From the history of how the European Union made it possible for different EU citizens to access healthcare systems in other EU countries to how long your European Health Insurance Card is valid after moving to Germany, we go through it all below!
Each country in the European Economic Area has its own social security system which includes things like pension contributions, health insurance, and other benefits. When looking at the overall systems of each of the countries, things get to be quite complicated.
The European Health Insurance Card or in short EHIC was established by regulation 883/2004 on the 1st of June 2004 until 31 December 2005 when on the 1st of January 2006, it was implemented and accepted by 30 countries.
Countries that have implemented the European Health Insurance Card
- 🇦🇹 Austria
- 🇧🇪 Belgium
- 🇨🇾 Cyprus
- 🇨🇿 Czech Republic
- 🇩🇰 Denmark
- 🇪🇪 Estonia
- 🇫🇮 Finland
- 🇫🇷 France
- 🇩🇪 Germany
- 🇬🇷 Greece
- 🇭🇺 Hungary
- 🇮🇸 Iceland
- 🇮🇪 Ireland
- 🇮🇹 Italy
- 🇱🇻 Latvia
- 🇱🇮 Liechtenstein
- 🇱🇹 Lithuania
- 🇱🇺 Luxembourg
- 🇲🇹 Malta
- 🇳🇱 The Netherlands
- 🇳🇴 Norway
- 🇵🇱 Poland
- 🇵🇹 Portugal
- 🇷🇴 Romania
- 🇸🇰 Slovakia
- 🇸🇮 Slovenia
- 🇪🇸 Spain
- 🇸🇪 Sweden
- 🇨🇭 Switzerland
- 🇬🇧 United Kingdom*
* As of the 1st of January 2021, only those covered by the Withdrawal Agreement continue to have coverage
Instead of creating a universal system for each participating country to adapt to, the goal was to coordinate the systems. What this means is that each system will cover the people dependent on them (this includes both EU and non-EU citizens given that they are covered under the public insurance system in an EU country).
These coordination rules were also modernized in 2010 under regulation 987/2009 which have since simplified the process between countries and make sure that those moving within the EU face no disadvantages in terms of social security rights when doing so.
Because social security is a basic human right included in articles 22 to 27 in the International Human Rights Law. Because of that, Germany has worked to create social security agreements with several countries.
Additional countries that have social security agreements with Germany
- 🇧🇦 Bosnia and Herzegovina
- 🇮🇱 Israel
- 🇲🇪 Montenegro
- 🇲🇰 North Macedonia
- 🇷🇸 Serbia
- 🇹🇷 Turkey
- 🇹🇳 Tunisia
The European Health Insurance Card
From these coordination rules, the European Union established the European Health Insurance Card (EHIC).
To apply for this card, people insured under public insurance systems in one of the countries listed above can contact their insurance provider.
Please note: if you are a non-EU citizen and have the EHIC, you are not covered in Iceland, Denmark, Liechtenstein, Norway, or Switzerland.
You can use the card when you’re residing in another country in the list above, but please also note this is not travel insurance, so it won’t cover costs such as a return flight home or stolen property.
Instead, the card covers what would normally be covered by the insurance provider who issued it like treating chronic or existing illnesses, pregnancy, and childbirth among other benefits. You can see a detailed list of the coverage by country here. The EHIC provides coverage from the country in which you obtained the card, so if your card was issued in Spain under the public insurance system, and you are in Germany, you would need to look at the guide for Spain and not Germany.
If you plan on moving long-term to another EU country and not working, you will need to register your insurance with the S1 form that you’ll need to request from your current health insurance provider.
Depending on your circumstances as well, you may need to apply for health insurance in your new country of residence. This generally happens when moving to another country with the intention of working.
Still, these regulations differ so greatly that we cannot make a general recommendation. Instead, you should look at the European Commission’s website to learn more about each country and its regulations.
The EHIC for students
Non-working students are generally able to use their EHIC after filing the S1 form for longer residencies abroad without a problem. There are, however, a few things to keep in mind that might impact your coverage in your new country.
Some countries will only cover students for a limited period of time when they’re abroad. You should contact your insurance provider for the S1 form and the EHIC and ask them if there are any time limits when changing your residency to another country on the list above. For older students (starting at around 28), this is almost always the case.
Ph.D. students can also run into problems as some countries consider them resident workers regardless of pay. This means they might need to get either public or private insurance when moving abroad. This information can be found through contacting the university they will be completing their Ph.D. at.
It’s also important to still file the S1 form which you will receive and submit to your current insurance provider connected with your EHIC. If your current insurance card is not also automatically an EHIC, you will also need to apply for the EHIC before leaving, so there is no lapse in coverage.
If a student begins working in the new country of residence, they will almost certainly be required to register for that country’s public health insurance. Because the system is not only dependent on which country you are from, but also which insurance you hold in that country along with your reasons for being in Germany, we cannot confidently make a good recommendation for you. Instead, we highly recommend speaking with your insurance before coming to Germany to make sure there is no accidental lapse in coverage.
Health insurance abroad after 55 is incredibly tricky, so having the EHIC to fall back on has major benefits. However, as always, there are some things you need to watch out for.
If you are receiving a pension from the country you live in, that country is responsible for your health insurance regardless of pensions received from other countries on the list above.
If you’re not receiving a pension or income from the country you currently live in, you can receive the medical treatment that would be covered in the country where you are drawing your pension from. So, for example, if you worked in Italy for several years, but are originally from France, and then moved to Italy to retire, you would receive the Italian pension and receive Italian healthcare, excluding you from the French system.
Generally, you are only able to seek medical treatment in the country in which you live, but if your pension is from one of the following countries, you are entitled to medical treatment in that country and the country in which you are currently residing:
Countries which allow you to get treatment when living abroad while receiving a pension
🇨🇿 Czech Republic
🇳🇱 The Netherlands
If your country where you have your pension is not listed above, you are only entitled to seek medical treatment in the country in which you currently live.
So, it really depends on your situation
Depending on your situation, country of origin, countries in which you worked and the current country in which you reside, your health insurance coverage might change even with the EHIC.
Because of how complex the system is, we recommend speaking with your current insurance provider to understand all of the specifics of your insurance in another country.
Want to learn more about life in Germany? Check out the other articles on our blog!