Visiting a doctor abroad is sometimes unavoidable

22.11.2017 11:14|Andrzej Tomasik

The European Health Insurance Card is the base for avoiding huge expenses in case of health problems and the need for medical assistance abroad. However, the EHIC doesn’t guarantee help with treatment costs everywhere and in every case.

Karta EKUZ

Illness always hits us at inappropriate times. Being abroad can accentuate our sickness. Having no chance for a quick visit to our trusted GP, far from home, worried about the illness and weakened by a fever can cause severer symptoms and give additional insecurities.

There is also the possibility that in all of our anxiety, we start thinking about unplanned but necessary costs. The price of a doctor’s visit and medicine in a foreign country may significantly exceed those to which we are used to it. However, in a pessimistic way and in the case of serious ailments, a stay in a hospital should not be excluded.

Emergency phone number 112 in every EU country

When an accident occurs, calling 112 will get us medical assistance. In most European countries operators who receive emergency calls speak English and communicate with, for example, emergency services. But they can also use the caller location system when necessary.

112 calls are free of charge throughout the European Union and can be dialled even if your phone or smartphone is missing its SIM card.

1 more card in your wallet

If you are travelling within the European Union or the European Free Trade Association (Iceland, Liechtenstein, Norway, Switzerland), many worries about the formalities involved in receiving medical assistance can be avoided with the European Health Insurance Card.

An individual and free of charge document issued (in Poland by the National Health Fund) confirms the right to benefit from state medical care. However, since in the EU Member States citizens are granted various medical privileges, the possession and presentation of the EHIC: "... provides patients with access to health care and, sometimes, reimbursement of expenses incurred under the same conditions as apply to nationals of the country you visit," according to the official portal of the European Union.

Money can be recovered

Let's assume that a Pole, covered by an average insurance policy and equipped with an EHIC, became ill while staying in another country. If citizens have free access to health services, the Pole would also not pay for a visit to the doctor. If it would turn out that payment is required, the card would be useful when applying for reimbursement. Compensation is in accordance with the country rules in which the patient has received medical treatment.

How does the procedure for recovering money spent on medical services look in practice? There is at least one information point in each EU country where the applicant will find out how to apply for it. In Poland, such assistance is provided by the National Contact Point (NCP) for Cross-Border Healthcare, which operates at the headquarters of the National Health Fund. And if, for example, a Polish citizen became ill when staying abroad and had to pay for a visit to a doctor and medicine there, then after coming back home to Poland he reports to the NFZ NCP. If he meets all the formalities, he will recover the money, "the Fund will reimburse the amount it would have spent by refunding specific benefits in the country," assures the Ministry of Health at mz.gov.pl. Sometimes the patient will have to cover the difference from his own pocket, if the service for which he paid abroad turns out to be more expensive than the NFZ valuation.

In order to apply for reimbursement of medical expenses at all, you need to take care of the bill with a description issued by the foreign clinic and a proof of payment. The application should be filled in, remembering that it must be within 6 months from the bill’s date of issue. Important requirement: the application together with the rest of the documents will only be considered by the Fund if they are sent by regular mail.

It's not a requirement but choice

The situation is different for people who voluntarily choose to be treated abroad. Someone who simply prefers to take advantage of a specialist's diagnosis or decides to undergo treatment in a foreign medical centre can also count on the reimbursement of incurred costs. However, a referral letter is very important in this case. If the GP issues a document recommending further treatment abroad one can try to seek compensate for the expenses in his/her country. It is not important whether the referral comes from a GP in Poland or whether the referral was made by a doctor in another country. The key to applying for reimbursement is to present such a document to the Fund and, if appropriate, to present the prescriptions, recommendations for purchasing the medical equipment or sanitary transport.

The huge pile of forms to be filled in should not surprise us as the countries spend a lot of money on healthcare. "According to Eurostat data (unfortunately, the latest data is from 2015), Luxembourg spends the most in the EU per capita 5557 EUR. However, if we compare total healthcare expenses to GDP, Germany is at the forefront with a rate of 11% of healthcare expenditure to GDP," states Bartosz Grejner, Conotoxia Analyst. "In case of both lists, the leading positions in Europe are occupied by developed countries, while the eastern EU countries are placed in the tail of both lists. In Poland, in 2015, the state spent an average of 684 EUR per person on health care, almost nine times less than in Luxembourg and six times less than in Germany. Romania, Bulgaria and Latvia spend less than Poland on average, according to Eurostat," adds the Conotoxia analyst.

Without an EHIC, the battle is not completely lost

The European Health Insurance Card eases procedures for registering for a medical visit to a foreign country and recovering fees, but sometimes it is useless. For example, when we receive help in a private hospital.

However, the absence of the card does not rule out access to medical care while travelling abroad, nor cross out the possibility of refunds if, of course, the patient pays basic health insurance in their country of residence.

Once you have returned home and submitted your bills, you can recover some or all of the money you have spent on treatment. Otherwise, if the patient doesn't want to pay in a foreign currency for a medical service, but at the same time cannot delay the treatment, the National Health Fund can be asked to send a proof of health insurance by fax or email. However, this will not work in all countries and not in all cases.

"If you do not have a European Health Insurance Card or cannot use it (e.g. in a private hospital), the medical institution cannot refuse you care. However, you may be asked to make a payment before you get treatment - once you return to your home country you will be able to request a refund," says the official EU portal.

Additional insurance - extra cost but a sense of security

Since the EHIC does not guarantee cost-free access to all types of medical services, other forms of insurance should be considered before travelling abroad. For example, during a short winter holiday, additional ski insurance for skiers may be useful. Many insurance policies cover not only expenses for treatment, but also for rescue services, additional accommodation, and, if necessary, home transport or even equipment damage. The advantage is also that some insurance policies may be valid beyond the countries of the Union and the European Free Trade Association (EFTA) which honour the EHIC.

Tourist insurance for shorter and longer trips are offered by almost all the most popular insurance companies. They are available online 24/7, formalities are completed in a few minutes and the price usually does not exceed several zloty per day. However, without an additional insurance policy and without an EHIC, a few days stay in a foreign hospital may be associated with a huge bill. In some EU countries, even the cardholder will have to pay an additional cost of 10 - 20 EUR per night at hospital.

 


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