Emergency healthcare abroad with the EHIC

Regulations (EC) 883/2004 and 987/2009 onSocial Security Coordination – European Health Insurance Card

Under the Regulations on the coordination of social security systems, the right to unpostponable healthcare in other EEA countries is granted to all European citizens with valid health insurance upon presentation of their European Health Insurance Card (EHIC). 

According to the yearly reports of the European Commission, the number of EHIC in circulation varies vastly across countries, as the issuing process and period of validity is subject to national determination. In Germany, for example, the EHIC is automatically printed on the back of the regular health insurance card; in Bulgaria, by contrast, not only is the card separate and issued only on request and after a two-week waiting period but is also valid for just one year at a time. The period of validity can range from just months to ten years or unlimited, and the issue rates – from 100% in countries which provide them automatically to a meagre 4-5% in countries with little awareness about the offer and a complicated issuing procedure (European Commission, 2018). 

The EHIC grants its holder “access to medically necessary, state-provided healthcare during a temporary stay”, meaning access to any medical treatment abroad that cannot be safely postponed until the patient’s planned return to their home country. This includes, but is not limited to: emergency care, including overnight hospitalization; check-ups and therapy for unhealed injuries; medical examinations and care for pain-inducing conditions (e.g. severe headaches, sprained joints, painful rashes etc.) and routine care for chronic illnesses and during pregnancy. 

The treatment is not covered by the EHIC if it is planned, meaning if the patient has travelled to the country of treatment specifically for the purpose of receiving this treatment. If, on the other hand, the treatment is part of routine care for someone suffering from long-lasting conditions which can not be put “on hold” during travels abroad or if the treatment has become necessary while abroad, it is covered. 

If the patient has sustained an injury and begun treatment in one member state, but then has travelled to another for a purpose unrelated to the treatment (e.g. as the next leg of a multi-country journey, visiting friends, pre-planned vacation etc), the treatment can be continued with the EHIC. In such cases the patient is not required to return to their home country at the first opportunity to receive treatment there – this would, in fact, be a breach of the principle of free movement within the EU – which the provisions of the Regulations and of the EHIC aim to protect. 

It is possible that the staff in the country where you need to access medical care, aren’t aware of your rights under under Regulations (EC) No 883/2004 and 987/2009 of the European Parliament and of the Council of 29 April 2004 on the coordination of social security systems. If this is the case, you can prepare a simple declaration in English and the local language, explaining that you did not travel with the purpose to access treatment and would like to make use of your rights.

You can find more information on this subject and also on routine or planned healthcare at