Any way of reclaiming insurance excess via EHIC?

A snowHead

My insurers have met the costs of medical treatment abroad following my recent injury, but left me with a £95 excess to pay to the clinic (at the time) myself. I had to go to a private clinic as there was not, or I could not find, any clinic available which took EHIC cards.
As part of the insurance claim which I'm now filling in, the UK insurers have asked me to complete a "DSS" EHIC reclaim form so that, presumably, they can reclaim the costs of medical treatment from the Austrians via the EHIC system (or however it works).
But what about my £95? Any way that I can also get that back using my own DSS reclaim form? Or is it just a lost cost or the experience?
Thanks.

A snowHead

@Grizzler, I think you can only claim back anything that a citizen of the country you received your treatment in could claim back. If the £95 can be reclaimed it will be. Hubby had to fill in a similar form after his treatment in France, but didn't pay anything upfront. It was all billed later and forwarded to our insurers who deducted our £75 excess, but didn't ask for anything else.

Well, the person's real but it's just a made up name, see?

@Grizzler,?? You agreed the excess when you entered into the insurance contact. Don't quite see why you're looking to get it back.

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If you were treated at a private clinic I don't think your insurer can claim the cost of your treatment back via EHIC. A private clinic is a private clinic, surely?

Anyway, snowHeads is much more fun if you do.

@rob@rar, if it was France, many private clinics are also part of the state system, but not sure about elsewhere. However you're treated though, it should be covered by your travel insurance, so I expect the £95 is the insurers excess.

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@Hurtle, I didn't really think about it, knew that from an insurance perspective I'd have to pay it, until the claim form pack required me to fill in a DSS form seemingly designed to enable the insurance company to claim back some or all of their costs met in paying my medical costs up front. That asks for EHIC details.
I then thought, hang on, I've paid some of those costs personally too, so can I also claim anything back via the DSS too? That's all. If I don't have to be £95 out of pocket, I'd prefer not to be. (To clarify, the insurers paid all the bill direct, there & then, except for the insurer's excess, which I paid direct to the clinic on card against nonspecific invoice.)
I found a phone number on the net when Googling this, after I'd made this post, so I'll check tomorrow if I can reclaim anything.

After all it is free

@Grizzler, good luck with that. Please let us know the outcome. An insurance company is of course entitled to expect you to minimise the costs of your treatment where reasonable to do so - such as using your EHIC. In the case of my insurance, my insurer Saga said this in my policy document (not the certificate of insurance):

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@rob@rar, from my experience, that looks correct.

snowHeads are a friendly bunch.

Well, I phoned the DSS overseas healthcare people this morning and they basically said that if it was not a "state" facility (which I assume it was not) then there is no EHIC involvement and it's just down to the insurance company and me, and so I've got to bear the excess.
I agree with @rob@rar as above on this, then.

Another lesson for all abroad: clutching EHIC card is no good if there is not a state EHIC-accepting clinic or doctor in the resort or nearby (depending on how severe your injury or illness). I have been to several resorts where the TO Reps have said that the doctor or clinic "does not accept EHICs" and thought this rather strange, but now presume that private clinics and doctors are rather the norm in many places, unless you go or are taken to a state-run hospital. I am quite surprised that there are not, seeminly, state facilities in all (or many?) resorts (I am experienced of late only in Austria and Finland, to be fair). The lady on the UK overseas healthcare line as above stated that there must be state facilities everywhere (but couldn't tell me where or how to find them); certainly I had thought that there would be something in Mayrhofen (where I was), but it turns out that the nearest hospital was 35 miles (or km?) away at somewhere I'd never heard of and didn't know how to get to. Although the TO said that there was an EHIC clinic in the town, I couldn't find it and the taxi drivers & bus drivers didn't seem to recognise it at all (or maybe it was shut at the time? Got a bit lost in my not speaking the lingo well enough.)
So make sure that you have insurance and a way to meet the costs (and at least excess) on you.

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@Grizzler, I think the majority of minor injury clinics in resorts are private, not all but the majority. If you are taken to a "full service" hospital in the major alpine countries it is likely to be a state facility, although even in those there may well be a small fee to pay which is not covered by EHIC especially if it involves an overnight stay and being fed. The reason why I "triple-up" on my insurance (see your other thread) is that often you have no choice about whether you are taken to a private or state-funded medical facility, and even if you do is that something you want to be concerned about if you are seriously enough injured to require evacuation and medical treatment?

You know it makes sense.

As an analogue is there an orthopaedic facility in every British town or village? I suspect not. Private clinics have grown up in response to demand and I suspect a large part of that demand is tourists or seasonal workers. The farmers in the valley probably didn't have much problem travelling to the relevant major town for medical treatment before tourism came along. Without transport of your own it is a lot more convenient to get treatment where you are staying and well worth the price of any excess for any major accident (caveat I think it is probably foolish for an adult going to a private medical centre with minor colds, flu and stomach bugs unless they are likely to prevent return travel)

Otherwise you'll just go on seeing the one name:

@Dave of the Marmottes, Yes, I agree, and when I think about it in that sense it isn't surprising. In the UK I live 20 miles + from the nearest A&E, 13 from the nearest Minor Injuries Unit and 5-10 from my GP's clinics, with no public transport available to any and no taxis in the area. I cope fine (so far... though currently not being able to drive might question that a tad). It's just the unfamiliarity when faced with something sudden in a country where you don't speak the language and don't know the ways and procedures, systems etc. There is this great perception that EHIC is the answer, and that it will cover you (I don't say without full, even 3-way, insurance back-up) and apply throughout the EU full stop. There is little publicity that it isn't the sole answer and that there are many private doctors and clinics: and many people are surprised by that, I am finding. Insurance companies also state that you should (or "reasonably" must try to find, I hope) use an EIHC-taking care provider. This can put some extra stress upon you in trying to find one when needing prompt illness or post-injury care.

@rob@rar, Yes. Where, for future reference, is that? How does one get there and back? Had I had an ambulance take me off the piste, rather than hobbling off myself, would I have been taken there?

A snowHead

When my wife was injured in Mayrhofen by a walking accident fall, The TO rep did not know of any local doctor that accepted the EHIC but We went to the nearest across the road from the TO's office and had no difficulty getting treatment immediately under the EHIC scheme. Try getting that service in England would have had to wait days for an appointment.

A snowHead

Well, the person's real but it's just a made up name, see?

@Grizzler, i am amazed to hear you say ". There is this great perception that EHIC is the answer, and that it will cover you (I don't say without full, even 3-way, insurance back-up) and apply throughout the EU full stop. There is little publicity that it isn't the sole answer and that there are many private doctors and clinics: and many people are surprised by that"

This forum is full of warnings and info on private doctors and clinics. I would also be amazed if folk generally thought there would be state facilities in their littke ski village. EHIC has its uses but good travel insurance is essential...i know you acknowledge that

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My local emergency injury clinic in France is also my local GP practice. They are not "private" in any shape or form. They are "sector 1" which means they do not add on any fees over and above the state prices. I pay the same when I go to the doctor now that I am a tax resident with a Carte Vitale as I did when I was still a UK tax resident with an EHIC and I get the same (hefty) % reimbursed - the difference is of course I get reimbursed directly now without having to do anything, whereas before I had to fill out paperwork and make a claim (or, if I were on holiday in France, have my travel insurance company do it). An X-ray is about 50 euros. A standard appointment is 23 euros (think actual cost to the patient - after reimbursement - is 9 euros or something for the appointment). I recently had to go there at 11pm on a Sunday night and it was ~65 euros.

There are not just warnings on here about medical expenses - EHIC will not cover all sorts of important stuff that insurance does.

Anyway, snowHeads is much more fun if you do.

@Hand Wringer, that is the case in my village in Serre Chevalier too, and as far as I know in all the other villages in the valley. Yes, you have to pay their fee and reclaim it later, but that doesn't mean it is private, it is affiliated to the healthcare system, as are many private clinics in France too. It won't just take your EHIC card and waive the fees though.

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@Hells Bells, yes I think there are "sector 2" clinics who add fees "within reason" to the state set fees and "sector 3" who I think can add whatever they like. None of them will just take EHIC upfront as you are treated like a local who also has to pay and then be reimbursed on the basis of state set fees. As noted by you and others, state hospital treatment is different and EHIC means not paying upfront.

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@PORTMAN, my problems too were in Mayrhofen and my TO didn't seem able to send me anywhere that took EHICs, though there supposedly was one (that's an argument which I'll take up with them).
@rob@rar, thanks, & take your points.
@holidayloverxx, A lot of skiers/boarders and general summer holidaymakers do not read this great font of wisdom. Are you really amazed that Joe General Public doesn't understand how EHIC and how health systems work overseas? I'm only just learning as a result of this, my first need to be involved in it: and I'm still mightily confused over some aspects. Many people still travel with EHIC and no insurance at all and think that it'll cover all eventualities - and meeting a private clinic or one where they have to pay upfront is certainly not what they're used to or expect. I've met many people whilst on ski trips who've proudly told me that they have an EHIC so why would they possibly need insurance because they will not have to pay anything (even those with preexisting medical conditions). They're also used to state GPs and clinics in the UK if they're travelling or holidaying there; why expect there not to be one in a tourist resort overseas? People get taken to and from their resort by TOs (winter & summer) and, if they're lucky, and if they've never had friend/relative who's had problems, they never have to think about these kind of things (I generalise, of course). People who travel more independently, more frequently or who live abroad probably have a greater grasp of things.

After all it is free

@Grizzler, i only used this forum as an example of where information is available.

Yes i am genuinely amazed that Joe Public doesnt know how EHIC works....If they are savvy enough to have one. I have only potentially needed to use it once ever since it and it's predecessor was introduced donkey's years ago; i have always known the limitations.

Call me sensible for ensuring i understand my travel documents. But equally if I didnt have my EHIC with me it wouldnt bother me as insurance would deal with the immediate issue and you can deal with EHIC on return. You can even get an expired card retrospectively issued to enable your insurance company to recover the correct costs.

@holidayloverxx, you can also phone the emergency line and get EHIC numbers issued same day.

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@Bennyboy1, @Bennyboy1, guy in the next bed to my husband in Grenoble was doing just that.

snowHeads are a friendly bunch.

And it can be so useful to get the EHIC sorted from an early age. Four years ago our five month old granddaughter was in Thonon hospital overnight on a drip. Our daughter had an EHIC for Maggie and that settled the 80% of the bill, around 1000 euros, she paid the balance, around 200 euros, which was then repaid by MPI. I dare say that if the hospitalisation had looked likely to go on for a few days they would have got on the phone to MPI to get the bill settled direct.
Some of us go belt and braces, read the small print, understand the cover they have bought, or are prepared to take the risk themselves. But there are lots who must just cross their fingers and hope for the best, or are blissfully unaware.

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@achilles, you are exactly right. No one should really be able to say that they weren't told. Do have to take the time to read though!

You know it makes sense.

I wonder how much travel insurance premiums will increase by after Brexit (assuming that we will no longer be eligible for an EHIC card).

Otherwise you'll just go on seeing the one name:

A snowHead

I am surprised that Joe Public expects state healthcare to be free in other countries just because it is in the UK - it's not like migrant "health tourists" coming to the UK to take advantage of the free NHS is an undiscussed topic in the British media, and the EHIC site does spell things out country by country.

A snowHead

@Hand Wringer, i didnt know the EHIC site spells it out. I just knew from here.

Well, the person's real but it's just a made up name, see?

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@achilles, but if it isn't, for example, the treatment my hubby received in France would have cost the insurers tens of thousands of pounds, instead of a few hundred. That is very very likely to increase premiums to a considerable extent.

Anyway, snowHeads is much more fun if you do.

As far as I am aware there are no 'state facilities" in the Tarentaisse resorts now. Certainly in La Plagne the med centres are all private. However, if you have your car it is quite simple to drive to Bourg St Maurice or Albertville A+E's where they will treat you quickly and efficiently once they have seen your EHIC. There are charges for drugs and X rays which EHIC doesn't cover as French folk are charged as well.
Technically, if injured and you can get to a public road you can call for a 'state' ambulance and your EHIC would cover the cost, haven't come across any Brits that have tried this.

As for Brexit and Ehics, the EHIC is under a different agreement to the EU so may not change (in the same way the UK Border in Calais is under a separate agreement).

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@boredsurfin, do they issue a 'feuille de soins' when you receive treatment?

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@Hells Bells, qu'est que c'est?

After all it is free

@holidayloverxx, it's a treatment form which you are given at the end of a consultation when you visit a medical centre in France. I'm trying to establish if these 'private' centres are in fact 'conventionée' and affiliated to the French health care system, as genuine private facilities are very rare in France.

When I went down to the hospital in Thonon before Christmas to have my head scanned after a fall, and very smashed helmet, when I arrived at Urgences (A&E) and checking in as soon as it was obvious I wasn't French I was directed to an adjacent desk where they took a copy of my passport and gave me a piece of paper stating that I would have to settle the bill and that they were only interested in looking at the EHIC for staying in cases, not day cases. When I was given the all clear later in the day I went back to the same office and paid 80 euros. Six days later when we were back in the UK a huge envelope arrived with a DVD of the scan results and loads of photos.

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@Hells Bells, ah ok. I got the equivalent in the totally private clinic in Austria

Help!!

Any way of reclaiming insurance excess via EHIC?

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