Your passport to a less expensive holiday....
The one thing guaranteed to spoil even the holiday of a lifetime is falling ill. Whether you come down with a dose of Spanish tummy, or ski into the trees rather than down the slope, the last thing you need to worry about is the cost of your treatment.
Tourists are constantly advised to take out insurance in case they find themselves in need of medical treatment abroad, as even basic costs of treatment can amount to a substantial sum, especially if any form of surgery is required.
Travelling to Europe has become the norm for Irish holiday-makers. Travel agencies continue to report an upturn in visits to the continent, with weekend city breaks a particularly popular option. Vacationing in Europe, with its diversity of culture and climate, has obvious appeal, especially when the cost of travelling is compared to that of visiting more far-flung destinations.
For Irish citizens, however, travelling to Europe has even greater appeal than simply its proximity. As citizens of the EU, we are entitled to basic urgent healthcare in all other EU states. In fact, this entitlement even applies to certain other countries that are not EU members, such as Iceland, Norway and Liechtenstein.
The system is known as E111, after the European regulation which governs it and it is administered by way of the E111 form, a two page certificate that you fill in before embarking on your holiday. The scheme works by exempting you from any medical expenses you incur while abroad.
The foreign health service then uses the details from your E111 form to reclaim these expenses from the Irish Department of Health. Similarly, EU nationals who require treatment while in Ireland can present their E111 forms and be excused payment here on the same basis.
The E111 scheme is not the equivalent of private health or travel insurance, however. It is only intended to ensure that EU citizens can receive emergency treatment while in any other EU country. Each country interprets the meaning of this slightly differently, since many of their health systems function in different ways.
In certain cases, treatment which is free in Ireland will come at a nominal cost in other EU states. You are only entitled to what the citizens of that country would receive under their state health system. Generally, standards of medical practice are extremely high throughout the EU.
Another pitfall is that you may find that the treatment you need is only available from a private hospital. In this case, you (or your travel insurance) will need to pay, but you will be reimbursed by the Department of Health when you return to Ireland.
So how does it work? Well, before travelling, it is essential to obtain and fill out an E111 form. These can be obtained from your local health centre, or by writing or telephoning your local health board. The health boards in the Eastern Region have a freephone customer service telephone number (1800 520520) and the numbers for the other boards are listed below:
- Midland Health Board - 0506 21868
- Mid-Western Health Board - 061 483287
- North Eastern Health Board - 046 40341
- North Western Health Board - 072 20400
- South Eastern Health Board - 056 20400
- Southern Health Board - 1850 742000
- Western Health Board - 091 751131
The form will ask for your name and those of any of your family who may be travelling with you. It also requires you to fill in your PPS number, which used to be known as your PRSI number. The form then has to be signed and stamped by the health board or local health centre.
It is only when the form is stamped that it can be used to obtain healthcare in Europe. The health board stamp confirms for foreign health services that you are entitled to free emergency health care from that board. They will then provide you with treatment and bill your local health board at a later date.
Members of your immediate family can also receive cover under your E111 form. Equally, assuming they are Irish citizens over 16, they can get their own E111 form. However, it is practical for a family travelling abroad to bring one form only which includes all of their names.
For the purposes of E111, your family can include your partner, and your children (under the age of 16) if any of them are travelling to Europe with you. However, if for example the husband's parents are travelling, they will need their own E111 form.
If any of your family are not EU citizens, they can only get the free emergency treatment that you would receive if they are named on your E111 form and are travelling with you.
So what are you covered for? Well, the E111 system is designed to ensure that people get treated in cases of medical emergency. That does not mean that you have to be on death's door to receive treatment, but your condition must be urgent. If you could reasonably be expected to wait until you returned home, you may find that the E111 will not cover that particular medical expense.
You are allowed under EU law to travel from state to state in possession of medicines that have been prescribed for you, even if those medicines are not licensed or not available in the countries which you are visiting. Make sure, however, that you do not bring significantly more pills than you need.
If you need to get a regular prescription renewed while abroad, you can attend a dispensing chemist or a doctor who can prescribe the drugs for you directly. You will need to present your E111 form and they should take a copy of it. Make sure you get it returned to you - you may need it again!
If you are treated by a public hospital or public health centre, simply present the E111 form on arrival. They should recognise it - even if it is in a different language. You will not be charged for such treatment. Treatment in a private clinic/hospital is not covered under an E111 form. The E111 is strictly a public form. Payment to a private clinic or hospital and producing a receipt does not entitle the holder of an E111 form to a refund.
If you are unfortunate enough to find yourself in a serious medical situation, then medical costs can quickly mount up, making them impossible to pay out of your holiday spending money. The best thing to do in such circumstances is to contact your local Irish embassy or consulate and let them know about what's happening. They will advise you on whether you need to contact your travel insurance company or not.
Just as each country has its own customs and idiosyncrasies, their health services all function differently as well. If you are unlucky enough to need to use your E111, try to take account of the fact that you are abroad and the system for processing patients is likely to be very different to Ireland. Be patient and explain your problem to someone who speaks English. Most EU citizens have a basic knowledge of English and you will soon find someone to help you.
E111 will not cover you for free or reduced cost medical treatment if you are going to another country specifically for medical or maternity care. If this is the case you should still complete the form for E111, but attach a letter explaining why you need to make this visit specially for treatment.
Then ask your GP or hospital consultant for a letter recommending that you seek treatment in another country and giving details of the treatment. He or she should also give evidence either that the treatment is available under the Irish health service but cannot be provided within the time normally necessary, or that your case is exceptional - and why.
Outside the EU
Unfortunately, the E111 scheme only applies to European countries, so you will still need to take out travel insurance that covers medical costs if you travel elsewhere. In fact, it is advisable to do so even if you do travel to Europe. After all, popular destinations like Switzerland, the Czech Republic, Malta and Croatia are not included in the scheme.
There are always many things to do before going away on holiday and it can be easy to forget to obtain your E111 form in advance. The forms are valid for a year, so the best thing to do is to get it now. Then, before you travel, make sure that it is stamped by your local health board so that it is valid.
If you treat your E111 like your passport, checking a few weeks before you travel that it is not out of date, then you need never worry about the cost of falling ill when on holiday in Europe. Your only concern will be getting better, which is as it should be.
If you have private health insurance with VHI or BUPA Ireland, check the separate cover for overseas emergency medical assistance.
* In June 2004, the E111 form was replaced with the new European Health Insurance Card. See..
European Health Insurance Card
Written by Jim Clarke of irishhealth.com.
If anything happens to you or a member of your family while on holidays you will be dealt with ASAP once you have the E111 so make sure to have it.
The E111 is 'useful' but remember it does not cover repatriation following accident/illness;nor air ambulance nor extra costs so always take out private travel insurance!Even for Europe!
Could the application form for E111 be included on the website? It would be useful.
I agree with Mike above, it would be great if we could get the E111 form from this website. Thanks Ruth
As thousands of Irish holidaymakers & sportsfans prepare to descend upon Europe over Easter & the Summer, my advice is DO take an E111 but do NOT think if you have got one you do not need medical expenses/travel insurance. Even if you speak the language of the country fluently you may not necessarily be in a condition to say "take me to a clinic where an E111 is accepted" AND in most of the tourist resorts/main cities in say Spain & the Balearics,"tourists" are almost always referred to a private clinic where form E111 is NOT accepted. A useful "extra" to have but do NOT forget it "only" entitles you to treatment to the same levels as local citizens and if you were unfortunate enough to need say an air ambulance from a Greek Island to Cork or Dublin an E111 will NOT apply and your "next of kin" will need to pay something like IR£18,000 upfront. As Irish Embassies & Consulates around Europe will tell you far too many tourists have paid a heavy price for their mistaken belief that if one has an E111 that is more than enough.It is not.
Your query re. getting the E111 form online via irishhealth.com is an interesting one - we will check it out and post our findings into this Discussion Channel. Regards from the Admin team at irishhealth.com
I hope you can reproduce the e111 on the web site as it would make a little easier!
I've been travelling abroad for the past 30 years, and I've only now discovered the E111! Holiday brochures and travel agents should point out the merits of having one.
I entirely agree.The Government should do much more to promote E111 with TV/Radio/Newspaper ads;many good Travel agents do have literature available but alas very many travel agency staff are unaware of its existence; there is a need for a much greater educational programme via Tour Operators,Ferry Companies,Banks,Travellers cheques bureaux and airlines. In fairness most do mention it somewhere but usually in such small print that it goes unnoticed. But as a taxpayer remember you are AUTOMATICALLY entitled to one subject only to one or two very minor conditions. It is freely available from Local Health Boards and most main Post Offices. Another reason of course why it does not get as much prominence as it deserves in the travel industry is that it could be seen to conflict with their promotion of travel insurance and for many agents COMMISSION from sale of travel insurance is a bigger earner than selling the holiday or tickets! Look upon the E111 as being complementary to rather than replacing Travel Insurance. See earlier posts!
The article says that "Irish citizens" are covered. But does that mean, for example, that an Irish Citizen living in the US is covered? Should it really say "resident Irish citizens" or are all citizens covered?
Is there a form to complete for travel to Tunisia, or is it just private insurance.
For Tunisia, 'private' travel insurance is ABSOLUTELY ESSENTIAL available from sources such as (but NOT limited to) AIB,ACE,EUROP ASSISTANCE IRELAND,GENERALI DUBLIN etc etc. Before you decide,ensure the one you choose has 24hrs emergency service both from an Irish & Tunisian office as Tunisian hospitals are often reluctant to invoice "out of country" (No reciprocal agreement covering medical expenses exists between Tunisia and Ireland and E111 only applies to EC countries).
I came to Finland to study after finishing my PhD and was given student status which expires in August. I no longer have this status in Ireland. After that I will be a foreign researcher funded by the Govt of Finland and hopefully EU funding for 12 months(from November 2001). I have an E111, but do I now need an E128 as well ? I thought to take out personal insurance here as well,as an extra precaution. My resdidence time in Finland will extend to over 12 months from initially arriving. I wish to have a minor operation done here, I have been on a waiting list for over 2 years in Ireland for same (not life-threatening-fibrolipoma removal)and the Finnish health authorities have requested an E112 form?? Can someone tell me what this is and what I have to do next ?
E111 is mainly for tourists and short term stay in an EC country (or one of those associate members of EC). E112 is basically for longer stays,especially extended work reasons. Similar to E111. Obtainable from any Finnish Health Service office. But like E111, the E112 has "limited" cover. Your best bet is take out a health insurance plan which covers private treatment without a wait or a good local Finnish plan. Good Luck Mike
Thanks for the info. Did some surfing and have come across a whole new range of E's. Apparently I should also get an E106 ! What is this and why is it better than an E112 or an E128 ? It seems to be getting more confusing the more I look ! Wish I had done all this BEFORE I came to Finland !
Thank you for the helpfull advice on the E111 form Les
re KEVOBR's further Finnish E-form query.Yes this is norm for EC bureaucracy. Dozens of E-forms which hopelessly confuse the public. Each one has very specific use depending on one's status. The Irish Embassy in Helsinki should be able to categorically say which is the right one for YOUR personal circumstances; if they do not have the form to hand they certainly have the "lines to Dublin" to be able to have them electronically sent over. Another avenue to explore if you prefer is get a family member in Ireland to approach the Area Health Board for advice.Depending on which part of Ireland you come from you can find the addresses,websites etc on http://www.doh.ie/contact/health_boards.html My "best advice" remains take some private health cover to supplement anything "free" under E-forms. After all if you were unfortunate enough to be involved in an accident you might want to be flown home which no e-form would cover....... Mike //
Great to be able to download the E111, now its only a quick trip to the Health Board office to get it stamped!! Wish that was online too!
I endorse all that's been said about taking the E111 Form on trips to other EU countries, as well as having travel insurance. I wonder though why the form is valid only for one year (or indeed why it's needed at all for holders of EU passports). It seems an unnecessary burden on EU citizens and the Health Authorities to have to get one each year. I went along to a Health Authority office thinking I might be able to extend the validity of my E111. Couldn't be done. The official had to give me a new one. All she entered on it was my PPS No. No record was taken of that, nor of my name or anything else. I wonder at the purpose of it all. Perhaps we should be campaigning for multiannual validity or better still a "smart card" that would have no expiry date. Think of the trees that could be saved!
I entirely agree.At present it is a bureaucratic nightmare especially when one realises that there are "dozens" of E-??? forms for different reasons. Here in UK where I am currently based it is possible to have an E111 issued for periods longer than 1 year. You can obtain these at any Main Post Office and do not need to go to a Health Authority/ But "smart card" is the way forward.......but then think of all those EC bureaucrats throughout Europe who have no longer any forms to fill or "books of rules" to write ...!!
More than 22 percent of Irish holidaymakers risk financial ruin this Summer by opting to travel abroad without the benefit of Medical Expenses insurance whilst the majority of those travelling to EC destinations do not even take form E111. Do NOT risk your health and your wealth. Already this year we have read of Irish clients faced with costs such as USD 900,000 following a Road Traffic accident;IR£35,OOO for medical expenses and air ambulance from Spain and IR£120,OOO following RTA in Hong Kong. Look at minimum £IR500,000 medical expenses(Europe);IR£3,000,000 for USA together with no limit Air Ambulance cover PLUS 24 hours a day, 7 days a week Emergency Assistance Helpline. Travelling to EC? Take E111 as well as travel cover. Do NOT believe that cover through credit cards is sufficient. Most cards only cover Travel ACCIDENT benefits due to such as loss of limb etc, no medical expenses;these are sometimes covered through Gold & Platinum schemes though. Enjoy your holidays but dont take unnecessary risks. Accidents don't always happen just to others....... Be warned! Be sensible! Be safe!
As usual the health boards make this a bureaucratic problem. You must GO to the office to collect the form necessitating a few hours in my case and they won't issue a blanket E111 to cover an extended period and for seperate periods. Why does this make sense in the age of email etc.
We all have our Social Service No. RSI or whatever name they give it, and have been issued with a nice little Plastic Card. I think it would be an idea to include the E111 function into this card. It would make it easier for all of us, and cut down on some of the bureaucracy. Alternatively why not just let us show our EU Passport, to prove we are EU citizens, should we be in need of medical service when abroad.
Going abroad for Christmas? If visiting an EC country dont forget to take your E111 and whether to EC or elsewhere take a good Private Travel Insurance policy too. Happy Holidays!
Article says that Finland is not an EU member state, it is. Norway is not. EDITOR'S NOTE: Thanks for pointing out the error. It will be updated shortly.
I agree about the coments for the E111 being available on line, as all information given can be kept on record.
Good news to hear that the EC is planning to introduce an E111-card for use in any country where E111 is valid.Meantime I repeat previous advice re absolute necessity of holding good travel insurance policy for overseas travel.E111 does NOT cover air or road ambulance transfer to Ireland,any hotel expenses or flight costs incurred by patient or family so be safe,be sensible,take out adequate cover which includes a 24hrs Emergency Service......... Mike
Is E111 form a prerequisite for health coverage of retired Irish citizens living in Spain ?
E111 is important but if you've got Vhi Cover, you also get uo to €100k worth of inpatient medical cover per person on the policy.
There is such a variance in the amount of time E111's are issued for. Each Health Board region seems to put their own interpretation on the time limit they allow. I work for one Board and can only issue forms for 11 months. A different H.B. 10 miles from us only issue them for 3 months at a time and another one in a neighbouring county have issued some for 4 years. What authority can I contact to clarify the correct time limits and find out more details on the progress of the card system to alleviate unnecessary repetition (for the public and the Health Boards)
I wish to know if I am treated in an EU country whether my personal travel insurance takes precedence over the E111 or if it is the E111 scheme that should pay he bills rather than the insurance I have paid a premium for?
Be careful where you obtain your medical treatment, especially in Spain /spanish Islands. The E111 might not be accepted in local small medical treatment centres. We wern't covered by it and it was costly!
If in Europe can you use the E111 to see GP if you get sick while there or is it only valid for public accident and emercency?
I would like to point that the E111 form no longer exists - it has been replaced by the EHIC (European Health Insurance Card)
Joe is correct. The European Health Insurance Card is just like a Credit Card / A.T.M. Card & can be affixed inside your Passport with Double Sided Tape so you always know where it is. Important Point it expires after 2 YEARS, If you already have one, check the expiry date. ( mine expired LAST MAY, silly me )
My EHI Card expires in September please what is my next course of action i.e how do I get it renewed.
To renew your EHI Card apply to your Regional Health Board or you can do it on line by logging on to their web site.
Can download an E111 Form. If so what is the site as i have been trying to do it now for the past half hour? Please help