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Rules for the use of the EHIC (European Health Insurance Card)
On the basis of the EHIC, you are entitled to medical services to the extent medically necessary. The treating doctor shall determine whether the benefit in question is necessary in the specific case, taking into account its nature and the expected length of the insured person's stay in the Member State concerned.
Each Member State sets its own criteria and rules for the provision of medical benefits, so a Polish beneficiary going to Austria will, as far as the right to medical benefits is concerned, be treated as a person who is insured in the Austrian healthcare system.
Some countries require you to show proof of identity (passport preferred) with the EHIC and leave a photocopy of the card with the doctor, so it is a good idea to carry several photocopies with you.
How to obtain medical care
You should receive health care in facilities that have signed a contract with the regional health insurance fund (Gebietskrankenkasse). You can obtain a list of these facilities from your local health insurance company.
If hospitalisation is necessary, the GP will issue a referral to a public hospital (Einweisungsschein), which must be presented at the time of admission to the institution concerned. In urgent cases, you can go to a public hospital without a referral.
The EHIC must be presented to the doctor.
Emergency number - 112
Charges for health services
The fees listed below may vary slightly and are generally non-refundable unless otherwise stated.
Charges apply for each day of hospital stay approx.EUR 20 per day (for a maximum of 28 days within each calendar year). Hospital staff can offer hospitalisation under the so-called Sonderklasse (special price list for an increased standard of care). If you agree to the Sonderklasse in writing, you must expect increased, non-refundable costs for your stay.
There is a partial payment for dental treatment. Price lists are freely set by the dentists, so it is worth asking about the price before using the service.
Medicines on the Austrian drug list can be purchased at any pharmacy on the basis of a prescription issued by a doctor with a contract with the cash register. There is a non-refundable charge of EUR 4.70 for each medicine. The cost of medicines outside the drug inventory can only be covered by the health insurance fund with the agreement of the fund's chief physician.
Transport to the nearest hospital is free of charge. Return transport to Poland is generally paid for by the patient. Mountain rescue in Austria and air transport are chargeable! It is advisable to have a private insurance policy covering benefits related to a skiing accident.
NOTE!
The EHIC does not provide cover for the costs of medical transport to Poland and the applicable fees for medical services in Austria, so it is advisable to take out additional private insurance to avoid the burden of these costs.
Prescriptions
Reimbursable prescriptions are issued by a doctor who has a contract with the health insurance fund. If the prescription is issued by a doctor without a contract, the sickness fund may consider it equivalent to a prescription from a contract doctor. Otherwise, you have to cover the cost of the medicines, being entitled to reimbursement up to the amount covered by the health insurance fund.
Private treatment
When using the services of a doctor who does not have a contract with a health insurance fund, the doctor's fees must be paid.
Documents needed for reimbursement
If you are charged for medical services (unless it is the patient's own contribution), you can obtain reimbursement of these costs by going to an Austrian health insurance fund or, after returning to Poland, by applying for reimbursement to the relevant regional branch of the NFZ.
Original receipts and proof of payment must be provided for reimbursement of medical expenses.
A place where you can get information in case of doubt
All information can be obtained from the regional health insurance funds (Gebietskrankenkasse) or the liaison body:
Hauptverband der österreichischen Sozialversicherungsträger
Kundmanngasse 2
Postfach 600
A1031 Wien, Austria
Tel. 0043 1 711 32
Fax 0043 1 711 32 3777
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