The E112 Form: Medical Treatment in Other EU Countries

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The E112 Form: Medical Treatment in Other EU Countries

EU/EEA citizens from one country may obtain medical treatment in another EU/EEA country (or Switzerland) and have their medical costs covered by their country of legal residence. This may be done by obtaining an E112 form.

Coverage

Health treatment will only be paid for if the patient's health care institution covers that particular treatment in the patient's country of residence. For example, spa cures are covered by the health system in some countries but not in others. If the patient comes from a country that does not cover this type of treatment, they may not obtain a spa cure in another country and expect it to be covered.

If an E112 form is obtained before medical treatment is administered in another country, the cost of treatment will be covered at the treating country's coverage rate. If the patient's country of residence pays a larger amount of health coverage costs than the treating country, the patient will be required to pay the difference, and then will be reimbursed that amount by the country of residence. For example, if the patient's treating country covers 70 percent of medical costs, the patient will need to pay the other 30 percent up front. If the same treatment in the patient's country of residence would have cost more than the amount paid on the patient's behalf, the patient may seek reimbursement for the difference.

For non-hospital treatment, pre-authorisation is not required, though costs will only be covered up to the rate covered by the patient's country of residence. If the rate of cover is higher in the country of treatment, the patient will not be paid the difference. Note: As of April 2008, there was no official definition of hospital versus non-hospital treatment, therefore it is highly recommended to seek advice from the patient's health coverage administrator.

Special requirements apply to care sought in Switzerland. It is highly recommended to seek advice from the patient's health plan provider before seeking treatment there.

If the patient's health plan in their country of residence covers additional expenses such as travel to the place of treatment and accommodation for accompanying persons, though the country of treatment does not, the patient should be reimbursed for these expenses. Patients have the same rights to treatment as they would have in the State in which they are insured.

• To find out what costs are reimbursed by each country: Click here

The E112 and Article 49

Instead of the E112 form, it may be possible to apply Article 49 to medical expenses incurred in another EU/EEA country. This requires the patient to pay expenses up front and seek reimbursement from their country of residence. Reimbursement will only be made for treatment the patient would have received in their country of residence, and reimbursement will not be made for the treatment would have cost in the patient's country of residence. It is recommended to inquire with the patient's health system administrator in advance to determine what expenses are covered.

E112

With an E112, treatment costs will be incurred as if the patient is a member of the treating country's health care system.

Using an E112, medical treatment cannot be obtained from private treatment centres- treatment must be obtained from State facilities.

There is no limit to payment amounts when using an E112, even if treatment costs are higher than if the treatment had been obtained in the patient's country of residence.

Article 49

When applying Article 49, the patient is treated as a member of their country of residence and the patient will need to pay costs up front.

Medical treatment can be obtained from State or private treatment centres when applying Article 49.

When applying Article 49, the patient will only be reimbursed what it would have cost to treat them in their country of residence.

Treatment Not Covered by the E112 Form or Article 49

EEA citizens who require unforeseen emergency medical treatment while in another EEA country should present the European Health Insurance Card (EHIC) to the treating doctor or hospital. The EHIC ensures that the cost of treatment will be paid by the holder's country of legal residence (the country to which health care/social security payments are made). When seeking unforeseen, emergency treatment, an E112 is not required.

• For information on the European Health Insurance Card (EHIC): Click here

Eligibility

Any person covered by a social security scheme in a member state of the EEA or Switzerland may obtain care in another EEA country. If seeking care in Switzerland, prior authorisation is always required.

How to Obtain an E112 Form

If there is an unacceptable waiting list for treatment in the country where the patient is insured, the patient may choose to seek care in another EU/EEA country. The insuring institution cannot refuse to cover treatment in another country on the grounds of costs alone.

To obtain an E112 form/receive authorisation for treatment, patients should contact their health insurance institution (for example, in the UK, contact the National Health Service or in France, contact Caisse Primaire d'Assurance Maladie).

• For links to national social security or health service websites in the EU: Click here
• For an example of an E112 form: Click here

Related Information

• For information on health coverage in France, see the INFOrmation Page, French Health Insurance
• For a list of medical terms in English and French, see the French Medical Terminology Glossary
• To find medical practitioners who speak English, see the INFOrmation Page, English-Speaking Doctors