Updated : 02/10/2014
If you need medical treatment while you are in another EU country, presenting your EHIC can simplify payment and reimbursement procedures.
With the European Health Insurance Card you can get healthcare - and claim reimbursement for the costs you incur - on the same terms as nationals of the country you are in. If the treatment you need is free for local residents, you won't have to pay. If the treatment requires payment, you can either ask for reimbursement from the national institution whilst still in the country and get reimbursement directly there, or ask for reimbursement from your health insurer when you get home. Your expenses will be reimbursed according to the rules and rates of the country where the treatment was received. So you will be reimbursed either for the full cost of the treatment, or you will have to bear the patient's fee according to the rules of the country where the treatment took place. Alternatively, your insurer may decide to reimburse the full cost according to its own rules.
Anna has statutory health insurance cover in EU country A and is spending a few months in EU country B to finish her studies. She has her European Health Insurance Card with her, issued in country A. She is pregnant and will give birth while in country B. Pregnancy and childbirth are considered urgent medical care, so Anna will get the necessary medical assistance in country B when she presents her European Health Insurance Card and identity card.
Anna will be treated in country B as if she were insured in that country. This means that if treatment is free for people insured there, it will be free for Anna too. If people pay and then apply for reimbursement, Anna will pay the same fees as locally insured people, then apply for reimbursement. She should apply for reimbursement in country B, where she will be reimbursed at the same rate as people insured there (country B will then liaise with health authorities in country A, where Anna is insured, to get their money back).
If the sole reason for Anna's stay in country B was to have her baby there, the European Health Insurance Card could be refused: she should instead make arrangements for her childbirth needs abroad before leaving for country B. That way, she can be sure ahead of time of which costs will be met.
If you don't have your European Health Insurance Card or you are not able to use it (for example, at a private hospital which is not covered by the EHIC scheme), you may be asked to pay and then claim reimbursement when you get home. This applies to both public and private healthcare providers. However, the terms will be different:
If you require urgent treatment, your local health authority might be able to help by faxing or e-mailing proof of your health insurance coverage to avoid you having to pay upfront.
If you are unsure about your entitlements and want to check before getting treatment, each EU country has at least one National Contact Point that can inform you whether or not you will be entitled to reimbursement, and whether any ceiling applies.
Useful national addresses and websites:
The rules are different if you travel abroad specifically for medical treatment.
In this case, the 28 EU member states + Iceland, Liechtenstein, Norway and Switzerland