European Health Insurance Card
A foreign health insurance certificate is the better known name for " claim certificates " for the use of services of the German or the Austrian public health insurance abroad. For the area of the EU and the European Economic Area (EEA ), the foreign health certificates have been replaced by the European Health Insurance Card (EHIC ). In certain other states, however, so-called country-specific holidays sickness certificates are further required.
German health insurance
Territoriality
In the German health insurance the territoriality principle, that is, benefits are only for the insured in the scope of the Act provided (§ 16 paragraph 1 item. 1 SGB V). The SGB V provides exceptions to this rule in the context of the so-called " radiation " or " radiation " before. This applies particularly to workers who are delegated from Germany abroad for a limited period of her employment or out - are nominated by their foreign employer to Germany - vice versa. They remain subject to their domestic legislation. However, special rules social security agreements remain unaffected.
Health insurance coverage in countries of the EU and the EEA
From this principle of territoriality departing within the countries of EU and EEA countries on the basis of Regulation 1408 /71. Even in these countries have insured person is entitled to health insurance benefits.
Health insurance coverage in countries with social security agreements
In countries outside the EU and EEA German insured only have a right to performance of the German health insurance if there is a social security agreement with these countries in the field of health insurance. The use of insurance coverage depending on the country requires different holiday health certificates or the European Health Insurance Card ( EHIC).
By December 2013 are in the following states such agreements:
Australia, Bosnia - Herzegovina, Brazil, Chile, China ( Entsendeabkommen ), India ( Entsendeabkommen ), Israel, Japan, Canada / Quebec, Kosovo, Morocco, Macedonia, Montenegro, Serbia, Republic of Korea, Tunisia, Turkey, United States
Cost sharing abroad
The scope of insurance claim abroad is governed by the national law. This may incur a significantly increased compared to the domestic cost sharing. These may include half the cost depending on the country both fixed amounts ( cost-sharing) as well as percentages to above. A private international health insurance is therefore strongly recommended when traveling to countries in the EU, the EEA or with social security agreements.
About the concrete scope of insurance coverage to inform country-specific data sheets for the German joint Health Insurance - International ( DVKA ).
Health insurance coverage in non-EU/EEA without social security agreement
In countries outside the EU and EEA, with which there is no social security agreement, insured only under very strict conditions of § 18 SGB V is entitled to benefits.
Patient repatriation transportation
The repatriation from abroad in the Federal Republic is not in principle be borne by the insurance company ( § 60 para 4 SGB V).
German Liaison Office for Health Insurance - International ( DVKA )
The German joint Health Insurance - International worn by the central associations of the German health insurance companies and established in 1950. She was responsible, among others, the implementation of EU law and the implementation of intergovernmental agreements on social security for the entire statutory health insurance (SHI ), for example, in the cost accounting with domestic and foreign locations.
She was a public corporation, its office was located in Bonn. After the entry into force of the 2007 health reform the tasks now performed by the Statutory Health Insurance Funds Association ( "Department DVKA " ) are.
Austrian health insurance
In countries outside the EU and EEA Austrian insured only have a right to benefits their health insurance if there is a social security agreement with these countries in the field of health insurance. The use of insurance coverage depending on the country requires different holiday health certificates. Exist with the following countries bilateral agreements:
Bosnia - Herzegovina, Montenegro, Serbia, Turkey
On 27 June 2012, the Social Committee of the National Council approved a new agreement with Serbia that is to replace the time between Austria and Yugoslavia completed and so far more pragmatically applied Agreement. No significant changes are planned for content, only in details, for example in relation to data protection and the compulsory insurance for diplomatic personnel, adjustments were made to similar recent agreements with other countries. At the same time, the Committee decided to terminate the agreement with Kosovo on the reuse of the Yugoslav Agreement. Thus, there is currently no social security agreement with Kosovo.
Furthermore, there is also an agreement with Macedonia, but there is valid since January 2013, the European Health Insurance Card, which is why no foreign health certificate is required.
European Health Insurance Card
Since June 1, 2004 in most Member States of the European Union, the European Health Insurance Card ( EHIC) (see photos at the beginning of the article ) is output, it will replace the forms E 111 at a later stage then other forms by the European Health Insurance Card to be replaced, namely
- E110 - for international road transport
- E119 - looking for work
- E128 - for study and for the posting of workers in another country
The EHIC is on the back of the Austrian e -card and can be carried on the back of the German electronic health card or health insurance card. It is valid in all EU Member States, Iceland, Liechtenstein, Norway, Macedonia and Switzerland. Appearance and exact design of the EHIC has laid down in a decision of the EU Administrative Commission, which was published on 27 October 2003 in the Official Journal of the European Union.
Due to the legal construction (and the type and source of financing), the European Health Insurance Card is issued only by statutory health insurance. Private funds do not issue the EHIC.
Also, the Federal Republic of Germany was obliged to implement these new rules as of 1 June 2004. A corresponding map, there were at that date but not yet, but questioned the German health insurance a replacement certificate from. This is valid in all Member States of the Union. The card can now be obtained from almost all cash online if you enter your own membership number and other personal data will be sent to the insured or when replacing the health insurance card. If necessary, continue to find the Provisional Replacement Certificate application.
The smartphone app " European Health Insurance Card" ( iOS, Android, Windows Mobile ) is a guide to using the European Health Insurance Card in the 28 EU Member States plus Iceland, Liechtenstein, Norway, Macedonia and Switzerland. It contains general information on the insurance card, emergency numbers, the covered treatments and costs, the procedures for reimbursement and contact person in the event of loss of the EHIC. The guide is available in 24 languages.
Better protection in the EU and the EEA
In the past, only the initial or emergency treatment could be availed in other EU and EEA countries as the domestic as services. Since June 1, 2004 are entitled to all medically necessary benefits under the legislation of this country specifications.
Since 1 July 2004, the detour via the competent foreign institution before use of medical services is not required. It is sufficient to European health insurance card or a provisional certificate as a certificate entitling them against the practitioner.
Nevertheless it is possible that handlers do not accept the claim certificate or the European Health Insurance Card and immediately issue to be settled private bill, which will be refunded only partially due to excessive charge rates for the own health insurance. In this case, you should alert the clinician to the law, because within the EU has made in cash doctors the right to direct billing. However, many doctors do not know this law. In the case that the foreign panel doctor ( private doctors are not obliged to do ) is not accepted, one should ask this, to deal with its regional health insurance in connection who are informed. If you pay directly, it gets an Austrian contrast, only 80 % of the cost refunded, even if the charged rates are not higher than in Austria.
This problem is largely eliminated by prior completion of a private travel insurance. This should also include the possible repatriation, as this should not be taken over by the German health insurance company. The previous view of the car protection letter may one here but save cost, as is contained in many Schutzbrief products even when traveling without a car of repatriation.