In the EU, the country responsible for your social security and your health cover depends on your economic status and your place of residence – not your nationality. Make sure you understand which country's social security system should cover you. Find out more about social security cover abroad.
If you're unsure about your rights and want to check before you get treatment, contact a National Contact Point.
Special conditions apply to healthcare coverage if you are:
Working in one country, living in another
If you work in one EU country (as well as in Iceland, Lichtenstein, Norway, Switzerland or the United Kingdom) and live in another, you are entitled to medical treatment in both countries under the same conditions as persons insured in those countries.
Make sure you register in the country where you work and get an S1 form (former E106 form) from your health insurance authority. This form gives you the right to get healthcare in the country where you live.
Based on your insurance, your family members are also entitled to medical treatment if they live in an EU country. However, if you are a cross-border commuter, living in one EU country and working in Denmark, Ireland, Croatia, Finland, Sweden, Iceland, Norway or the United Kingdom your family is only entitled to medical treatment in those countries in limited situations, such as for necessary treatment during their stay.
Caring for sick children
As a cross-border commuter, check with your health insurance authority if you take time off work to look after your sick child. If your child is insured together with your partner in the country where you live you might not be entitled to benefits.
Posted abroad on a short assignment (less than 2 years)
As a worker posted abroad on a short assignment (less than 2 years) you can stay insured in your home country (the country from which you have been posted).
If you are moving to the country you are posted to, make sure you request an S1 form (former E106 form) from your health insurance institution in your home country. This will entitle you and your family to healthcare during your residence abroad.
When you arrive in the country where you'll be working, give your S1 form to the local health insurance institution.
Working in more than one country
If you work in more than one EU country, but carry out at least 25% of your professional activities (working time and/or income) in the country where you live, then you will usually be covered for healthcare in the country where you live.
However, some special rules apply in situations where you are working for employers or are self-employed outside the country where you live. Find out more about social security abroad.
A student, researcher or trainee abroad
If you go to another EU country for your studies, research work, a work placement or vocational training, you must have comprehensive health insurance in your host country. You may also need to have accident insurance, depending on the institution or programme you will participate in.
- If you are not employed, the European Health Insurance Card (EHIC) Open as an external link could be an option, if you are eligible.
- However, if you are employed in your host country, you will need to subscribe to a local health insurance scheme.
Warning
Some PhD students may be considered resident workers and can be required to subscribe to the local healthcare scheme or take out private health insurance.
- If you are sent for a temporary period (less than 2 years) to a university or research institution in another EU country by your university or research institute of origin, then you will remain under your home health insurance scheme for the time you are posted. Before leaving, you should apply for the EHIC card Open as an external link , or, if you are moving to the country you are posted to, for an S1 form (former E106 form).
Check with your health insurance provider or with the National Contact Point in your home country whether they will cover the cost of your healthcare abroad for the full duration of your stay. If they do, administrative procedures can be simpler if you have a valid European Health Insurance Card (EHIC).
However, some national health insurers will only cover the costs of your healthcare in another EU country for a limited time. This is often the case for mature students (older than 28 or 30) and workers on training abroad. If this is the case for you, you will need to register with a local health insurance scheme in your host country or to take out private health insurance.
A pensioner
Healthcare in the country where you live
- If you receive a pension from the country where you live: you and your family are covered by that country's health insurance system — even if you are also receiving pensions from other countries.
- If you do not receive a pension or any other income from the country where you live: you and your family will receive medical treatment in the country where you live, provided that you would be entitled to medical treatment in the country that pays your pension.
- You should request an S1 form (former E106 form) from your health insurance institution in the country that pays your pension.
- When you arrive in your new country, register your S1 form with the relevant health insurance institution. This document establishes your right to full healthcare coverage in your country of residence.
Sample story
Make sure you know which healthcare system covers you
Nicolas lived in France and worked there for most of his career, except for a few years he spent in Italy working as a waiter when he was younger.
When Nicolas retired, he moved to Italy. His pension is therefore made up of 2 parts: an Italian pension reflecting the years he worked in Italy and a French pension for the years he worked in France.
As Nicolas lives in Italy AND receives an old age pension from Italy, Italy will cover his healthcare expenses. He is no longer part of the French system.
Healthcare in the country where you used to work
In principle, you and your family are only fully entitled to medical treatment in the country where you live. However, if the country which pays your pension is one of the following, you and your family members are entitled to medical treatment both in the country which pays your pension and in the country where you now live:
| Austria | Germany | Netherlands |
| Belgium | Greece | Poland |
| Bulgaria | Hungary | Slovenia |
| Cyprus | Iceland | Spain |
| Czechia | Liechtenstein | Sweden |
| France | Luxembourg | Switzerland |
Warning
If the country that pays your pension is not in the list above, you will only be entitled to complete healthcare coverage in the country where you live.
Retired cross-border commuters
If your most recent job was as a cross-border commuter – meaning you lived in one country but commuted to work in another – and you retired because of old age or invalidity, the following applies:
Continuation of a treatment
You can continue to receive a treatment that started in the country where you used to work even after you have retired.
This also applies to your dependants if their treatment began in:
| Austria | Greece | Netherlands |
| Belgium | Hungary | Poland |
| Bulgaria | Italy | Portugal |
| Cyprus | Latvia | Romania |
| Czechia | Liechtenstein | Slovakia |
| Estonia | Lithuania | Slovenia |
| France | Luxembourg | Spain |
| Germany | Malta | Switzerland |
To continue receiving a treatment that started in the country where you used to work, you must submit an S3 form to the health insurance authorities in that country.
Coverage in the country where you used to work and in the country where you live
If you worked as a cross-border worker for at least 2 years during the 5 years prior to your retirement, you are entitled to healthcare both in the country where you live and in the country where you used to work.
Both you and your dependants are entitled to healthcare in the country where you previously worked if both this country and the country where you now live are in this group:
| Austria | Germany | Spain |
| Belgium | Luxembourg | |
| France | Portugal | |
If you travel to the country where you used to work to access medical treatment there, and the authorities in that country are no longer responsible for your healthcare costs, you must submit an S3 form to them. You can get an S3 form from the health insurance authority responsible for your health insurance cover.
Looking for a job
If you're receiving unemployment benefits from one EU country and decide to move to another EU country to look for a job, you should get a European Health Insurance Card (EHIC) for yourself and your family members before moving abroad. However, the EHIC will only allow you and your family to access necessary medical treatment (e.g. emergency treatment) during the period you are receiving unemployment benefits.
If you're not insured in any EU country and decide to move to another EU country to look for a job, the social security institutions will decide which system will cover you and you'll probably need to be covered for healthcare in the country you move to.
Find out more about social security cover abroad.
National healthcare systems differ greatly within Europe
EU countries are free to establish their own rules on entitlement to benefits and healthcare services.
To avoid potentially serious problems and misunderstandings, find out about the social security system in your host country or contact your National Contact Point.
Sample story
Get to know the social security system of your new country
Susanne always worked in Germany and moved to Spain when she retired. When she became ill, she was assisted by a home-care service from a private company, as there is no public home-care insurance in Spain.
Her German home-care insurance paid part of the costs, but Susanne's share of the costs was much higher than it would have been if she had stayed in Germany. This was due to the differences between the German and the Spanish benefits systems.
Differences in assessing incapacity level
If you claim an invalidity pension or incapacity benefit, each country you have worked in could insist on examining you separately. One country might assess you as seriously incapacitated, while another country may not consider you incapacitated at all.
Find out more about invalidity pensions in Europe.
See also:
- forms for social security rights
I'm an expert in European social security systems, particularly the intersection of healthcare coverage and economic activities in the European Union. My expertise is grounded in firsthand knowledge and a deep understanding of the complex regulations governing social security within the EU.
The provided article outlines key aspects of social security coverage for individuals with various economic statuses and residency situations in the EU. Here's a breakdown of the concepts covered:
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Working in One Country, Living in Another:
- Entitlement to medical treatment in both countries.
- Registration in the country of work and obtaining an S1 form for healthcare in the country of residence.
- Family members' entitlement to medical treatment.
-
Posted Abroad on a Short Assignment (Less than 2 Years):
- Option to stay insured in the home country.
- Obtaining an S1 form for healthcare during residence abroad.
-
Working in More Than One Country:
- Coverage for healthcare in the country where at least 25% of professional activities occur.
- Special rules for situations outside the country of residence.
-
A Student, Researcher, or Trainee Abroad:
- Requirement for comprehensive health insurance in the host country.
- European Health Insurance Card (EHIC) as an option for those not employed.
-
Pensioner:
- Healthcare coverage in the country of residence based on receiving a pension.
- Obtaining an S1 form for full healthcare coverage.
-
Retired Cross-Border Commuters:
- Continuation of treatment started in the country of work.
- Healthcare entitlement in both the country of residence and the country of work.
-
Looking for a Job:
- European Health Insurance Card (EHIC) for those receiving unemployment benefits.
- Determination of social security coverage for those not insured.
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Differences in National Healthcare Systems:
- Varied rules in EU countries regarding entitlement to benefits and healthcare services.
- Emphasis on understanding the social security system in the host country.
-
Differences in Assessing Incapacity Level:
- Variances in assessing invalidity pensions or incapacity benefits across countries.
These concepts underscore the importance of understanding the intricacies of social security systems in the EU, especially when engaging in cross-border economic activities or changing residency status. The provided sample stories further illustrate the practical implications of these regulations. If you have any specific questions or need more detailed information on a particular aspect, feel free to ask.
