Urgent and unplanned treatment abroad
The European Health Insurance Card (EHIC) is used in all cases of temporary stay abroad during which you need medical services.
The purpose of a temporary stay abroad can be:
- tourism,
- professional activity or
- study.
Before going abroad, order an EHIC. If you must travel urgently and therefore need an EHIC immediately, you can apply for provisional replacement certificate (PRC) at the regional unit or offices of ZZZS. You can also order the PRC via an online order of EHIC.
EHIC cannot be used for planned treatment abroad, i.e. when the purpose of the stay abroad is solely to obtain healthcare.
EHIC is valid in:
- EU member states (EU regulations also apply to the French territories of Guadeloupe, Martinique, Reunion, French Guiana, Saint Bartholomew, Saint Martin and Mayotte and the Portuguese territories of the Azores and Madeira; Denmark - the regulations also apply to Greenland; Spain - the regulations also apply to African cities Ceuta and Melilla and for Majorca and the Canary Islands), Iceland, Liechtenstein, Norway (with the exception of Spitzbergen and Bear Island) and Switzerland,
- United Kingdom,
- Australia,
- Bosnia and Herzegovina,
- Montenegro,
- North Macedonia and
- Serbia.
For all other countries of the world, EHIC, PRC or any other certificate issued by ZZZS is not valid.
How to use EHIC:
- EU member states, Iceland, Liechtenstein, Norway, Switzerland, United Kingdom:
In these countries, you can claim urgent and necessary medical services with EHIC or PRC, directly from doctors and medical institutions that are part of the public, national health network.
On the website of the European Commission, you can find more information about the use of EHIC in other countries.
- countries with which Slovenia has concluded an international agreement on social insurance:
In Australia, you can claim emergency treatment directly from doctors and medical institutions that are part of the public, national health network. You must present your passport in addition to your EHIC or PRC. If you had to pay for medical services yourself in Australia, you must submit a claim for reimbursement directly to the Australian competent authority (Medicare offices) in the place of temporary stay. ZZZS cannot reimburse these costs.
In Bosnia and Herzegovina, Montenegro and Serbia, you can claim emergency treatment with EHIC or PRC and the corresponding accompanying letter with a printout of personal data. It is necessary to report to the health insurance office in the place of temporary stay abroad, but in emergency cases you can report directly to doctors and medical institutions that are part of the public, national health network.
In North Macedonia, you can claim emergency treatment with EHIC or PRC, directly from doctors and medical institutions that are part of the public, state health network. In addition to the EHIC, you must also attach a cover letter with a printout of your personal data.
Emergency treatment means all those medical services that cannot be postponed without endangering the life or health of a person.
- other countries of the world:
In other countries of the world, EHIC is not valid, you have to cover the costs of medical treatment yourself. Based on submitted documentation, in justified cases, ZZZS will reimburse you for the costs of emergency treatment in the amount of average price of such treatment in Slovenia.
Reimbursement of costs
If you had to pay for medical treatment during temporary stay abroad, you can apply for reimbursement of these costs.
Fill out the application for reimbursement of costs of treatment abroad (medical services during residence abroad) with the following data:
- personal data,
- information on your bank account, to which the funds shall be transferred,
- data on the representative or proxy holder, if any,
- data on the medical treatment you received abroad.
Submit the following with the application:
- invoice and proof of payment,
- medical records,
- other (eg: prescriptions for medicines, order form for a medical device, order for ambulance transport).
Possible ways of submitting the application:
- via an online form (you do not need a digital certificate for electronic signing to submit)
- by mail or
- by email or
- in person to regional units or offices of the ZZZS.
ZZZS will reimburse you (in justified cases):
- in the amount that would be recognized by a foreign insurance company for medical treatment provided in EU member states, Iceland, Liechtenstein, Norway, the United Kingdom, Switzerland or in countries with which Slovenia has an international agreement on social insurance (Bosnia and Herzegovina, Montenegro, North Macedonia, Serbia),
- in the amount of the average price of such a treatment in Slovenia, but not more than the actual costs for emergency treatment provided in other countries of the world.
ZZZS does not reimburse costs of medical treatment provided in Australia. Before returning to your home country, you must claim reimbursement in Australia at the nearest Medicare office, where you present your EHIC, passport and original invoice. Medicare offices are in all major cities and shopping centres.