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Medically-necessary benefits in kind in case of pregnancy

There may be a variety of reasons why you are in another Member State during your pregnancy. The important aspect for the assumption of costs via the European Health Insurance Card is only that obtaining medical benefits during pregnancy or childbirth is not the sole reason for your stay in another EU country.

The range of benefits available

The European Health Insurance Card (EHIC) or Provisional Replacement Certificate (PRC) entitles you to all benefits in accordance with the legislation of the State of stay related to pregnancy or childbirth which are medically necessary. The medical benefits are hence not restricted to acute health problems. This means that you can receive the screening examinations during your stay in another EU country which are planned in accordance with the list of benefits there for the appropriate stage of the pregnancy. If there are any risks involved in your pregnancy, or if risks arise, the healthcare provider in the other EU country must take all medically-necessary measures to remedy or minimise them.

The difference as against planned treatment

The EHIC does not entitle you to take up medical benefits in another EU country during pregnancy if the birth, or the examinations or medical treatment necessary in connection with it, are the only reason for your stay in that country. This would constitute planned treatment in another EU country. Different conditions apply, and you need different proof of entitlement.

You live in Germany on the border to Austria. The closest gynaecologist’s practice is in Austria. The same applies to the closest hospital in which you could give birth. You would have to travel much further in Germany to the closest gynaecologist’s practice or hospital. You would therefore like to have all the screening examinations during the pregnancy carried out by healthcare providers in Austria, and would also like to give birth there.

You cannot receive the medical benefits in Austria with your EHIC. The only reason for your stays in Austria is to take up medical benefits. This constitutes planned treatment. Please consult your German health insurance fund as to whether it is willing to issue a form E 112 or S2, or to reimburse at least some of the treatment costs.

Childbirth via the European Health Insurance Card

Even if you know the due date well in advance, you can still give birth in another EU country via the EHIC in special constellations. This is always the case if you would like to have your child in the other EU country simply because of your particular family situation.

The European Commission lists in its explanatory notes on necessary care the necessary benefits in kind (Explanatory Note of the European Commission N _ Necessary Cae, see link below for more information):

“Special attention should be granted to the situation of migrant women who wish to go back to their home country to give birth there in order to take advantage of the help offered by their families. The purpose of the stay in their home country is not only to give birth but also to return to a familiar environment where they can count on the support of their relatives in the period before and after the birth of their child. Health care provided in this situation to mother and child should be considered as being necessary care and therefore covered by the European Health Insurance Card.

A similar situation is the one where a woman wants to give birth in the State of residence of her husband or partner. In most of the cases, the future mother will not just go to the State of residence of her husband or partner to give birth and return immediately afterwards to her State of residence, but she will often stay with her husband or partner for a certain period before and after the birth of the child. Healthcare provided during the stay of the woman in the State of residence of her husband or partner (including care given to the child) is to be considered as necessary care and is covered by the European Health Insurance Card.”

The situations listed in the European Commission’s Explanatory notes are those which occur most frequently in practice. There may be other constellations which also need to be assessed.

You live and work in Germany, together with the child’s father. Your parents have already died. The parents of the child’s father live in Spain. Because of the extensive work commitments of the child’s father, he would be unable to look after you in the period before, during and after childbirth. You would therefore like to give birth close to the parents of the child’s father in Spain and also to stay there several weeks before and after the due date.

You are therefore only thinking about giving birth in Spain because the parents of the child’s father who could support you live there. The primary reason for your stay in Spain is not to give birth as such, but the opportunity in your specific family situation to be able to avail yourself of the assistance of the parents of the child’s father. It should therefore be possible to use the EHIC to give birth.

It has been revealed in practice that problems repeatedly occur in these constellations. Please therefore contact the hospital in the other EU country where the birth is to take place in good time in order to consult them as to whether it is possible to give birth there via your EHIC in your situation. If the hospital requires a form E 112 or S2 to be presented in such cases, please ask your German health insurance fund whether it is willing to issue this form. Should this not be the case, please contact the competent National Contact Point. Explain your situation, referring to the Explanatory notes of the Commission on necessary care, and ask it to help you assert your claims on the spot via the EHIC.

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Pennefeldsweg 12 c
53177 Bonn

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+49 228 9530-802/800

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