The European health insurance card (EHIC) is located on the back of the e-card, the health insurance card of the Austrian social insurance institutions. With this card, you can be treated by doctors and in hospitals if you fall ill while on holiday. However, this does not apply in all countries.

According to the Austrian Health Insurance Fund, the EHIC is valid in the following countries: "It is valid in the EU/EEA countries, Bosnia and Herzegovina, North Macedonia, Montenegro, Serbia, Switzerland and the United Kingdom". In most countries you can show the card directly to the doctor or in the hospital and you may have to fill out an additional form that the practitioner fills out for the billing, which he uses for the patient via the local health insurance company, which then settles accounts with the ÖGK, for example .

However, there are also three special cases: “In Bosnia and Herzegovina, Montenegro and Serbia, the EHIC or the PEB must be submitted to the responsible health insurance provider. This will issue a treatment certificate that is customary for the area,” according to the ÖGK. In concrete terms, this means that in the three states mentioned, you first have to show your e-card to a local health insurance office. They will then issue you with a “medical certificate”. With this you can then get medical help in surgeries and hospitals.

Foreign health certificate required for Turkey

Due to contracts, the e-card is also valid in Turkey, but you need an additional certificate from the Austrian social security agency. “In Turkey, the holiday sickness certificate (foreign care certificate) from the responsible health insurance provider must be used. This is to be issued by the employer and provided with the data of the insured person or the relatives, the period of the certificate as well as the date, company stamp and signature,” according to the ÖGK. Persons who do not have an employer, for example because they are on maternity leave, can apply for this certificate directly from the Austrian Health Insurance Fund. This can be done in person in the office or online. For the latter you need the so-called mobile phone signature.

There is also another special case that requires active action before the start of the holiday. If there are just a lot of asterisks on the back of the e-card instead of the EHIC data, then you do not have a valid European health insurance card. In contrast to surgeries and hospitals at home, practitioners abroad cannot read the chip. Therefore, they are dependent on the printed data. The Austrian health insurance company explains what you have to do in such a case before you go on vacation: “If insured persons or relatives who are entitled to claim do not have a valid EHIC or have lost it, the responsible Austrian health insurance provider can issue a replacement certificate. This is considered a provisional replacement for the EHIC (PEB for short). This replacement form is then completely equivalent.

Outside the EHIC countries, there is an obligation to pay in advance

People who go on holiday outside of the EHIC contracting states should note that the e-card is simply not valid. You have insurance cover in emergencies, but you have to pay in advance. In concrete terms, this means that you first have to pay the doctor's fee or the hospital bill on the spot out of your own pocket. You can then submit this in Austria, but you only get back 80 percent of the rate that an Austrian doctor would have received for the same treatment. In the United States in particular, medical services can quickly become expensive.

“In all other countries (Egypt, Tunisia, etc.) you have to pay for medical treatment and medication yourself in advance. Therefore, an invoice that is as detailed as possible about the type, scope, duration and date of the treatment should be available in order to facilitate the reimbursement of costs," says the ÖGK, which also recommends the following: "Take out private travel health insurance before your trip to protect yourself against high costs to be protected by deductibles. Make sure that the travel health insurance also includes medical repatriation from abroad”.

Furthermore, it should be pointed out that there are enormous differences in the billing for private travel insurance with international health insurance. Many insurance companies require that the invoices are first advanced and then first submitted to the social security system in Austria. The certificate that you then get from the ÖGK, for example, must then be submitted to the private insurance company together with a copy of the invoice. This then replaces the rest. It should also be noted that there are different reporting deadlines depending on the insurer. Some prescribe that a damage report, for example by telephone, must be made before the service can be used. In cases where you are not able to do this at all, for example because you were taken to the hospital unconscious by the ambulance, this must be done at the earliest possible time.

There are also private health insurance companies that offer direct billing, at least in the area of ​​treatment in hospitals. Therefore, if possible in the situation, you should contact the respective emergency hotline of the respective insurance company by telephone. This can then provide information about where the nearest treatment facility with direct billing option is located and also explain to the vacationer what you have to show and say to the hospital so that you don't have to pay in advance yourself. This can be extremely important, especially in the United States, where you are protected from outrageous bail and medical bills.

No planned treatments abroad without prior approval

Important: Regardless of whether you can use the e-card abroad or use private insurance. The insurance cover only exists in the case of acute emergencies, injuries or unexpected illnesses. If you only travel abroad for the purpose of treating an existing illness, you need prior approval from the social security agency. In the case of private insurance, the cover protection can even be omitted completely. If you don't comply, you may be confronted with a refund.