European Health Insurance Card (EHIC)

Launched in June 2004, the EHIC or "Health Card" enables holders to access medical resources when travelling outside of their EU country of residence...

European residents who are covered by a social security scheme in their country of residence are entitled to a European Health Insurance Card (EHIC). The card simplifies the procedure when receiving unforeseen medical assistance during their visit to a member state. It should be carried when travelling within the European Economic Area, (i.e. the European Union, Norway, Iceland and Liechtenstein) and Switzerland. Each person travelling should have their own card.

The EHIC entitles the holder to the same treatment at the same cost as a national of that country. For example, if medical care is provided free of charge in the member state where treatment is required, the claimant will be entitled to free medical care on presentation of the card or an equivalent document.

Presentation of the EHIC guarantees reimbursement of the medical costs on the spot, or soon after returning home.

The card is only valid for state provided services and not private hospitals or treatments.

It is suggested to verify with the social security administration in the country of residence prior to travel.

Note: Third-country nationals (from outside the EU/EEA) resident in the EU and holding an EHIC cannot use their EHIC in Norway, Liechtenstein or Switzerland. In Iceland, non EU/EEA nationals are only covered for emergency treatment. Holders of an EHIC in Denmark will only be eligible for free treatment in a public hospital in the event of:

  • a sudden illness
  • an unexpected aggravation of a chronic condition
  • an emergency
  • childbirth
The Card

The only personal information on the EHIC is the card holder's surname and first name, personal identification number and date of birth. The card does not contain medical data. It contains the same information in all countries where it is issued.

The card validity period varies from country to country.

Replacement of E Forms

The European Health Insurance Card replaces forms previously used within the EU:

  • E111 and E111B used by tourists
  • E110 used by international road transporters
  • E128 used by students and people working in a Member State other than their own
  • E119 used by people registered as unemployed and seeking work in another Member State

Note: The forms E111 (and others) have not been valid since 31 December 2005.

The EHIC in Spain

The EHIC is called a Tarjeta Sanitaria Europea (TSE) in Spain. It allows legal residents of Spain to benefit from emergency medical treatment and care when temporarily in a member country.

Anyone covered by the Spanish social security system or a system is entitled to a TSE

Residents of Spain can apply to the local Social Security Service and Information Centre (CAISS) for the card.

Note: The TSE cannot be used in Spain to make medical claims. The EHIC (TSE) is for use when visiting a member state other than the country of residence where the card has been issued. That means a resident of Spain with a TSE may use it while travelling in other EU/EEA countries.

Foreign nationals permanently resident of Spain paying into the Spanish social security system must obtain their EHIC (TSE) in Spain; the card will not be issued by the applicant's country of origin.

EU citizens receiving pensions from their home country

As of 1 May 2010, the responsibility of issuing the EHIC is no longer with a person's state of residence, but with the state where a person is paying to or benefiting from the Social Security System. This affects people receiving pensions from their EU home country rather than their country of residency. A resident of Spain, receiving pension in for example the UK, should now apply for the EHIC card in UK.

Non-residents Claiming in Spain

Doctors and Dentists: Present the EHIC card immediately and ensure that the doctor is not a private physician, there is no refund system for private treatment unless there is a private insurance policy in effect. Dentistry is not usually covered by the health service and as such fees will not be refunded.

Prescriptions: State (EEA) pensioners (with proof of status) are eligible for free prescriptions, all other cases must pay up to 40 percent of the total cost.

Hospital Treatment: Confirm that the treating hospital is not private; otherwise the patient is liable for the entire treatment cost. Present the EHIC upon arrival.

EHIC Smartphone App

The European Commission (Directorate General Employment, Social Affairs and Inclusion) has developed a useful multi-language smartphone application which gives details of how to use the EHIC card in different countries within the EU. It summarises the treatments, costs, procedure for reimbursement and emergency numbers.

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