European Health Insurance Card: EHIC for digital nomads

Whether on the coast of Portugal, in a country hut in the heart of Italy or in the lively flow of the French capital – as a digital nomad, you follow your urge for freedom. Laptop in hand, mobile Internet in your pocket and the journey can begin!

If it weren’t for the tricky question: How am I actually covered as a digital nomad in another European country if I have statutory insurance in my European home country?

With the EHIC! This is the European Health Insurance Card. Read here what it can do and where it has its limits.

Summary: The EHIC for digital nomads

• helps with acute medical emergencies in other European countries if you still have statutory health insurance in your home country,
• does not replace your private travel insurance,
• does not reimburse any costs that you may incur, such as medical repatriation to your home country or the replacement of lost or stolen property,
• does not cover any costs if you are traveling specifically for the purpose of medical treatment (“medical tourism”),
• does not guarantee free treatment: medical care systems vary from country to country.

Content of this page

EHIC: The European Health Insurance Card

As an EU citizen, your European Health Insurance Card (EHIC) entitles you to basic state healthcare for acute medical needs

• in the EU member states and in
• the three EEA states (Iceland, Liechtenstein, Norway),
• the three agreement states of North Macedonia, Montenegro and Serbia (important: the EHIC only covers emergency benefits here)
• and Switzerland

A quick look at your existing health card from the statutory health insurance scheme will show you whether you already have this type of health card (most current health cards have already been converted to this system). In some countries where the national ID card serves as access tool for public health services (like Estonia) the EHIC needs to be applied for separately. The information on the European Health Insurance Card can be found on the back of your health card: it has a light blue background. If you cannot find the information on the EHIC on your health card, please contact your statutory health insurance provider – they will provide you with such a card free of charge.

What costs are covered by the EHIC European Health Insurance Card?

It is important for digital nomads to understand that although the European Health Insurance Card provides benefits in other European countries, it does not replace private travel insurance. The statutory health insurance fund covers the costs of medically necessary treatment – but only if the symptoms occured during the trip and within countries that are party to the European agreement. This excludes, for example, follow-up care for past surgeries or chronic illnesses.

Treatment costs incurred during a stay outside Europe are also not covered by health insurance (exceptions: see below).

Services that are not covered by the EHIC:

Repatriation, search and rescue costs

Anyone who falls ill or is injured in the country of travel to such an extent that appropriate treatment cannot be provided locally must be transported back to their home country. However, statutory health insurance does not pay for medically necessary repatriation (either within or outside Europe). Even if you have an accident in the mountains or at sea, for example, and have to be searched for and rescued at great expense (e.g. by helicopter), this is not covered by statutory health insurance.

For you, this means that you may be confronted with very high costs.

Private medical treatments

Treatment may only be provided by doctors or in hospitals that belong to the respective statutory health insurance system.

Private medical treatment is excluded. You must therefore make sure that the treatment takes place in public and not in private clinical facilities. We therefore recommend that you check with your own health insurance provider in advance. This is because even public facilities can incur additional costs for optional services that are not covered. A call to your own health insurance company can provide clarity here.

Planned medical treatment

If you specifically decide to undergo treatment abroad, you must clarify this with your health insurance company beforehand. You can ask your health insurance company to confirm on form E112 that it will cover the costs of planned treatment abroad in Europe. For the chronically ill, this also applies if the illness requires special medical monitoring and the use of special techniques or equipment (e.g. dialysis treatments).

The scope of the European Health Insurance Card only covers immediately necessary medical treatment, for example in the event of a broken leg, acutely diseased teeth and similar emergencies. Dental treatment that is not immediately medically necessary will not be reimbursed by the health insurance provider during a stay abroad.

Bills that are incurred abroad due to planned treatments are paid out of your own pocket. By prior arrangement, they can be reimbursed by your domestic health insurance provider. It should be noted that the costs of treatment abroad are only covered to the same extent as the costs that would have been incurred for treatment in your home country.

Caution with dentures: submit a treatment and cost plan

In recent years, it has become common practice to go abroad for planned medical treatment of the teeth. The health insurance funds are quite happy to go along with this because the costs of comparably qualified dentists, for example, in Hungary can be significantly cheaper. However, this must be agreed in advance with the health insurance provider!
For example, if you want to have your teeth straightened abroad, you should have your dentist there draw up a treatment and cost plan according to the standards of your home country. This must be submitted to your home health insurance company for approval in good time BEFORE the treatment.

What if the EHIC is not accepted in other European countries?

Despite the best precautions, it is quite possible that the doctor treating you will not accept your EHIC. But there’s no need to panic: You will receive an invoice and pay in advance. You should keep the invoices and payment receipts (also for prescribed medicines) in a safe place, as you will use these to apply for reimbursement from your health insurance provider at a later date. If anything is unclear, it is always advisable to seek advice from the health insurance provider by telephone. This helps to avoid misunderstandings later on.

Important: The domestic health insurance only covers the costs that would have been reimbursed in the respective country according to the local benefits catalog. It is quite possible that deductibles or co-payments, which are common in the specific country, will have to be paid out of your own pocket. For many countries, you will find an information page on the local particularities of each individual country here at the EU.

In principle, the domestic health insurance fund applies the law of the country of treatment and invoices according to the local rates. In most cases, medical services are covered which a patient from the country of treatment could also make use of. If, for example, dental treatment in the destination country is not included in the benefits catalog of the statutory health insurance, but is included in the benefits catalog in your home country, the domestic health insurance provider automatically applies their law and thus its own rates.

Tip: Before you leave, find out which doctors and clinics in the health insurance system are eligible for treatment via the EHIC. Exclusively private doctors or private clinics are excluded. Pre-departure research will save you having to search if an accident or illness has already occurred and will definitely give you a feeling of prepared security.

Invoices abroad: pay in advance first – but how?

Outpatient treatment abroad (i.e. treatment that does not take place in a hospital but in a doctor’s surgery) must usually be paid for directly by you. You send the invoices you receive to your insurance company. Always make sure that the following points are included on your invoice:

• Name and address of the practitioner
• Name and address of the person being treated
• Diagnosis
• the individual services broken down by treatment details and costs

In the case of inpatient stays and longer-term treatment, it is advisable to obtain a confirmation of cost coverage from the health insurance provider (also for long-term travel health insurance).

Important details on treatment in other European countries through the EHIC

To avoid later confusion and misunderstandings with the health insurance fund, it is advisable to contact them before undergoing extensive treatment.

You should consider the following points before undergoing treatment in another European country:

• The attending physician must be authorized to bill the treatment in the national system of the country of travel. Only then is the doctor who is treating you authorized to bill your home health insurance company.
• Depending on which country you are in, you may have to make co-payments and deductibles. Here you will find information pages for each individual treaty state.
• If you need to see a specialist, it is advisable to consult a general practitioner abroad in advance, who will give you a referral. This should be clarified in advance with the health insurance company.
• Hotels, tour guides or local administrative offices often have information about contract doctors
  (but be careful: a private doctor is often recommended here. You would then have to pay the costs yourself).

As in your home country, costs for treatment abroad that are not medically necessary are not reimbursable. An example of such a non-medically necessary treatment is professional teeth cleaning. You are responsible for these costs abroad.

Countries with social security agreements (beyond the EHIC)

Certain social security agreements have been concluded with other countries outside the EU and EEA. These agreements provide basic health insurance cover for acute emergencies. However, we recommend that you contact your own health insurance provider before traveling to these countries. If necessary, you will receive a so-called certificate of entitlement for these countries from your health insurance company after a brief consultation. This is because in some cases the benefits are reduced or reimbursable to a limited extent (depending on the content of the agreement).

Your statutory health insurance at home can generally be used for emergencies in the following countries:

• Bosnia-Herzegovina
• North Macedonia (EHIC)
• Montenegro (EHIC)
• Serbia (EHIC)
• Israel
• Tunisia
• Morocco and
• Turkey

In countries that have an agreement but do not bill via the EHIC, you must make an advance payment.

Do I still need travel health insurance?

Anything that goes beyond acute medical necessity and treatment in a state hospital is not covered by the insurance card. The EHIC is therefore not a sustainable solution for digital nomads who spend time in different places and also want to take advantage of outpatient treatment or preventive medical check-ups.

If, for example, you are also thinking about your family planning in the context of your independence of location and have the costs of pregnancy and childbirth abroad in mind, you should let us advise you on a suitable solution for long-term travel or international private health insurance. This consultation is free of charge for you.

Christoph Huebner, specialist broker for digital nomads

In addition, statutory health insurance only covers those benefits that are mandatory in the country you are traveling to. Additional payments may therefore have to be made. In addition to the European Health Insurance Card, it is possible to take out (long-term) travel health insurance for nomads that includes these additional benefits:

• Medical repatriation (e.g. via special aircraft)
• Rescue and recovery costs (e.g. for glacier hikes or at sea)
• Outpatient medical treatment
• Access to private doctors and clinics
• depending on the provider:
  • Preventive medical check-ups
  • Telemedicine (medical consultation via video call)
  • Costs for pregnancy and childbirth
  • Treatment by alternative practitioners, osteopaths and chiropractors

Conclusion: Is the EHIC sufficient for digital nomads?

Yes, at least for “winter nomads” who

• only travel within Europe and
• remain registered in their home country and continue to pay their taxes and social security contributions there.

If you deregister at home in order to travel permanently, you will also lose the protection of your statutory health insurance (even if the EHIC may have a different “validity date”). And if you want to travel the world and spend your winters outside Europe in Mexico, Brazil, Thailand or Bali, you will need international health insurance beyond the EHIC anyway.

FAQ: Frequently asked questions about the EHIC

Christoph Huebner Chief Nomad

Christoph, an entrepreneurial spirit and avid traveler, has been a leading insurance industry expert since 2010. Founding a remote insurance brokerage, he turned into a perpetual traveler by 2017. Today, he's a top authority in global health insurance for digital nomads.

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