you will not lose your sickness insurance coverage when changing employment and moving to another country.

For example, in some countries, you may only become entitled to sickness benefits after six months of insurance there. EU rules ensure that you will be entitled to sickness benefits from the beginning of your insurance period there if you had previously been covered for 6 months or more in any other EU country, Iceland, Liechtenstein, Norway or Switzerland.

Where can I find out more about my health and medical care rights if I take up residence in another Member State?

You can access further detailed information on your health and medical care rights on taking up residence in another State on the following website: http://ec.europa.eu/social/main.jsp?catId=859&langId=en

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Last update: 05/02/2014  |Top