News from the Commission > Commission expresses concerns about refusals by Spanish public hospitals to recognise European Health Insurance Card

The European Commission has requested information from Spain about complaints that Spanish hospitals providing public healthcare are refusing to recognise the European Health Insurance Card (EHIC). The Commission is concerned that Spain might be failing to fulfil its obligations under EU law to provide emergency healthcare to temporary visitors from other Member States on the same terms and conditions as are available to Spanish nationals under the public healthcare scheme.

The Commission’s request for information follows an increasing number of complaints it has received concerning hospitals providing public healthcare services, mainly in tourist areas of Spain, which refuse to treat citizens on the basis of their European Health Insurance Card and instead request a travel insurance policy and credit card details.

Public healthcare is generally free of charge in Spain and the European Health Insurance Card entitles its holder to be treated on the same terms as Spanish nationals. However, in some cases, citizens have been erroneously informed that their European Health Insurance Card is not valid if they have travel insurance. Other patients believed they were being treated on the basis of their European Health Insurance Card, but later found out that their travel insurance company had been sent a bill for treatment.

The actions of the hospitals concerned means that European Health Insurance Card holders are being denied access to public healthcare on the same terms as Spanish nationals, and are being offered only private treatment. The much higher cost of such private treatment is being passed on to the travel insurance companies or, increasingly, is being billed to the citizens directly. The travel insurance industry has underlined to the European Commission that in most cases travel insurance will not cover private healthcare.

The European Commission has been in contact with the Spanish authorities about this issue since 2010. The Spanish authorities have indicated to the Commission that they have taken certain actions to tackle the issue. Nonetheless, the Commission continues to receive complaints about this practice by hospitals providing public healthcare services in tourist areas.

The Commission's request for information takes the form of a letter of formal notice, the first step in EU infringement procedures. Spain has now two months to respond to the concerns expressed by the Commission.

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