European Healthcare 2025: EHIC/GHIC, S1/S2, CPAM, LAMal… The Expat Pillar Guide

Published November 12, 2025

Healthcare abroad isn’t luck—it’s a process. With the right documents and two habits (detailed invoice + digital folder), you get appointments and refunds without stress. This 2025 pillar compares FR/DE/ES/CH, explains when to use EHIC/GHIC, how to register as a resident, what S1/S2 cover, and how to act in emergencies.

1) The four situations

Visitor / temporary stay → EHIC/GHIC = medically necessary care at local rates.
Resident → register with the local system (CPAM FR, Krankenkasse DE, Seguridad Social ES, LAMal CH).
Detached / cross-border → forms S1 (register in residence country) and E106 (CH→FR).
Planned care → S2 (prior authorization).

Key: status decides coverage, not preference.

2) EHIC/GHIC: what it does and doesn’t

Yes: necessary care during a stay (emergency, GP, public hospital).
No: repatriation, private out-of-contract care, complex dental.
Do: keep digital copies + receipts; submit reimbursement form if you paid upfront.

Reminder: renew before holidays (peak season). See EHIC Renewal Made Simple (2025-11-02)

3) From visitor to resident: country registrations

France (CPAM) — Online file on Ameli: ameli.fr after 3 months of stable residence. Declare a médecin traitant for better reimbursements. Carte Vitale → frequent third-party payment.

Germany (Krankenkasse) — Choose a fund (TK, AOK). Health card, often direct billing.

Spain (Seguridad Social) — Empadronamiento + social security number. Ministry of Health: sanidad.gob.es.

Switzerland (LAMal) — Mandatory insurance within 3 months: bag.admin.ch. Family doctor/HMO models → deductibles and premiums vary.

Scripts FR/EN — calling the practice

FR: "Bonjour, je viens de m’inscrire à [CPAM/Krankenkasse/Seguridad/LAMal]. J’ai besoin d’un premier rendez-vous et d’une facture détaillée. Parlez-vous [langue] ?"

EN: "Hello, I’ve just registered with [system]. I need a first appointment and a detailed invoice. Do you speak [language]?"

Internal links: Finding a doctor/dentist abroad (2025-11-07) and Healthcare for European Expats (2025-10-09)

4) S1, S2, E106: when to request

S1: live in one country, pay in another (cross-border/detached) → register in residence country.
S2: planned care abroad (e.g., surgery) with prior authorization.
E106 (CH): care rights in France for LAMal insured (cross-border).

Tip: scan forms and keep acknowledgments.

5) Emergencies & out-of-hours

112 (EU), 116 117 (on-call, depending on country).
France: 3624 SOS Médecins, Switzerland: 144, Spain: 061/112 by region.

One-minute checklist: saved numbers, allergies/treatments in Notes, insurance/EHIC as PDF.

6) Dental & eyewear: pay less without losing quality

Compare 2–3 quotes; in Germany, get the Heil- und Kostenplan approved.
Spain/Portugal: prosthetics often 20–30% cheaper than FR/CH; verify reviews/quality.
Local top-up vs international: price your city reality (often €20–€40/month locally is enough).

7) Example: Hannah, DE→FR (employee)

Week 1: lease + FR account.
Week 2: CPAM online, EHIC scanned.
Week 3: Doctolib → GP declaration.
Two months later: Carte Vitale received.
Minor accident: call 112 + keep detailed invoice → Ameli reimbursement within 7 days.

8) Recommended cross-links

Frequently Asked Questions

Is EHIC enough for full-year living?

No. EHIC covers necessary care during temporary stays. Residents must register with the local system.

Can I have planned surgery in another country?

Sometimes—via S2 prior authorisation. Check timelines and eligible hospitals.

Stay updated

For more practical insights on this topic, explore our related articles:

Conclusion: Expat healthcare is simple when you follow status → registration → invoices → storage. With these habits, you move between systems without losing time or money.

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About the author:

Jules Guerini is a European expat guide sharing practical, tested advice for navigating life abroad. Contact: info@expatadminhub.com

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European Healthcare 2025: EHIC/GHIC, S1/S2, CPAM, LAMal… The Expat Pillar Guide

Published November 12, 2025

1) The four situations

Visitor / temporary stay → EHIC/GHIC = medically necessary care at local rates.
Resident → register with the local system (CPAM FR, Krankenkasse DE, Seguridad Social ES, LAMal CH).
Detached / cross-border → forms S1 (register in residence country) and E106 (CH→FR).
Planned care → S2 (prior authorization).

Key: status decides coverage, not preference.

2) EHIC/GHIC: what it does and doesn’t

Yes: necessary care during a stay (emergency, GP, public hospital).
No: repatriation, private out-of-contract care, complex dental.
Do: keep digital copies + receipts; submit reimbursement form if you paid upfront.

Reminder: renew before holidays (peak season). See EHIC Renewal Made Simple (2025-11-02)

3) From visitor to resident: country registrations

France (CPAM) — Online file on Ameli: ameli.fr after 3 months of stable residence. Declare a médecin traitant for better reimbursements. Carte Vitale → frequent third-party payment.

Germany (Krankenkasse) — Choose a fund (TK, AOK). Health card, often direct billing.

Spain (Seguridad Social) — Empadronamiento + social security number. Ministry of Health: sanidad.gob.es.

Switzerland (LAMal) — Mandatory insurance within 3 months: bag.admin.ch. Family doctor/HMO models → deductibles and premiums vary.

Scripts FR/EN — calling the practice

FR: "Bonjour, je viens de m’inscrire à [CPAM/Krankenkasse/Seguridad/LAMal]. J’ai besoin d’un premier rendez-vous et d’une facture détaillée. Parlez-vous [langue] ?"

EN: "Hello, I’ve just registered with [system]. I need a first appointment and a detailed invoice. Do you speak [language]?"

Internal links: Finding a doctor/dentist abroad (2025-11-07) and Healthcare for European Expats (2025-10-09)

4) S1, S2, E106: when to request

S1: live in one country, pay in another (cross-border/detached) → register in residence country.
S2: planned care abroad (e.g., surgery) with prior authorization.
E106 (CH): care rights in France for LAMal insured (cross-border).

Tip: scan forms and keep acknowledgments.

5) Emergencies & out-of-hours

112 (EU), 116 117 (on-call, depending on country).
France: 3624 SOS Médecins, Switzerland: 144, Spain: 061/112 by region.

One-minute checklist: saved numbers, allergies/treatments in Notes, insurance/EHIC as PDF.

6) Dental & eyewear: pay less without losing quality

Compare 2–3 quotes; in Germany, get the Heil- und Kostenplan approved.
Spain/Portugal: prosthetics often 20–30% cheaper than FR/CH; verify reviews/quality.
Local top-up vs international: price your city reality (often €20–€40/month locally is enough).

7) Example: Hannah, DE→FR (employee)

Week 1: lease + FR account.
Week 2: CPAM online, EHIC scanned.
Week 3: Doctolib → GP declaration.
Two months later: Carte Vitale received.
Minor accident: call 112 + keep detailed invoice → Ameli reimbursement within 7 days.

8) Recommended cross-links