Unplanned healthcare: payments and reimbursements
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With a European Health Insurance Card (EHIC)
With your EHIC 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 you have to pay for your treatment, 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 either be reimbursed for the full cost of the treatment, or you will have to pay the patient's fee according to the rules of the country where you were treated. Alternatively, your insurer may decide to reimburse the full cost according to its own rules.
Each EU country has at least one National Contact Point that can assist you with questions on reimbursement.
Find out about social security rules in the country you're visiting
Anna has statutory health insurance cover in France and is spending a few months in Belgium to finish her studies. She has her European Health Insurance Card (EHIC) with her, issued in France. She is pregnant and will give birth while in Belgium. Pregnancy and childbirth are considered urgent medical care, so Anna will get the necessary medical assistance in Belgium when she presents her EHIC and identity card.
Anna will be treated in Belgium 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 Belgium, where she will be reimbursed at the same rate as people insured there. Belgium will then liaise with health authorities in France, where Anna is insured, to get their money back.
However, if the only reason for Anna's stay in Belgium is 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 Belgium. That way, she can be sure which costs will be covered.
Without a European Health Insurance Card
If you don't have your European Health Insurance Card (EHIC) 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 for your treatment. You can then claim reimbursement from your health insurer when you get home. This applies to both public and private healthcare providers. However, the terms will be different:
- only treatments which you are entitled to receive at home will be reimbursed
- you will be reimbursed only up to the cost of treatment in your home country – which may be less than you paid for the treatment
If you need urgent treatment, your local health authority might be able to help by faxing or emailing proof of your health insurance coverage to avoid you having to pay upfront.
If you're not sure 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.
The rules are different if you travel abroad specifically for medical treatment.