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What Does the European Health Card (EHIC) Cover?

Posted in: Maria's Blog
Author: Maria Cecilia Tacchi
Tags: , ,

The European Health Insurance Card (EHIC or TSE in Spanish – tarjeta sanitaria europea) is a personal and non-transferable document that certifies the holder’s entitlement to receive any necessary medically-related healthcare benefits during their temporary stay as a result of work, study or tourism, in the territory of the European Union, the European Economic Area and Switzerland, taking into account the type of the benefits and the duration of the stay, in accordance with the legislation of the destination country.

 

The following link is for the Spanish social security page about the EHIC.

EHIC

The important concept here is TEMPORARY, this means that if you intend to stay for more than 90 days is Spain, you should, by law, become a resident and are no longer entitled to use the UK’s EHIC.

What is is and what is not Covered by the EHIC?

Here is the information that the Europe page gives to healthcare providers:

“A patient in possession of a European Health Insurance Card is entitled to all benefits in kind which ‘become medically necessary during a stay in the territory of another Member State, taking into account the nature of the benefits and the expected length of the stay.’

Therefore, he must be provided all the types of medical care and treatment that the patient’s state of health necessitates to enable him to continue his stay in your country under safe medical conditions. The key is that he should not be obliged to cut short his visit in order to return to his country of residence for treatment.

However, you are not obliged to provide certain kinds of treatment that can wait until the patient has returned home (most types of dental treatment, for example).

The patient might well have problems obtaining reimbursement for treatment that goes beyond what is strictly necessary in the context of a temporary stay.

In addition, some types of treatment extend over a period of time and necessitate follow-up which is not compatible with the temporary duration of the patient’s stay in another country. In these cases, once the patient has received “holding” or primary treatment, generally speaking it is preferable for him to return to his own country of residence and his own doctor for further examinations or certain types of treatment.”

Here is the link to that page:

http://ec.europa.eu/social/main.jsp?catId=857&langId=en&intPageId=1304

Be careful: When you travel in Europe, you are under the law of the land, not the rules of your own country.

It does NOT matter where you COME FROM, but where you ARE. This means that you will be using the healthcare system as any citizen of that country, if they pay 30% of treatment, you do also.

Also remember that the EHIC covers only treatment in public Hospitals, not private ones. So be careful when going to a hospital, be sure that it’s a public one.

Also, it is quite advisable to know what kind of system they have: for example, in France patients pay 30% of medical treatments (with a cap), so anybody using the EHIC would have to.

Here is a country by country guide http://www.nhs.uk/NHSEngland/Healthcareabroad/countryguide/Pages/EEAcountries.aspx

Also, there is an app to download to smartphones http://ec.europa.eu/social/main.jsp?catId=559&langId=en

Be careful, there is also an app done by the UK, but that one does not distinguish between private and public hospitals, that can be a very costly mistake.

Also, remember that the EHIC cannot be used on cruises! they are private. So if go to one, it would be wise to take out private insurance, I had a patient that had a heart attack in a cruise, they saved his life with a drug, but that cost 4000€.

Why does the consulate recommend taking out travel insurance? they recommend this to cover repatriation, and other costs of having to stay in the country during treatment (lodgement, food, etc).

Practical matters:

If you need any services from a GP, you must go to the healthcare centre that corresponds to your address and register in a temporary fashion.

prescriptions: You can either bring your own prescriptions from your doctor (the EU cross-border prescription)

In Spain, you are entitled to the use of the NHS as a Spaniard: this means free, there are no copays. And you are entitled to “normal treatment”: for example, I had a patient that was visiting here while pregnant; she went to the healthcare Centre and got a first consultation, a urinary culture and antibiotics. But she needed a second, follow-up visit, she was denied that. That is WRONG, not only she was entitled to treatment under the EHIC, but, as a pregnant lady she was entitled to free care anyway!

Be careful because many secretaries of hospitals have the wrong information and think that the EHIC covers only “first aid” treatment.

 

Please note: The information provided is based upon our understanding of current legislation. It is not legal advice but is provided freely to enable you to be properly informed. We recommend that if you are considering taking action, you should seek professional advice.

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