The EHIC (European Health Insurance Card), or Carte Européenne d’Assurance Maladie (CEAM) as it’s known in France, provides access to medical treatment for EU citizens travelling within the EU and it’s available to all those registered in France’s healthcare system. Here’s what you need to know about the European Health Insurance Card.
European Health Insurance Card/CEAM: What Does It Cover?
Your EHIC/CEAM covers any necessary medical treatment due either to an accident or an illness while you are travelling in the European Economic Area (the EU, along with Switzerland, Norway, Liechtenstein, and Iceland). The card entitles the holder to state-provided medical treatment within the country they are visiting and the service provided will be the same as received by a person covered by the country’s ‘insured’ medical scheme.
The EHIC can also be used to receive treatment for pre-existing illness, chronic diseases and routine maternity care, but conditions do apply and the EHIC certainly does not cover persons who are visiting a country with the main intention of receiving medical treatment.
The EHIC entitles a visitor to ‘necessary’ healthcare but not necessarily the total cost of care. It is not the intention, for example, of the EHIC to provide treatment that could wait until a person returned home (most types of dental treatment, for example) nor to cover treatment that, when taking a trip or holiday, requires specialist medical surveillance, and in particular the employment of special techniques or equipment. However, in such cases (a dialysis for example), we are aware of instances where, if a an EHIC holder visits their local UK dialysis unit, then that unit should be able to make arrangements for the EHIC holder to receive treatment in a similar unit in France. Should that EHIC holder discover that their dialysis unit is unable to help, or, even worse, on arrival, that such arrangements have not been made, then they can attempt to contact the local doctor in their locality in France and request that they make such arrangements.
Entitlement in France under the French State medical insurance system differs widely from that in other EEA countries. All reimbursements are based on the ‘official price list’ called the tarif de convention. It should be pointed out that medical practitioners are permitted to charge more than the tarif de convention. This, the depassement as it is known, is paid by the patient, and the gap between the cost and reimbursement is substantial and in some cases can be serious. Thus, it is important to ensure that any treatment or advice you receive falls under the tarif de convention.
What treatment is covered and what will I be charged for?
Doctors, dentists and prescriptions
Make sure the doctor or dentist you consult is ‘conventionné’ – i.e. they work within the French health system and under the tarif de convention. After treatment, obtain a signed statement of the treatment given (a feuille de soins) – you cannot claim a refund without it. You will be charged for the treatment you receive, as well as for any prescribed medicines, and the amount(s) should be shown on the feuille de soins.
Around 70% of standard doctor and dentist fees are refunded and 35% – 65% of the cost of most prescribed medicines. The cost of common remedies and items such as bandages are refunded at the lower rate. Make sure you keep your receipts. The cost of medicines marked with a ‘vignette’ or NR’ is not recoverable.
You must pay for out-patient treatment and then claim a partial refund from the local Caisse Primaire d’Assurance-Maladie or CPAM, while you are still in France. To do this, take your claim to the local office. They will take your details and you will hand over the claim with your receipts. When you are back in the UK, you will receive an itemised list of your claim. Once agreed, a bank order will be posted to you. This can all take a couple of months.
If you are treated as an in-patient in an approved hospital and show your EHIC, the office will pay 75 per cent or more of the cost direct to the hospital. You pay the balance. You must also pay a fixed daily hospital charge (forfait journalier). The 25% balance and the forfait journalier are non-refundable.
French Residents: Applying for Your European Health Insurance Card
If you are resident in France and are registered in the French healthcare system, you are entitled to an EHIC/CEAM. However, it will not be issued to you automatically – you must apply for it online at Ameli.fr (sign into your account and you’ll find the application form under ‘Mes démarches). Cards can take around 30 days to be sent out to you, so it’s advisable to request yours within plenty of time for your trip.
Each member of the family must have their own EHIC/CEAM – parents must apply on behalf of children under 16. The EHIC is normally valid for three to five years.
UK Residents Post-Brexit: EHIC or GHIC?
Post-Brexit, UK citizens will no longer be entitled to an EHIC. Instead, they will be able to apply for a GHIC or UK Global Health Insurance Card (you can apply online through the NHS website). This card allows the same rights to essential or emergency healthcare while travelling in the EU as before. However, the GHIC is limited to the EU—it does not provide cover for countries in the European Economic Area (EEA), i.e. Switzerland, Norway, Liechtenstein, or Iceland.
Do you need to apply for an EHIC?
If you are a UK citizen who currently holds a UK-issued EHIC you can use this card up until its expiry date, and it will cover you under the same conditions as a GHIC. If you don’t yet have a card or your EHIC has expired, you will need to apply for a GHIC.
You can apply for your GHIC online.
British pensioners in France
One exception to the above rule is for British pensioners resident in France. Under the Brexit Withdrawal Agreement, pensioners resident in France prior to December 31, 2020, with a registered S1, E121, E106 or E109 form issued by the UK, will continue to be granted access to the French healthcare system as before. However, being as their healthcare is still funded by the UK, they will not be entitled to a France-issued EHIC/CEAM. Instead, pensioners can apply for a special UK-issued EHIC.
Unlike the GHIC, this card provides cover within the whole European Economic Zone, providing pensioners in France with the same rights as those of French citizens when travelling in the EU.
If you are a pensioner in France and hold an EHIC issued prior to December 31, 2020, you must change this for a new EHIC card through the NHS. Similarly, if you don’t yet have an EHIC, you should apply for one through the NHS. This can be done online here.
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