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N.C.P. on the application of Patients' Rights on Cross Border Healthcare

History on Regulation (EC) No. 883/2004

Regulation (EC) No 883/2004 of the European Parliament and of the Council of 29 April 2004 on the coordination of social security systems [See amending act(s)].


The social security systems of the countries of the European Union (EU) are coordinated. However, social benefits and the conditions under which they are granted are determined at national level, depending on the traditions and culture of each country.

European law lays down rules and principles to guarantee the right of free movement of persons in the EU.

This Regulation applies to all nationals of an EU country who are or who have been covered by the social security legislation of one of those countries, as well as to the members of their family and their survivors.

It also applies to third country nationals living legally in the EU and whose situation connects them to several Member States. The Regulation also applies to members of their families and their survivors.

According to the principle of equal treatment, nationals of an EU country and persons residing in that country without being nationals of it are equal in terms of the rights and obligations provided for by the national legislation.

The provisions of this Regulation apply to all the traditional branches of social security:

  • sickness,
  • maternity,
  • accidents at work,
  • occupational diseases,
  • invalidity benefits,
  • unemployment benefits,
  • family benefits,
  • retirement and pre-retirement benefits,
  • death grants.

    The Regulation also recognizes the principle of the aggregation of periods, pursuant to which periods of insurance, employment or residence in an EU country are taken into account in all the other EU countries. This means that the acquisition of the right to benefits in one State must take account of periods of insurance, employment, self-employment or residence in another EU Member State.

    The insured person is subject to the legislation of a single Member State only. The Member State concerned is the one in which he or she pursues a gainful activity.

    Particular rules are provided for certain categories of workers, such as civil servants who are subject to the legislation of the Member State to which the administration employing them is subject, and workers who are employed or self-employed in several EU countries.

    Frontier workers are affiliated to the body of the country in which they work, while residing in another EU country and having access to health care in both States. Special provisions are provided concerning benefits in kind intended for members of their family.

    Persons staying in an EU country other than their country of residence, in particular during holidays, must be able to receive necessary medical benefits during their stay. It is the legislation of the State in which they are staying which determines the financial conditions for the award of the benefits, but the costs are borne/reimbursed by the social security body of the country of origin. This right is certified by the European Health Insurance Card (EHIC), which every insured person may request from his/her social security body.

    The EHIC is a free card that gives access to medically necessary, state - provided healthcare during a temporarystay in any of the 28 European Union countries, Iceland, Lichtenstein, Norway and Switzerland, under the same conditions and at the same cost as people insured in that country. The EHIC is not alternative to travel insurance. It does not cover any private healthcare or costs such as flight, does not cover your costs if insure person is travelling for the express purpose of obtaining medical treatment and does not quarantee free services.

    Coordination of social security systems got under way in 1971 with the adoption of Council Regulation (EEC) No 1408/71. This Regulation guaranteed equal treatment and social security benefits to all workers who are Member State nationals, regardless of their place of employment or residence.

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