E111
Tips on drinking and eating
Whilst you are travelling abroad you need to be very careful as to what you eat and drink, the water and food may be contaminated in different ways – this includes the water in the swimming pools, rivers, lakes and the sea you should try and avoid swallowing the water whilst swimming. Diarrhoea is very common disease for people who travel to hot countries as well as Typhoid, Cholera, Hepatitis A and these are commonly caught in food and water that is contaminated. You could follow the following precautions to try and avoid these diseases.
1. Always wash your hands after going to the lavatory.
2. You should buy bottled water and use this for drinking, washing up and cleaning your teeth etc.
3. When ordering drinks decline the offer of ice unless you are sure this is made with bottled water and this includes eating any food that is chilled by ice.
4. Hot beverages, wine, soft drinks and juices are all usually fine.
5. Food should be thoroughly cooked and still hot when they are served to you.
6. Food that has been kept warm should be avoided.
7. Uncooked food should be avoided unless it is shelled or peeled by your self.
8. If there is food that is in the open avoid it as it could be exposed to flies.
9. Ice Cream should be avoided from places such as Kiosks or unreliable traders.
10. Unpasteurised milk should be avoided.
11. Uncooked Fish or Shellfish should be avoided as these are a bit suspect in some countries especially fish like oysters.
Taking care out doors
Most people travel abroad to get away from the cold weather of this country, this should be for our enjoyment, avoid staying in the sun to long as not to get sunburn and use a higher factor of sun cream, to much sun can cause premature skin ageing it increases the risk of skin cancer, this is caused by the ultraviolet rays, nearer to the equator you go the more powerful it will be. Following some of our tips should help you.
1. Taking care of the children by not putting them in direct sunlight.
2. Everyone should try and stay out of the sun around midday for about 2 hours
3. Using the shade that is available at other times of the day will help prevent you from being burnt.
4. Wearing a hat to protect your head and loose clothing.
5. Protective sun cream that is for your skin type will help protect parts of your body that are exposed to the sun.
6. Drink plenty of non-alcoholic drinks to avoid dehydration,
7. Try to prevent insect and animal bites use insect-repellent as you can get infections which can be serious and fatal.
8. When swimming do not go alone, swimming will cool you but fatal accidents can happen very easily and in unexpected conditions, swimming with a friend or relative means you will be able to watch for signs of trouble for each other, children should be supervised when swimming and not left alone near any kind of water. When diving you should make sure that the depth of the water is adequate as this could lead to you being permanently paralysed.
9. Whilst driving or walking check the local traffic regulations, you should always wear the seat belts provided and if you are travelling on a motor or pedal bike then always wear a helmet. Hired cars should be checked over before driving.
10. If you are planning any dangerous sports then you should follow the relevant guidelines making sure there is adequate medical facilities near by. Make sure that your insurance covers you fully.
11. There are some countries that have areas which are unsafe to travel to due to violence, you should always check the Foreign Office Advice to Travellers telephone No: 0207 270 4129.
12. If you are planning to take day trips to another country, make sure that your travel insurance is adequate to cover you and taking a completed E111 form with you to European Economic Areas to cover you also.
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Diseases and Precautions that should be taken
These precautions will not give you full protection, if you develop a fever or become unwell whilst you are abroad or up to at least three months after you return home you must inform your medical practitioner straight away.
1. Malaria – This disease is spread by bites of infected mosquitoes, it causes fever and in some cases can cause complications to kidneys, liver, blood and the brain sometimes this can be fatal. If you intend to visit a malarial country you should visit your doctor and advise them of the country that you intend to visit and they will be able to advise you of the best anti-malaria medicines that are best suited for you to take, the medication should be taken for all persons travelling for a week before you go then whilst you are there and for a month after you return.
2. Mosquito-To limit the risk of getting bitten by mosquitos you should use insect repellent, in the evenings it is best to cover up as much as possible and try and get a mosquito net around the bed, this should be impregnated with insecticide making sure that there are no holes in it.
3. Rabies – Usually found in animals in North America and Europe, sometimes in the less developed countries, this is contracted if you are bitten by an infected animal. It is an acute viral infection of the nervous system it can cause painful muscle spasms in the throat, if this is developed in human beings the disease is usually fatal.
4. HIV/AIDS – Unfortunately there is no cure for AIDS or HIV, you can contract aids by having unprotected sex with a person who is infected, using infected syringes, dental and medical instruments and anything else that is used to puncture the skin. Transfusions of infected blood or from an infected mother to her baby during child-birth or through breast feeding.
5. Bilharziasis – This disease is mostly common in waterways in Africa, it is a parasitic disease caused by a worm. The worm penetrates the skin and can cause damage to the Urinary, Liver and Intestines. There is no vaccine available, if you plan to travel to these areas then you should avoid bathing in rivers, lakes or streams.
6. Cholera- This is a intestinal infection that will cause severe diarrhoea, this can cause dehydration and can be fatal, this caught from eating contaminated food and water, this is an increasing problem of countries with poor sanitation. You can avoid this by personal hygiene.
7. Dengue – This is a disease that is caught by a mosquito bite, this generally occurs in the tropics. You can not get a vaccine against this you need to do all you can to prevent being bitten day and night.
8. Diphtheria – This is a serious disease that runs much through the world but mostly in tropical countries where there is a huge population and poor hygiene this is caught by close contact with someone who is infected.
9. Hepatitis A – This can be caught from contaminated food and drink it is spread from person to person, you can have a vaccination against Hepatitis A.
10. Hepatitis B – This disease is spread in the same way as AIDS, the vaccination gives you good protection against the disease but can take up to 6 months to take affect.
11. Hepatitis C – This is also spread the same way as AIDS, unfortunately there is no vaccination for this, to avoid this you need to take precautions.
12. poliomyelitis – It is a viral infection which can cause paralysis of the muscle, you should make sure that you have up to date immunisations.
13. Tetanus – This is a very dangerous disease, which will cause severe muscle spasms, this is caught through bacterial spores into the body through maybe the tiniest of cuts. Spores are mainly found in soil and manure. You should be protected with the immunisation that is available from your doctor.
14. Tuberculosis – This disease is growing fast worldwide and the whole family should be immunised against the disease. If you plan to travel to Central or South America, Asia or Eastern Europe and plan to stay for longer than one month you should discuss with your doctor about the immunisation.
15. Typhoid – This is caught through eating contaminated food or water. If you plan to travel to a country that is known for poor sanitation then you should really be immunised against this.
What to do if you are bitten by an animal whilst travelling
1. Immediately wash the wound either using soap or detergent and flush with clean water if possible use alcohol.
2. Go immediately to the nearest doctor or hospital, they may give you a rabies vaccination and the course must start immediately, if there was any difficulty you should contact the nearest British Consular official.
3. Take note of the date time and a full description of the animal whether it be a wild animal or stray.
4. If the animal is not wild try to locate its owner to find out if it has been sick, exchange names addresses and telephone numbers with the owner so you can keep in contact to find out if the animal becomes ill or dies within the next two weeks.
5. Go to the local police to report the incident.
6. As soon as you return to the UK inform your doctor.
The recommendation of immunisation for different countries
All Areas
If you have not been immunised before against diphtheria, polio or tetanus then you should really do this before travelling.
All Areas (Excluding North and Western Europe, North America, Australia)
Poliomyelitis
Areas Where Hygiene and Sanitation is poor
Hepatitis A and Typhoid
For some countries
You would need to check with your doctor or travel clinic.
Meningococcal Meningitis
Tick-Borne Encephalitis
Tuberculosis
Japanese Encephalitis
Rabies
Hepatitis B
Diphtheria Booster
Measles/ MMR
Tell your doctor before you travel
To arrange for immunisations you should tell your doctor at least two months before you are travelling, these immunisations can not always be given at the same time. It is very important that your doctor knows all circumstances if you fall pregnant or if you intend to take children as they may not of had all there immunisations. If you require anti-malaria tablets your doctor will advise which is best suitable for your self and this should be started one week before you are travelling. If you take prescribed medication you should check there availability at the place you intend to stay if they do not have you medication you would need to consult your doctor about getting extra supplies from the UK. You may be asked to pay for the immunisations, some are free under the NHS you can buy anti-malaria tablets from the chemist without a prescription. If you need to take medication with you when you travel you should find out if there is any restrictions on the country that you are travelling to. Medication should be properly labelled in a container and it may be worth asking your doctor for a letter stating your medication on there as some medicines that are available over here may be controlled in the country that you are travelling to. It is always worth having a dental check up before you travel as dental treatment outside the UK can be expensive, When travelling it is always worth carrying a medical first aid kit.
Health Insurance
The E111 never covers you to be repatriated back home, you would need to take travel insurance with you. If you need medical treatment whilst away you may be covered by the reciprocal agreement there but in a case of emergency you may be sent across the border for treatment and there could possibly be no reciprocal agreement. If you have a credit card this often covers you with health insurance but you need to make certain that this is adequate amount. When driving in a foreign country and you have an accident you may not be covered medically or for hospital expenses.
Still receiving your benefits whilst out of the UK
If you receive any kind of benefits you would need to tell the department of Social Security that you are planning to go away, sometimes the benefits will still be paid but you should find out the rules for obtaining benefits abroad before you leave. If you receive the State Retirement Pension you must inform your DSS office if you are going to be travelling longer than six months at any one time. If you are travelling in another EEA country and are taken ill your employer (in the UK) should pay for the first 28 weeks but not for any treatment that you may need. If Self employed you would need to claim Incapacity Benefit as soon as you return or this could cause you to loose money.
Plan for your return
You must plan not just for the trip its self but the return journey and when you return home.
1. If somebody gives you any kind of medicine whilst you are in another country you should not attempt to bring these back to the UK as they may be illegal, if you are in any doubt declare to the customs and excise.
2. Remember to take any anti-malaria tablets for at least one month after you return.
3. If your job involves handling food and you develop diarrhoea you must inform your employee straight away.
4. You should inform your doctor straight away if you feel unwell when you return to the UK.
5. Whilst you are in another country and you received medical treatment even if you feel well- If you have been bitten by any sort of animal or at risk of catching any sort of disease you should consult your doctor.
Emergency Checklist
The checklist below is to help you remember some of the things to do to help you deal with any health problems when you are travelling.
1. Make sure that before you travel you have all relevant documents with you such as: Your passport, A valid E111 form, Drivers Licence or NHS card, Vaccination certificates.
2. Make sure you read the travel insurance thoroughly so you know what it will cover you for.
3. If you require any help and advise it is always a good idea to go through your travel representative.
4. When visiting a practitioner always tell them if you are currently on medication and give them the generic name as it reads on the prescription label.
5. If you become ill tell the practitioner if you have been to another country before.
6. If you are going to make a claim under your travel insurance you will need to keep all receipts, proof of purchases, price tags labels.
7. It is always a good idea to keep names and addresses of friends and relatives with your passport so the British Consular can contact them if they need there help.
8. If you needed to return to the UK quickly contacting the British Consular should help but you will be expected to bear the cost yourself.
Treatment in Countries that have no Care Agreements with the UK
There are a lot of countries that have no health agreement with the UK, including Cyprus, Turkey, United States, Canada, Mexico, nearly all of the Caribbean, All of the South American nations, All of the middle east, All of Asia and Africa, including India, Japan Hong Kong and Thailand the whole of the Pacific region except Australia and New Zealand. To be covered in these countries you would need to take out comprehensive medical insurance, in the case of travelling to the United States you would need adequate medical cover.
Receiving treatment in countries outside the EEA with reciprocal health care agreement with the UK
The UK has reciprocal agreements with many countries for the need of urgent medical treatment and this could be at a reduced cost or sometimes free. If you need urgent medical treatment this will be provided to you and on the same terms as residents of that country in question. Some medical services may be more restricted than under the NHS, if there are any charges involved they will not be refunded by the British Government, you would need to carry sufficient insurance cover. In order to receive treatment, you may be asked to produce either your passport or some proof of UK residence.
In most cases you and your dependants are entitled to emergency treatment, if you are not a UK national you may still be entitled to treatment in the countries listed if you normally live in the UK. If you intend to live or work in one of the reciprocal agreement countries the details given may not apply to you.
Receiving medical treatment in countries in the EEA
You are eligible for E111 form if you are ordinarily resident in the United Kingdom and you are a national of the UK or you are a national of any EEA country if you are a refugee or a widow who receives a UK state pension whose late husband was a national of an EEA country living in the UK at the time of death. If you do not have a British passport and consider yourself as a British for the E111 you will be asked to provide evidence of your British nationality.
Enquiries for British Citizenship:
Home Office
Immigration & Nationality Departments
India Buildings (3rd Floor)
Water Street
Liverpool
L2 0QN
If you are paying social security contributions to an EEA country and you are EEA national, refugee or stateless person you should get your E111 form from the institution to where you pay your contributions. You can obtain your E111 from the local Post Office, they will stamp and sign this and return it to you, it is free you should keep this safe with you when you are travelling in the EEA. Once you have an E111 you do not have to renew it and it is valid indefinitely as long as you remain resident in the UK. If you use your E111 to receive treatment and they fail to give it back to you, you would need to apply for another one. This will invalidate if you decide to live outside the UK. The E111 covers the whole family which is yourself your spouse and dependant children up to the age of 16, 19 if they are in full time education. It will cover you if you have an unmarried partner and have children together. Once your children pass the ages given they then should get there own E111. Foster children can be included on there Foster parents E111. When you need medical treatment some countries will take your E111 and keep the original, however places like Germany, France, Italy and the Netherlands will ask for a photocopy to keep. You may be asked to pay towards the cost or asked to pay for all your treatment (some it is free) and claim the refund when you get back. If you need to make a claim you should apply to the following address:
DSS Benefits Agency
Pensions and Overseas
Benefits Directorate (Med)
Tyneview Park
Whitley Road
Newcastle-upon-Tyne
NE98 1BA
Under the E111, arrangements can be made for Renal dialysis in all EEA countries, however you must make arrangements before you travel. If you contact your UK NHS renal unit they will advise you on this. Oxygen can be provided as Emergency in all EEA countries, you would need to make prior arrangements with the country that you are visiting to ensure availability this is a must in remote areas.
Nannies and Au Pairs
If you are normally a UK resident and planning to go to work in another EEA country as a nanny or Au pair you are entitled to the E111 form for up to 12 months. Pupils going abroad on organised excursions who have an E111 form with there parents should take the original form when travelling with the school. The members of the Armed forces are able to use the E111, however if you are stationed in Germany you would not be able to use the E111. If you are normally resident of the UK but plan to study in another EEA country an E111 is not appropriate, you would be entitled to E128 this will cover you for two years, you can apply to:
Inland Revenue
National Insurance
Contributions Office
International Services
Longbenton
Newcastle-upon-Tyne
NE98 1ZZ
If you plan to become a Student in an EEA country as an integral part of a recognised UK course and is working relating to the course they are also entitled to the E128 for up to 2 years, if the country does not provide cover apply to the above address. If you plan to work temporarily in another EEA country for up to one year and been confirmed by the DSS that you continue to pay UK national insurance you would be entitled to E128 dependants who travel with you will be covered under the E128 also. If your employment last longer than the one year and the EEA agrees you may remain under the UK scheme for a longer period of one more year. When planning to work abroad permanently then neither the E111 or E128 will apply and further information can be found in SA29 leaflet.
Non-Emergency Treatment
The E111 does not cover you for reduced-cost or free treatment, if you are travelling to another EEA country for medical treatment you would need a E112 this would only be given to you through the department of health and would need authorisation if you do not have this form you will be expected to pay all cost for treatment you receive and there will be no refund on this. If it is an on going medical condition which would require treatment whilst your abroad – eg, injections, blood tests or medication you need to apply by letter giving details like dates of treatment and such like and supporting evidence from you doctor and you E111 to this address:
Department of Health
International Branch
Room 512
Richmond House
79 Whitehall
London
SW1A 2NS
You will only be accepted for the E112 where extreme need for on-going treatment, they will not present you with this form for a just in case basis. If you require maternity care in another EEA country you would need to write and tell them why and including evidence from your GP or Midwife confirming your expected delivery date. The E112 will only be issued if a NHS consultant says that treatment in that country is necessary, if your health authority will agree to meet the costs, if the treatment that you need is available under the country’s insurance scheme.
EEA Country to Country Checklist
Austria – Any UK nationals planning on visiting Austria an E111 is not required as a British passport is adequate to receive medical treatment. For any other EEA national including Austrians who reside in the UK would require an E111. If you was to visit a private doctor you may get a refund for part of the costs not for private fees.
Prescriptions, dentists and Doctors
You would need to contact the Regional Health Insurance office, they will give you the go ahead for the need of treatment they will issue you with a scheme voucher and the addresses of the nearest medical practitioner. You will be able to get your prescription from any pharmacy and they will charge you a fix amount.
Treatment in Hospital
If you need treatment for an Out-patient this can be obtained in the casualty wards. For treatment as an In-patient a doctor would normally refer you to a public hospital, you must show the admission voucher given to you by the doctor, in the event of emergency you should show your passport to the hospital which will then confirm with the insurance office that the costs will be met for standard treatment, the hospital will charge you a small fee daily for the first 28 days. If you opt for private treatment whether this is at your request or an emergency, you may be entitled to a refund this will be decided by the health insurance office.
Belgium – If you are travelling to Belgium to obtain information and refunds you should visit the regional offices of Auxiliary fund for sickness insurance, they are usually found in each provincial capital.
Prescriptions, Dentists and Doctors
If you need to see a doctor whilst visiting Belgium or dentist you should show your E111 form, you will need to pay for any treatment at the time but also need to keep a receipt. You can take your prescription to any chemist you will need to show your E111 and you will also be expected to pay for the prescription keep the receipt and always get this stamped. You will be refunded up to 75% of the cost of treatment.
Treatment in Hospital
If you need to have treatment in hospital give your E111 form to the local Sickness Fund Office and they will give you authorization of payment for the percentage of hospital costs but this does not include the costs against ambulance charges, you should ask them to advise you of the most respectable rates. If it is an emergency give the hospital the E111 form and ask them to obtain information from the sickness office that the cost will be at least partly paid for you.
Denmark – If you are visiting Denmark on a temporary basis and you are a UK national the E111 form is not necessary, if you just produce your British passport this will be sufficient for you to get medical treatment.
Prescriptions, Dentists and Doctors
Whilst visiting Denmark and you need to go to see a doctor or dentist you only need to show your passport if they charge you for the treatment you should ask for a receipt and claim the money back, you will need to apply to the local council with all your receipts before you leave Denmark. You will not receive a refund under 500dkk for people under 18 the refund for children is 50%. When you visit the pharmacy for the first time you will be given a special card to register your purchase this is if you show your passport, if not keep all your receipts and apply for a refund to the local council.
Treatment in Hospital
If you was to be hospitalised whilst visiting Denmark a doctor would arrange for this to be free, if you do not get to see a doctor show your passport or E111 to the authorities of the hospital and ask them to arrange free treatment. In Greenland and the Faroe Islands are not part of the EEA they are covered by a separate reciprocal agreement, UK residents would be entitled to emergency treatment on the same basis as the local residents.
Finland – If you are a UK national and temporarily visiting Finland the E111 is not required, if you needed medical attention you should show your passport and this should be sufficient. An E111 is required if you are non- UK EEA national residing in the UK. The health services in Finland are balanced between private and public providers, Charges will vary depending on where you receive treatment, if you receive private treatment either in hospital or with a doctor you will need to keep all receipts and you should give all details to the local KELA as you should be entitled to a partial refund and this must be within six months of the date you paid for it.
Prescriptions, Doctors and Dentists
In the event of needing medical treatment you should go to a municipal health centre and either present your E111 or passport the treatment needed, will be either free or they will ask for a standard fee. If you need emergency dental treatment you should contact the local dentist that is on duty at the municipal health centre and let them see your E111 or passport. They may ask for a standard fee depending on the service given, however you may find that dental treatment is severely restricted in the public sector.
Treatment in Hospital
If you go to see the doctor and they refer you to a public hospital you must present your E111 or your passport. If it is an emergency you can seek treatment from the nearest public hospital without visiting the doctor first. If you are an in-patient the treatment you receive will be charged at a fixed daily rate of FIM 125 which you would not be entitled to a refund on, outpatient visiting the hospital will be charged at a fixed rate of FIM 100 which will also be non-refundable.
France – To obtain information in France you should visit the Office for the Social Security of Migrant Workers there address is:
11 rue de la Tour des Dames
75436 Paris Cedex 09.
Prescriptions, and Dentists Doctors
You need to make certain that the doctor or dentist that you visit is conventionne, that is they work for the French health. Once you have had your treatment you should obtain a signed statement of the treatment you received this will allow you to claim a refund. When you get your prescription from the chemist the pharmacist should hand you back the prescription, you need to attach this to the feuille and this will allow you to claim a refund. The medication you receive will come in a container and they have a removable label on showing the name and price of the contents, you should remove this and stick it on to the feuille, where appropriate, sign and date this. Once you have finished taking your treatment you should send your prescription and E111 to the nearest sickness office while you are still in France, you should receive this once you return home to your UK address, this may carry a bank charge. This could take up to 2 months as the French authorities itemise this statement.
Treatment in Hospital
If you are an out-patient you must pay for the treatment and then claim a refund from the local sickness office, for the treatment as in-patient, the doctor you receive treatment from will issue you with a certificate, then the hospital will send an Acceptance of Admission to the local sickness office. If they do not do this for you, you will need to do this yourself and if it is an approved hospital the office will pay up to 75% direct to the hospital, you must pay the balance and also pay the fixed daily hospital charge of FF70 and these are not refundable.
Germany – Whilst you are in Germany if you need information then you should contact any insurance company where you are staying, these companies are open from Monday to Friday.
Prescriptions, Doctors and Dentists
If you require medical treatment you should present your E111 to the nearest insurance company and ask for the a list of doctors that are contracted to the insurance company if you take your form to one of the listed doctors they will give you free treatment. This is also for dental treatment The dentist is entitled to ask you for payment straight away, if you obtain an Erfassungsschein from your chosen insurance company and show it to the dentist in question 10 days after treatment the dentist must give you the money back. If you go to the chemist with your prescription you will be expected to pay for this either DM8, DM9 or DM10 depending on the size of the prescription, you will not be able to get a refund. Medication such as cough medicine or painkillers you will be expected to pay the full amount.
Treatment in Hospital
If you go to the doctors and he thinks you need hospital treatment you will be given a form (Verordnung uber Krankenhauspflege) you must show this to your insurance company, if the insurance company agrees that you need hospitalisation they will give you another form (kostenubernahmeschein) this is so your insurance company will meet the cost in general nursing care.
Gibraltar – You can obtain all information from your hotel, the Casemates Health Centre or the Gibraltar Health Authority.
Prescriptions, Doctors and Dentists
Under the local medical scheme the treatment is free, you may have to pay a small fee if you are visited at an address, you would need to show your UK passport, if you are not a UK national they would need to see your E111. You will be charged a small fee for prescribed medication under this scheme. Any dental cost will need to be paid in full, except at weekends or outside the hours of work.
Treatment in Hospital
At St Bernard’s Hospital free treatment in public wards is available you must not that you will be eligible for emergency treatment that arise whilst in Gibraltar.
Greece
To obtain information in Athens you should contact IKA, or there local offices, If you need to seek treatment through the IKA you may find that they have long waits. The waiting rooms may be crowded and you may not receive the quality of service you would here. If you are charged for the treatment that you receive through the IKA you need to keep the receipt with a number stamped across it.
Prescriptions, Dentists and Doctors
You will need to take your passport and E111 form to the local IKA office, they will issue you with a health service book and direct you to the nearest IKA clinic, doctor or dentist that are part of the IKA scheme, this treatment is free, however if you need secondary examinations you will need to pay part of the costs I.E x-rays. If you need treatment on dentures or treatment like physiotherapy then you will be expected to pay. For medication on prescription hand this to any chemist in the IKA scheme along with your health book., you will have to pay a standard charge plus up to 25% of the cost of the medication which you will not be able to claim back., if they charge you the full amount keep the receipt and get the prescription back. On the medication it self there will be a self adhesive label and you should attach this to the prescription this will allow you to refund.
Treatment in Hospital
If you visit a doctor and they give you a diagnosis you must ask for a ticket, this is for the admittance to hospital on the IKA scheme. If you do not get this ticket before going to the hospital you should show the hospital your E111 and they should contact the IKA. Any treatment taken privately will need to be paid for by your self. If you take all receipts to the health service they should reimburse you up to the limits.
Iceland - To obtain information about medical treatment in Iceland you should visit the State Social Security Institute, Usually patients are charged at a standard rate and you will not be able to claim back. Patients will normally be charged at a standard fee and this is not refundable, however if you do think that the charges as a private patient is wrong you can apply for a refund giving the main office all your receipts.
Prescriptions, Doctors and Dentists
If you need to see a doctor, go to the health centre or a registered doctor within the state scheme, tell them that you are an EEA national resident in the UK. You will be expected to pay a fee of IKR 700 which is not refundable. If you require dental treatment you will be expected to pay the whole amount, this is only free for children under 16. You can get your prescriptions from the local pharmacy and you need to give your E111 form with it, they will charge you a fee depending on which medication that is prescribed.
Treatment in Hospital
Patients will only be admitted to hospital if they are referred by the doctor, however if it is an emergency patients can be admitted immediately to the serving emergency hospital at the time. In-patient hospital treatment is free if you show your E111, otherwise they will charge you.
The republic of Ireland – If you need information in Ireland you can obtain this at the health board near where you are staying.
Prescriptions, Doctors and Dentists
If you need to see the local doctor or dentist , contact the local health board and they will arrange this for you. You must make it clear that you wish to be treated under the European Community’s social security arrangements, your E111 is not required you just need to prove that you are a resident of the UK, by either your driving licence or NHS medical card. Treatments and medicines are free as long as you attend a General Medical Service doctor and they put the prescription on GMS paper.
Treatment in Hospital
If you need to be admitted to hospital a doctor will arrange for you to go to a health service hospital. In the public wards the treatment will normally be free. If you don’t get a chance to visit the doctor first tell the hospital you want to be treated under the EC arrangements before you are admitted. If you need emergency medication when leaving the hospital go to the Health board doctor or you will need to pay for this treatment.
Italy – If you need information in Italy The Local Health Unit will be able to help you.
Prescriptions, Doctors and Dentists
You should hand your E111 to the USL and get a certificate of entitlement, you should ask them to give you a list of all the schemes practitioners. Take the certificate to any one of them, they will charge you a fee. If you need prescribed medication you will be charged a standard fee and you would not be able to claim a refund on this. If the Chemist receipt has the word ticket, the full cost of the medication is payable. If you do not get a USL certificate you will have to pay for all treatment and you may not find it very easy to get the money back for this and if you do it may only be a partial refund. If you pay the whole amount for medication you need to keep all the price tags, as you will not get a refund without them.
Treatment in Hospital
If you need to be hospitalised whilst in Italy you will be given a certificate and this will entitle you to reduced costs in certain hospitals, you should take this to the USL so they can authorize it, they will give you the relevant lists of hospitals. If you are unable to get to the USL first you should show your E111 at the hospital and ask them to contact the local office, they will then advice you of the treatment that you will be entitled to under the scheme.
Liechtenstein – If you need to get information whilst in Liechtenstein you should go to the National Office of Economy.
Treatment for medical
If you need emergency medical treatment from the doctor your passport and E111 is required, you can see any doctor. Depending on how long you receive treatment for a standard fee of CHF 67 or CHF 134.
Dental Treatment
Any dental treatment will not be covered under the insurance scheme, so costs for private treatment will need to be paid for by your self.
Treatment in Hospital
If you need emergency hospital treatment you would not need to get prior approval, As there is only one hospital in Liechtenstein unless it is an emergency you should get approval from the authority. If you need to claim for a refund you should send medical bills and the E111 form to the National Office of the Economy.
Luxembourg – For information in Luxembourg you should go to The Sickness Insurance Fund for Manual Workers.
Prescriptions, Doctors and Dentists
You can consult any doctor, if you show them your E111. You will need to pay for any prescriptions or treatment that you have, you will need to keep all receipts this will enable you to obtain a refund you may not get the full amount. You should do this by getting in touch with the Sickness Fund Office.
Treatment in Hospital
If the doctor thinks you need hospital treatment he will issue you with a certificate, you will need to pass this on to the hospital together with your E111. The treatment that you receive is normally free but they will expect you to pay a daily fee, which you will not get a refund for. In the event of an emergency (being admitted to hospital) show your E111 form to the hospital and ask them to contact the Sickness Fund.
The Netherlands – If you need information whilst in Netherlands, you should contact the ANOZ Verzekeringen or the local health insurance fund office.
Prescriptions, Dentists and Doctors
If you need to see a doctor make sure it is one who practises within the health insurance scheme, try and do this in surgery hours. You should provide a photocopy of the E111 form and the Chemist will want a photocopy as well. If you have treatment with the doctor this is usually free, some prescribed medication is free but quite a few you will need to pay for (the whole cost with no refund) some are partial refunds. If you require to see the dentist it is limited to treatment for children and preventative for adults and the local health office will give you all the information about dental and medical services. They will advise you of all the names and addresses of hospitals, health centres and practitioners that are part of the health scheme.
Treatment in Hospital
Any doctor you visit must obtain ANOZ authorisation for you to receive free hospital treatment, in order for this to be authorised you must have a photocopy of the E111. If you do not get a chance to contact the doctor before you are admitted to hospital, provide the hospital with your E111 and they should then contact the ANOZ, if you needed Ambulance transport you will need to be able to confirm this was necessary by getting a certificate from the doctor.
Norway – If you need to find out any information for medical or claiming back on medical whilst in Norway you would go to the Local Sickness Offices, The National Office for Social Insurance Abroad. For EEA Nationals resident in the UK must have E111, for UK nationals on holiday in Norway this is not required.
Prescriptions, Doctors and Dentists
You must obtain medical treatment from a doctor and any refunds must be arranged through the National Insurance Administration. If you consult a doctor direct you will have to produce your passport or E111 and they may charge you a standard fee, which you would not be able to claim back. If you are in need of dental treatment or prescribed medication by a doctor (on a blue prescription) this is generally a prescription for a chronic illness you will have to pay up to 36% of the costs.
Treatment in Hospital
Normally a doctor will request a patients admission to hospital, if it is an emergency you can get treatment from the nearest public hospital, hospital treatment is free and this includes necessary medication.
Portugal – if you require information in Portugal Mainland Portugal you would go to Regional Health Service, The Azores: Regional Health Service Directorate in Angra do Heroismo, Madeira: Regional Health Directorate in Funchal. If you are a UK national visiting Portugal your E111 is not required, If you are EEA national resident in the UK you will need the E111.
Prescriptions, Doctors and Dentists
At health centres on the mainland, show your passport (if you are not a UK national then it will be the medical care book issued in exchange for the E111) and ask to be treated under the European arrangements. They will charge you a fee, you will not be able to claim back. In Madeira if you consult a private doctor you will be charged if you ask them to give you a receipt this will allow you to claim some money back, any refunds in Madeira must be claimed whilst you are there. Dental treatment is very limited under the state scheme and you will more than likely have to pay and not get a refund for this treatment. Some prescribed medication will require you to pay the full costs, for others it will be between 40-70% of the price. There will be no charge if a prescription is given for certain serious illnesses.
Treatment in Hospital
Basic hospital treatment is free but for secondary examinations such as X-rays and laboratory tests will need to be paid for. You will need to show your passport and or E111 for non UK nationals you need to ask if you can be treated under the EC Arrangements.
Spain – For information whilst in Spain, Balearic Islands or Canary Islands, you should visit either the District Offices of the National Social Security Institute or the Health Service office of the autonomous.
Prescription, Doctors and Dentists
Under the E111 arrangements are only provided by doctors within the Spanish Health Service, some parts of the country may cause you to travel some distance to get to a hospital. If you require a doctor in an emergency you must tell them that you have E111 and tell them you want to be treated under the EC arrangements. If you need treatment at anytime show the doctor the original copy of your E111 and give them a photocopy to keep. Dental treatment is not covered in Spain and you would not be able to claim for this. In Spain Health centres, hospitals and doctors have separate surgery time for private treatment, if they ask you to pay you are not being treated under the Spanish Health Service.
Treatment in Hospital
If you need hospital treatment this is usually arranged by the doctor, urgent treatment will only be provided free if you are in a public ward at the public hospital. For UK or EEA state pensioners the medicines will be free of charge. In Spain the Health Service is very strict charges are extremely rare for private patients this will only be considered in a life or death situation and there was no availability in a public hospital at that time.
Sweden – For information in Sweden you should go to the Local Social Insurance Offices. If you show your E111, they will charge you a fee, which is not refundable. You will not get a refund for private health care either.
Prescriptions, Dentists and Doctors
You should visit a doctor who is under the medical scheme and show them your E111 form, if you do not then you will be charged the full cost of any treatment, even so you will have to pay a portion. Prescribed medication will need to be paid for by your self.
Treatment in Hospital
You can be treated in any public hospital, the emergency unit is called the akutmottagningen. You will have to pay some of the cost of out-patient care, the in-patient treatment is free of charge except for the fixed daily charge which you can not claim back..