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The European Health Insurance Card (EHIC) or Provisional Replacement Certificate (PRC) entitles you to all benefits in kind which are medically necessary during a temporary stay in another EU country, taking the length of your stay into account. Medical benefits are not only necessary in another EU country after an accident or where illnesses occur suddenly. You also need to receive suitable medical care for pre-existing conditions during a stay in another EU country. This is the case for instance if your condition requires you to take certain medicines.
Since the EHIC or PRC affords you the same status as if you had health insurance within the healthcare system of the State of stay, you need to adhere to the procedures provided for there. This means as a rule that you first need to consult a healthcare provider who is approved for the treatment of persons insured there, who will examine you and prescribe the appropriate medicine. This is contingent on the medicine which you need being approved in that country at all and that it can be provided at the expense of the healthcare insurer there. Should you have any questions regarding this topic, please feel free to contact the National Contact Point of the country in question or us.
Vital medical treatment can as a rule only be provided in specialised medical facilities. The following, among others, are regarded as vital medical treatment:
The local availability of such treatment is particularly important. Please therefore contact the appropriate healthcare provider in advance. Ascertain from the provider whether sufficient capacities are available for your treatment during your intended stay and what the arrangements are for claiming them there via the EHIC.
If the law of the State of stay provides for co-payments to be paid when medicines are dispensed, these arrangements also apply to you. You will find information on co-payment arrangements in other Member States in the Holiday information leaflets of the German Liaison Agency Health Insurance – International.
The co-payments which were made in another EU country can only be considered in the assessment of whether you can be exempt from co-payments because they are in excess of the annual burden limit if they would also have been incurred had the treatment been provided in Germany. They are also only taken into account up to the amount provided for under German legislation.
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