Reimbursement based on the rates of the country where health care was provided in case of necessary health care (Regulation (EC) No 883/2004)
Last updated: 15.12.20
Only possible in case of necessary health care during a temporary stay in another member state i.e. in a situation where the necessity arose while already being in another member state. The decision about the necessity of the service is made by the doctor in the other member state, considering the medical justification, presumable duration of the stay and the nature of the health service. Reimbursement might be necessary for example in case you have forgotten your European Health Insurance Card.
Reimbursement under this provision is not possible if the purpose of the stay was to receive health care.
The right for reimbursement only covers medical institutions of the public health care system.
The EHIF sends an enquiry to the member state where you were treated and based on the reply, transfers the reimbursable amount to your bank account.
The decision on reimbursement is made by the member state where you were treated and it is based on their legislation. The reimbursement is calculated on the basis of that member state’s tariffs.
Since the request for reimbursement rates is sent to another member state, the processing of your claim might take at least 6 months.
