In-kind medical contributions in Belgium and Germany

Subject: In-kind medical contributions in Belgium and Germany

From 1 July 2018, a German citizen living in Belgium will receive a pension from Germany and accept an employment position in Belgium. This engagement ends on 1 July 2020, so he will then receive pensions from Belgium and Germany.

Can he receive in-kind medical contributions from 1 July 2020 both in Belgium and in Germany with the ‘S3 certification/form’?

If this is the case, does this then also apply to new treatments?

Does the Commission intend to make appropriate amendments to Regulation (EC) No 883/2004?

Joint answer given by Ms Thyssen on behalf of the Commission

(11 June 2018)

Based on Regulation (EC) No 883/2004 on the coordination of social security systems (1), if a person receives pensions from two Member States, one of them being the State of residence, and this person has the right to medical treatment under the latter's legislation, he/she shall receive such treatment from and at the expense of that Member State.

Therefore, a pensioner, residing in Belgium and receiving pensions from Germany and Belgium, will receive medical treatment in Belgium, at the expense of Belgium.

When going back to Germany for a temporary stay, the pensioner will benefit only from necessary medical treatment (e.g. emergencies) based on the European Health Insurance Card.

The Portable Document S3 is meant for retired frontier workers (2), which does not seem to be the case of the person referred to in the question. By 2020, he/she would have worked and resided in the same Member State (i.e. Belgium) and therefore, could not be considered to be a (retired) frontier worker.

In this context, Article 28 of the regulation covering retired frontier workers cannot apply to the described situation.

The Commission does not intend to make additional amendments to Regulation (EC) No 883/2004 beyond the current revision (3).

Independently of the regulation, a patient may choose to get healthcare abroad under the terms of the directive 2011/24/EU (4). It means that if the pensioner is entitled to a given treatment in Belgium he/she may claim reimbursement for that treatment received in another Member State. For certain treatments the patient may be required to seek prior authorisation before travelling for treatment.

⋅1∙ Article 23

⋅2∙ Article 28 of Regulation (EC) No 883/2004

⋅3∙ COM(2016) 815 final

⋅4∙ Directive 2011/24/EU on the application of patients' rights in cross border healthcare.